Ask any of the 45 million Americans who diet each year and they will tell you it’s a struggle to lose weight. For people with obesity, the process can be outright daunting because while a weight loss of several pounds in a week is positive, there likely is no immediate change to appearance. Looking good on paper is hardly the same as looking good to yourself or others.
The weight loss struggle is exacerbated by what Dr. Patrick M. O’Neil calls our “toxic environment.” We are bombarded by ads for foods made to look enticing and even, inexplicably, as good options. At the same time that we’re tempted by the convenience and ease of take-out, life and job pressures make it difficult to find the time to exercise like we want or need to. More calories are being taken in and far fewer are being expended — a potentially deadly combination.
To achieve and maintain weight loss requires behavioral change on a large scale. This is particularly critical for people with obesity because an intervention is only as successful as its ability to address weight loss for that specific population and this happens when it’s focused on a targeted behavioral outcome. But again, obstacles abound. Making smart, healthy choices help achieve long-term goals but getting there is slow. Who wants broiled chicken and water when your dinner partner is getting steak and a glass (or two) of wine? Bad choices are fast, easy and immediately rewarding, while healthy choices can be boring and unsatisfying, successful outcomes notwithstanding.
Dr. O’Neil recommends the “ABCDs” approach to lifestyle: Activity increase; Behavior, Cognitive, and Dietary change; and Social Support. Most people understand the need for physical activity and dietary change, but knowing and doing can be worlds apart. Behavioral changes means breaking a long-time and likely enjoyable habit, like a daily croissant and Frappuccino, and replacing it with a less desirable, more time-consuming effort, like menu-planning, grocery shopping and meal preparation. No wonder so many people give up on their weight loss goals!
There are many ways to help patients determine how ready they are to initiate a change. In fact, there was a recent complimentary webinar we recommend presented by Patrick M. O’Neil, Ph.D., titled Behavioral Aspects of Obesity Management, which you can view by clicking here.
Motivational interviewing, for example, is an important component of a weight loss program because it engages patients in a discussion of their goals and concerns so that you can help them focus on specific patterns that they can work on changing and develop a plan with measurable, achievable milestones.
Patient self-monitoring, including tracking consumption, exercise and weight, is also an important, effective behavioral change technique. Recommendations for restructuring their environment to support their change efforts and providing feedback on progress are other contributors to successful interventions. How the intervention is delivered also can impact effective outcomes. For example, technology provides many options for support for those who may not be comfortable in group settings.
Behavioral change is important because it has a domino effect in other areas. Although weight loss is a positive outcome of behavioral intention, weight maintenance remains a challenge for many who attempt to lose weight. Research on self-regulation mediators found that autonomous motivation, self-efficacy, self-regulation skills, flexible eating restraint and positive body image were mediators of medium- and long-term weight control; the first three also were effective mediators for physical activity.
As such, self-regulation often benefits other areas of an individual’s life beyond weight loss. That is, they likely will benefit from improvement to their health or avoidance of potential health issues, such as diabetes or cardiovascular disease. Further, and importantly, individuals who self-regulate their behaviors are more likely to sustain them, resulting in a longer-term impact.