Over the next few weeks I’m going to write a series of blog posts about changing habits and behaviours to improve overall health and fitness. Nowadays it feels like most of us know what to eat and what to do to be healthy but it’s actually doing this, finding the motivation and resisting temptation that’s the hard part!
During my placement last semester I spent time working in a specialist weight management clinic. In this clinic patients attended a Dietitian, Physiotherapist, Psychologist and a Doctor once a month for 12 months. The basis of their treatment was not to just give patients a diet plan and tell them to stick to it – because we know that that doesn’t work for everyone. The treatment focused on changing patients behaviours and habits. It was personalized and centred around the patient and their lifestyle which is why it worked so well.
I really like this approach to weight loss and although it’s a style that probably works better one on one during a consultation, I thought I’d share the rationale behind the method as it might really resonate with some people! So the first in my series of blog posts will be about changing behaviour, the theory behind it and why it is so important for weight management.
A behaviour is something that you do and are used to doing, it’s similar to habit. You’re probably so used to doing it and may find it hard to change or stop. Eating the wrong foods, wrong types of foods, too much food or doing too little exercise are all types of behaviour. These “bad” behaviours over time may lead to weight gain e.g. having a scone mid-morning everyday. More than likely this might just be a habit that you have gotten into over time. The extra calories from this scone add up over the weeks, months, years and lead to weight gain. Changing your behaviour and swapping your scone for a piece of fruit cuts down the amount of calories you are eating and will help lead to weight loss.
The behaviour that you change does not have to be huge or life-altering, in fact picking a smaller behaviour that you do everyday, such a the scone, will have a huge benefit over time. I’d suggest picking 2-3 behaviours to work on for 4 weeks and see how you get on. Some examples could include:
- Switching from coke to diet coke.
- Decrease dinner portion size by using smaller dinner plates.
- Cut down takeaways from every night times to twice a week.
- Get off the bus two stops early to get more exercise.
- Cut down from a glass of wine with dinner every night of the week to three nights a week.
None of these may even apply to you so pick something that you know does and that you feel you could change.
You might find that some things are easy to change while others are more difficult. You should remember though that change takes times, especially if it is a long standing behaviour. Behaviour change can be looked at as a continuous circle. This theory was originally devised by Prochaska and Di Clemente. They suggested that there are a number of stages of change which a person goes through before reaching a maintenance stage. It also takes relapses into account. Knowing which stage of the cycle you’re at is useful.
Stage 1: Precontemplation – You’re probably not currently thinking about changing anything. Maybe you don’t feel ready to make a change or don’t feel a need to change. That’s ok, there’s no point trying to change until you want to and feel ready.
Stage 2: Contemplation – You might be thinking about changing but don’t feel ready to take action just yet. A useful exercise at this stage is to make a list of all the Pros and Cons associated with changing your behaviour and lifestyle. Also make a list of all the Pros and Cons associated with not changing. Weigh them up against each other.
Stage 3: Preparation – You are thinking about changing within the next month or so. You may have tried to change before. Start by setting 2-3 manageable goals. Try and identify any obstacles or things that might get in the way of you making a change. When you identify these, then try and come up with solutions or alternative plans. You should also try and pick out some family members, friends or other groups (e.g. weight loss groups) who can help and support you along the way and keep you on track.
Step 4: Action – By now you will have made some changes and have been keeping it up for the last few months (about 3-6 months). Continue to identify obstacles and barriers and make plans for how to overcome them work out how to overcome them. Continue to use your support system and focus on the long term benefits of change (maybe look at the Pros and Cons of change/not changing again).
Step 5: Maintenance – This is about 6 months or more after you’ve made your change. You should be looking to keep up the changes you’ve made. By now you will have started to form new, healthier habits. Now is also an ideal time to plan how you would cope or recover from a relapse.
Step 6: Relapse – As the name suggests this is the stage at which you may end up falling off the wagon and reverting to your old behaviour. But don’t panic – relapse is a normal part of the change cycle and you may relapse a number of times before fully changing. The idea here is to recognise that it’s ok and that you can enter the cycle again. Some questions to ask yourself at this stage are:
- What triggered this relapse?
- Am I still motivated to change?
- What are the barriers preventing me from changing?
- What new strategies can I learn to help me cope?
The circle of change is also like an upward spiral, each time you enter the circle you move up a level and learn from previous experiences. Use this to your advantage and try to put in place coping mechanisms to help you overcome these issues in the future. For example, if you had tried to cut down on takeaways yet find you are too busy in the evening to cook, you may end up falling back into old habits and getting takeaways. However, if you recognise this issues you can take steps to counteract it – e.g. prepare extra portions of meals on days you are cooking and freeze them for days you aren’t cooking. You could also replace takeaways with healthier microwave meals – while these aren’t the ideal choice they are still healthier and lower in calories than most takeaways so can be a good option for people looking to lose weight.
This may sound a bit wordy and confusing but I wanted to give a general overview of where I am coming from! Over the next few weeks I’m going to break this down in smaller steps and give more practical advice and tips so if you have any specific questions just let me know!
I hope you found this blogpost useful and a good introduction to the idea of behaviour change. Like I mentioned, I hope to write a series of blogposts on this topic but if there is anything in particular you want me to focus on then I’d love to know! I want to write what stuff that is interesting and useful for you guys and maybe you might like to see something totally different so don’t hesitate to give me some suggestions and ideas!