A few months ago, a family member of mine made the commitment to start losing weight and improve his health. From what I gathered in our conversations, he wasn't satisfied with his appearance, and the extra weight made him feel unproductive and sluggish. As a result, he decided to limit his caloric intake by taking on the
ketogenic diet, which is a diet associated with low carbohydrate intake. By lowering the total number of calories, he felt he could begin to lose the weight, and start to look thinner and healthier.
After a few weeks, I noticed a significant improvement in his appearance – he stayed true to his word by choosing foods that were nutritionally adequate, and had avoided excessive consumption.
I was impressed, I felt he'd finally beat the odds and overcame his genetic predisposition of being overweight and obese. A month or two later, however, I noticed the tides starting to turn. Family members who were originally supportive of his dieting started to feel discontent that they constantly had to modify their meal plans and family outings because of him. At times, they began pressuring him to eat more, and were concerned for his well-being, given he was a full-time student and worked part-time. His strenuous schedule sometimes made him miss meals, leading to binge eating – to him, a learned behavioral response to the stress. Unfortunately, he gave into the pressure and stopped following his careful dieting plans that was working so well.
Since then, he has regained all the weight he had lost, and doesn't have a plan set for the future. What ultimately contributed to his relapse was not giving himself enough time to modify his attitude towards eating. Eating is a learned behavior, and while the effort was there at the beginning, the stimulus to keep it going was lacking. In addition, another key variable that was missing in his regimen was exercise. Even though his food choices improved, exercise is still required to maintain any weight loss that is achieved. It also strengthens your mindset to push you into action, reminding you of the end goal. Finally, he lacked a consistent support group, because while his family initially cheered him on, they weren't prepared for all the sudden changes they too had to endure during that period.
To be successful at any weight-loss program, the following behavioral changes need to be made:
Eliminate inappropriate eating cues:- Buy foods that are low in fat.
- Shop when you are not hungry.
- Serve low-fat meals.
- Let other family members buy, store, and serve their own sweets (monitor children’s intakes).
- Change channels or look away when food commercials appear on television.
- Shop only from a list and stay away from convenience stores.
- Carry appropriate snacks from home and avoid vending machines.
Suppress the cues you cannot eliminate:- Eat only in one place (at a table), and in one room; use plates, bowls, and eating utensils.
- Clear plates directly into the garbage.
- Create obstacles to the eating of problem foods (make it necessary to unwrap, cook, and serve each one separately).
- Minimize contact with excessive food (serve individual plates, don’t put serving dishes on the table, and leave or clean the table when you have finished eating).
- Make small portions of food look large by spreading food out and serving on small plates.
- Control deprivation (eat regular meals, don’t skip meals, avoid getting tired, avoid boredom by keeping cues to fun activities in sight).
Strengthen the cues to appropriate eating and exercise:- Encourage others to eat appropriate foods with you.
- Keep your favorite appropriate foods in the front of the refrigerator.
- Learn appropriate portion sizes and prepare one portion at a time.
- Establish specific times for meals and snacks.
- Prepare foods attractively.
- Keep your walking shoes (ski poles, tennis racket) by the door.
Engage in desired eating or exercise behaviors:- Eat only at planned times; plan not to eat after a specified time (say, 7:00 or 8:00 p.m.).
- Slow down (pause several times during a meal, put down utensils between mouthfuls, chew thoroughly before swallowing, swallow before reloading the fork, always use utensils).
- Leave some food on the plate.
- Engage in no other activities while eating (such as reading or watching television).
- Move more (shake a leg, pace, fidget, flex your muscles).
- Join in and exercise with a group of active people.
Arrange or emphasize negative consequences of inappropriate eating:- Eat your meals with other people.
- Ask that others respond neutrally when you deviate from your plan (make no comment). This is a negative consequence because it withholds attention.
- If you slip, don’t punish yourself.
Arrange or emphasize positive consequences of appropriate behaviors:- Update records of food intake, exercise, and weight change regularly.
- Arrange for rewards for each unit of behavior change or weight loss.
- Ask family and friends for reinforcement (praise and encouragement).
