u.s. public health service “fit for duty, fit for life” weight management program: session 5
TRANSCRIPT
U.S. Public Health ServiceU.S. Public Health Service““Fit for Duty, Fit for Life”Fit for Duty, Fit for Life”
Weight Management Program: Weight Management Program: Session 5 Session 5
Slide 2.wav
Review of last sessionReview of last session
Importance of carefully
monitoring portion sizes.
Reading food labels with attention to portion size.
• Hints for eating out.
Review of assignmentsReview of assignments
1. Continue keeping food and activity records. Focus on recording portions. Measure foods and drinks whenever possible. Were your portion sizes reasonable?
2. Practice reading food labels and determining calories in your usual portion.
Any surprises?
3. Practice making special requests when eating out.
What special requests did you make?
Topics for todayTopics for today
Behavioral change– What is it?– What techniques may work for you?
Keeping on track– To continue losing weight– To keep from re-gaining weight lost
These sessions are not meant to substitute for individual recommendations from your personal health care provider(s).
The ABCs of Behavioral ChangeThe ABCs of Behavioral Change
Definition: Principles and techniques used to modify eating and activity behaviors
A- Antecedents - occur before a behavior
B- Behaviors – occur during eating (or exercising)
C- Consequences – occur after the behavior
AntecedentsAntecedents
Occur before a behavior– Situations, places– Events, activities– Feelings, emotions – Thoughts
… home alone… favorite TV show on
… depressed, lonely
… “I deserve a treat”
BehaviorBehavior
The conduct itself and Any related events, situations,
thoughts, and feelings occurring during the behavior
Behaviors: ExamplesBehaviors: ExamplesEating Behavior: Eating brownies Related: Taste of food, speed of eating, rate of
chewing, level of enjoyment
Physical activity Behavior: Taking a walk Related: Intensity, duration, pain or exhilaration
Inactivity Behavior: Watching television Related: Duration, feelings
ConsequencesConsequences
Occur after a behavior
– Thoughts– Feelings – Events
– Situations
…guilty
…failure
…eat more brownies (behavior)
…keep watching TV instead of taking a walk (behavior)
The behavioral The behavioral chain of eventschain of events
Antecedents →
Behaviors →
Consequences →
Behaviors
Using behavioral change Using behavioral change techniquestechniques
To gain control of antecedents Control your environment (situation and events).
– Be aware of your “triggers” or “cues.”– Avoid situations that tempt you to overeat.– Keep tempting foods out of the house.– Keep your exercise clothing handy; plan for rainy
days. Control your thoughts and feelings.
– Think positive.– Believe in yourself.
Using behavioral change Using behavioral change techniquestechniques
To gain control of behaviors Track your behaviors.
– Keep diet and activity records.– Pay attention to who, what, where, when,
and why. Set effective goals that are:
– Specific and measurable– Realistic– Forgiving (less than perfect)
Using behavioral change Using behavioral change techniquestechniques
Behaviors (continued) Eat mindfully
– Eat slowly and savor each mouthful.– Be aware of all senses: taste, smell, texture…– Avoid other activities while eating (TV, etc)
Exercise purposefully– Be aware and enjoy your surroundings.– Focus on benefits and pleasures.
Using behavioral change Using behavioral change techniquestechniques
Thinking through the consequences Reward and praise yourself.
“I made a good choice, and I feel good about it!”
Learn from your experiences.
“I made a poor choice; how can I do better next time?”
Classic elements of behavioral Classic elements of behavioral changechange
Self-monitoringKeeping food and activity records
Stimulus controlControlling triggers and cues
Problem-solvingHow can I handle this situation better?
Cognitive restructuringChanging your thinking
Applying classic elements of Applying classic elements of behavioral changebehavioral change
Problem: over-snacking in the evening
Self-monitoring Keep a log of food intake and activities in the
evenings. Look for patterns.
Stimulus control When watching TV and drinking beer, you crave
salty snacks.
Applying classic elements of Applying classic elements of behavioral change: over-snackingbehavioral change: over-snacking
Problem-solving What are my options? Don’t watch TV, don’t drink beer, limit pretzels
to a 1-ounce portion, don’t buy pretzels, buy fruit instead
Cognitive restructuring What am I willing to change? What can I live without? Can I find another evening activity? Can I drink a beverage that I don't associate
with salty foods?
Applying behavioral Applying behavioral change techniqueschange techniques
Think of a recent situation when you ate too much….
Pastries and donuts at work A retirement celebration A cocktail party All-you-can-eat buffet
Applying behavioral Applying behavioral change techniqueschange techniques
Can you identify antecedents, the behavior itself, and the consequences?
How could you have broken a link in the behavioral chain to prevent overeating?
What did you learn from this episode that can help you handle a situation like this in the future?
Let’s look at your progressLet’s look at your progress
1. Are you pleased with your progress so far?
2. Are you successfully losing weight? Are you satisfied with your rate of weight loss?
3. Are you making lifestyle changes that will help you keep off the weight you are losing?
If “no” to any of these 3 questions -- Why not?
To stay on track…To stay on track…
Keep the right foods available. Keep the problem foods out-of-sight. Avoid places and situations that may be
problematic. Be actively involved with shopping, planning,
and cooking meals. Watch portions. Measure foods. Don’t use food as a reward, or withhold it as
punishment.
To stay on track…To stay on track… Continue to keep food and activity records,
focusing on behaviors you are working on Think positive: “I can do this!” (self-efficacy) Plan ahead.
– How will you handle an upcoming holiday or vacation?
Plan to occasionally treat yourself to a moderate portion of favorite food.
Keep physical activity a priority.
Be aware of your Be aware of your “screen time” “screen time”
Screen time = inactive timeTelevisionVideos/DVDsComputerComputer gamesHandheld electronic devices
How many hours each day are you spending doing these activities?
How can you reduce this “inactive” time?
Reality checkReality check
At this time, what is your primary focus?
Losing weight ?
or
Maintaining your current weight ?
Focusing on keeping it off?Focusing on keeping it off?“National Weight Control Registry”Tracks individuals who have lost ≥ 30 pounds and kept it
off for at least 1 year http://www.nwcr.ws/
These successful weight-maintainers report… Eating a low fat diet Watching calories Eating breakfast Weighing often, maybe even daily Exercising 60 to 90 minutes daily
When you get off trackWhen you get off track
Don’t let lapses lead to relapse… or collapse!
Expect “slips”…but get back on course. Don’t set unrealistic expectations for yourself. Never use the terms “cheating” or “failure” Expect to not be perfect. Learn from your experiences.
Summary of today’s sessionSummary of today’s session
Behavioral change– The ABCs (Antecedents, Behavior, Consequences)– Using techniques to stay in control
Keeping on track– To continue losing weight– To keep from re-gaining weight
Assignments for the coming Assignments for the coming weekweek
1. Continue to keep food and activity records --
- Add a column for thoughts and feelings. - Monitor your screen time.
2. Look at antecedents and consequences related to your eating and activity behaviors.
3. Set 1 or 2 behavioral goals to address these issues.