Behavior Modification and Physical Activity
(Weight maintenance, Overweight, Obesity and Severe Obesity)
Behavior plays a significant role in weight management. Modifying behaviors that contributed to developing obesity is one way to treat the disease of obesity either alone or in conjunction with other treatments. A few behavior change strategies include:
- Increasing physical activity
- Becoming educated about the body and how to nourish it appropriately
- Engaging in a support group
- Setting realistic goals
Though scientists have now proven that losing weight is more complex than simply taking in fewer calories than you burn off, keeping track of how many calories you consume and how active you are continue to be beneficial to successful weight-loss and weight maintenance. Because self-monitoring is critical for success with lifestyle changes, it is important to look at the various self-monitoring techniques.
Self-monitoring refers to the observing and recording of eating, drinking and physical activity patterns, followed by feedback on the behaviors. The goal of self-monitoring is to increase self-awareness of target behaviors and outcomes, thus it can serve as an early warning system if problems arise and can help track success.
Some commonly used self-monitoring techniques include:
- Food diaries
- Regular self-weighing
- Exercise logs
- High-tech tools such as pedometers, accelerometers and metabolic devices
All of these techniques can be utilized simultaneously to track patterns in daily activity. You can then use these patterns to determine which behaviors tend to result in weight gain versus weight-loss. To optimize your weight-loss, focus on making the healthy patterns part of your long-term lifestyle change.
With technology advancements, self-monitoring techniques are changing and improving to help defeat some of the major barriers to adherence. The bottom line is that no matter how you do it, self-monitoring should be an important part of your weight-loss, weight maintenance or healthy lifestyle change.
Studies have proven that individuals affected by obesity who maintain an optimal level of fitness have lower risk of heart attacks than individuals affected by obesity who are not very fit. Regular physical activity is necessary for good health. It is primarily important for someone who is trying to lose weight or maintain a healthy weight. Exercise can not only help to control weight, but it also contributes to healthy bones and emotional health. Be sure to check with your doctor that you are healthy enough to exercise before embarking on an exercise routine.
To maintain your weight, the Centers for Disease Control (CDC) recommends 150 minutes of moderate aerobic activity, 75 minutes of vigorous activity or an equivalent mix of the two each week. This recommendation can vary, however, depending on your fitness level and abilities, so consult with a healthcare professional for your individual needs.
Aerobic activity of 240 to 300 minutes per week may add additional benefits to reduced calorie intake.
Moderate and Vigorous Physical Activities
Physical activity does not have to be strenuous to be beneficial. Someone who has been sedentary but wants to get started with an exercise program should begin by incorporating a few minutes of activity into each day.
Moderate: Moderate activity is physical activity ranging from 64 to 76 percent of maximum heart rate. Moderate intensity activity causes a slightly increased rate of breathing and it feels “light” to “somewhat hard.”
Examples of moderate intensity activities:
- Brisk walking (a 15 minute mile)
- Yard/house work
- Leisure bike ride
- Playing with family
- Light swimming
Vigorous: Vigorous intensity is physical activity greater than 76 percent of maximum heart rate. Vigorous intensity activities result in increased rates of breathing and sweating and feel from “somewhat hard” to “very hard.” It is quite difficult to hold a conversation when performing this type of activity
Examples of vigorous intensity activities:
- Competitive sports such as soccer or basketball
Developing Your Physical Activity Goals
Once you have decided why you want to exercise and make a commitment, then you can set a SMART goal and use the FITT principle to make a plan.
Your goals should be SMART
- S Specific: Choose one specific behavior modifier per goal to work on.
- M Measurable: Can you measure this against a baseline?
- A Attainable or Action-based behaviors: Is the goal attainable? Use action words when writing goals such as “I will” and “I do,” rather than “try, should, would, could.”
- R Realistic: Do you have honest and realistic expectations of yourself with your time, body, likes/dislikes?
- T Timely: Is the time allotted reasonable and manageable for you right now? And, when will it conclude?
Then use the FITT principle to develop your physical activity plan:
- F Frequency: How often?
- I Intensity: What percentage of your target heart rate do you exercise? How hard do you plan on working?
- T Type: What mode of exercise are you using (walk, swim, aerobics, bike, dance, weights, yoga, Pilates, etc.)?
- T Time: How long can you exercise per day?
(This does not have to be all in one session. Time can be divided throughout the day.)
Now, let us look at how to put these two principles together and start our plan. Here are some examples of poor and well-written goals:
- I want to increase my cardiovascular exercise.
- I need to lose weight.
These goals are too general and do not clearly define the plan.
- I will increase my exercise by walking Monday, Wednesday and Friday two times a day for 15 minutes each time. I will walk at a pace that is somewhat difficult.
- I will record my food intake and exercise every day. My goal is to stay under 2,000 calories and to exercise 150 minutes this week.
These SMART goals are specific and allow you to easily determine if you are following your plan or not.
Remember these few things about exercise:
- Make it simple.
- Make it realistic.
- Make it happen.
- Most importantly, make it fun!
The most important commitment YOU make is to YOUR health and wellness.
Education and Your Body:
Although we often take it for granted, the body is a complex system. Recognizing this and making an effort to learn more are essential to your weight-loss and health. There are a wide variety of ways you can learn about your body, ways to properly nourish it and more, such as:
Talk to Your Primary Care Provider (PCP) – Discussing your weight with your PCP is an excellent place to start. It is important to be prepared for this visit. Here are some quick tips to help you prep for your visit:
- Write down food consumed in a food diary (even snacks).
- List any exercise activities you participate in daily, weekly.
- List any family history of conditions (type 2 diabetes, heart disease, etc.).
- Bring a list of any medications and dietary supplements you currently take (hint: almost all pharmacies can easily print this information for you for free).
Speak to a Dietitian – Dietitians are an excellent resource for an individual wanting to lose weight and improve health. Quite often, we think we know what’s healthy for our bodies, but we are commonly mistaken. Dietitians can provide you with the following:
- Meal plans
- Information on foods and how they impact your weight and health
- Help developing nutritional goals
The journey of weight-loss can often be a difficult one and a lonely one. We all know that one person who can “eat anything and not gain a pound.” Realistically, this is not true for the majority of Americans. Most individuals battling obesity or severe obesity find themselves needing support. Support groups are an excellent resource to share your story and learn from others. Here are some quick tips to help you find and engage in support groups:
- Ask your PCP for support group references. There are a wide variety of support groups available (women-only, men-only, faith-based, etc.)
- Don’t be afraid to speak up and share your story. There’s a good chance someone is thinking the same thing you are.
- Not ready to meet face-to-face? There are numerous online support groups available. Ask your PCP or dietitian for some of their favorites.
Setting Realistic Goals:
When developing your goals for weight-loss, exercise, eating healthy and more, it is important to keep them realistic. Quite often, individuals become frustrated when they do not see immediate weight-loss results. It is important to not let yourself become frustrated with your weight-loss plan. Changing your diet, incorporating exercise and more can all be significant life changes and they need to be taken seriously. Here are a few tips for developing realistic goals:
- Average weight-loss is one to two pounds per week.
- Start slow with exercise and find an activity you enjoy.
- Ask your spouse, family member or friend to exercise with you.
- Make meal times a family affair. Have your children help with cooking and let them choose healthy foods as well.
- Recognize your progress. Continue a proactive mindset and remember that each day is another day forward.
- Don’t be afraid to ask for help. Feel like you might be slipping with your eating or exercise routine? Talk to a family member, friend or healthcare professional and they’ll help you get back on track.
Behavior modification is the cornerstone of any weight-loss option. It may also be one of the most difficult aspects of weight-loss or weight maintenance. Our behaviors are engrained in our daily routines, families, lifestyles and more. Don’t expect to change your behaviors in one day or even one week for that matter. It will take time, but it is important to stick with your behavioral changes, as they will greatly help you in your weight-loss journey.
Always remember, YOU are the leader of your healthcare team!