Wednesday, October 5, 2011

You can behave your way to weight loss. By Lisa Hanchey

If you’re like most people, you don’t weigh anywhere near what you did in high school. We’ve all gained a few pounds. On average, people pack on about five to 10 pounds every decade, according to Valerie Myers, Ph.D., instructor of clinical psychology at Pennington Biomedical Center. Over time, that extra weight could increase your chances for high blood pressure, Type II diabetes and obesity.

Myers recently spoke on “Behavioral Factors in Weight Loss & Management” at the Pennington Quest for Wellness held at City Club in River Ranch, explaining that losing just five to 10 percent of excess weight could mean better years of living. “You reduce your risk of stroke, heart disease, you have improvements in blood pressure and diabetes, you increase your life expectancy, and you spend a lot less money on medical health,” she says.

With a 5 percent weight loss (10 pounds for a 200-pound person), you could see an improvement in cholesterol, measures of diabetes and blood pressure. “For every kilogram (2.2 pounds) of weight lost, you could have an improvement in blood pressure of about two points,” Myers says. 

How can you do it? It takes diet, physical activity and behavior modification. Diet means consuming fewer calories. To lose a pound per week, cut back by 500 calories per day. For women, Myers recommends limiting calories to 1,500 to 1,800 per day. Men should aim for 2,000 to 2,300 daily. “We really do encourage weight loss of a half a pound to a pound a week,” Myers says. “When we lose more aggressively than that, it’s very difficult to keep it off. In fact, I think it comes back, and it comes back with friends.”

Another goal is to limit alcohol consumption. That means no more than one adult beverage (eight ounces) a day for women, and two for men.

Pennington’s recommended dietary approach is called DASH (Dietary Approaches to Stop Hypertension). This nutritionally-balanced diet consists of nine to 12 servings of fruits or vegetables daily, two to three servings of low-fat dairy products, 25 percent calories from fat and low sodium (2,400 mg or less).

To maintain your weight loss, you must increase your physical activity. “Just increasing your exercising by five to 10 minutes a week can have a huge impact on your maintenance efforts,” Myers says. PBRC’s recommendation is 180 minutes ­— 30 minutes a day, six times a week — at moderate intensity. Moderate means that you can talk while exercising, but cannot annunciate. Find extra opportunities to move: Take the stairs instead of the elevator; park your car farther away from your destination.

Myers says the key to achieving weight loss is to change your behavior. This requires five steps: goal setting, self-monitoring, stimulus control, contingency management, cognitive behavior techniques and stress management.

Step one is to set two types of goals — short-term and long-term. “You will never achieve your long-term goal unless you break it down into small goals and how you are going to do them,” Myers cautions. This requires setting SMART goals — Specific, Measurable, Attainable, Realistic and within a Time frame — regarding diet, physical activities and other changeable behaviors. Don’t just say, “I will eat better and exercise more,” Myers advises. Think more in terms of: “I will walk 20 minutes a day for five days a week,” or “I will eat more protein, less sugar and less fat over the next two weeks.”

Myers gave some practical tips on how to accomplish your goal, including writing it down, planning ahead and changing goals if necessary. Once you set your target, tell somebody about it. “When you verbalize it to someone else, you take accountability for it,” Myers says. “Stay around positive people. You may need to ‘weed your garden’ during your efforts.”

Self-monitoring is the next step. Write down everything you eat. Weigh yourself at the same time daily, beginning with once a week then building up. “There is some really compelling evidence now that daily weighing is the way to be successful in losing weight and keeping it off,” Myers reports.

Next is stimulus control. Change the influences in your environment to keep you on track with your weight loss goals. For example, avoid driving by the donut shop or French fry establishment. Turn the channel during food commercials. Put your tennis shoes by the door instead of in the closet.

You might also need to make some changes as to food preparation. Plan ahead for your meals and snacks by portioning them into storage bags or containers. Keep a granola bar with you for when you’re in a bind. Another trick is to serve meals on salad plates so portions will look bigger. For parties, eat before you go or bring a healthy dish with you. Avoid buffets, and don’t pile up food on your plate. Eat slowly and socialize to distract you.

Cognitive behavioral techniques involve the relationship between thoughts, feelings and behaviors. “How you think about a situation can determine not only how you act, but how you end up feeling,” Myers explains.

The final behavioral technique is stress management. To reduce stress, Myers recommends diaphragmatic breathing. “Most people breathe incorrectly,” she says. The correct way is to breathe in through the nose to expand the diaphragm, then blow out gently through the mouth. “Breathe like you are smelling soup, then cooling it off,” she suggests.

Other stress management techniques include using imagery, improving sleep hygiene (how we prepare ourselves for bed and maintain our sleeping space) and reducing caffeine. What Myers recommends most is exercise. “When you are exercising, you significantly reduce your stress levels,” she says.

Myers’ final tip is what she calls “Goal Medal” behavior. She explains how swimmer Michael Phelps achieved his milestone of winning eight Olympic gold medals with the help of his teammates. “The two things that highly impact your ability to make a successful behavioral change are self-efficacy and social support,” she explains. “Michael Phelps had a tremendous amount of self-confidence. But, he surrounded himself with a team who was invested in him. So, if you engage in something that you really, really want to do to change, take a look at who around you is on your team. Those are the people that you need to surround yourself with.”  

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