Houston Weight Loss

Lifestyle Change Counseling Strategies

To help patients develop a healthy lifestyle, there are a number of cognitive behavioral counseling strategies that have been shown to be especially efficacious.

Realistic Goals.
When asked, patients often have unrealistic weight-loss goals. Using dietary and exercise counseling strategies, the average patient will lose about 8% to 10% of body weight, a weight loss that will improve risk factors but will be disappointing to many individuals. We typically help the patient set moderate short-term goals, such as making small increases in daily walking and decreases in portion sizes. We also help the patient focus on the psychological improvements, such as improvements in well-being and feeling better about oneself, and the health benefits of this modest weight loss. Goals are reevaluated periodically and revised when necessary. Patients feel good about meeting modest goals and typically approach longer goals, including maintenance, in a better frame of mind. We sometimes remind patients that unrealistic short-term goals, such as losing weight too quickly, typically result in failure and frustration.

Self-monitoring.
If physicians had only the time to counsel patients in one behavioral strategy, self-monitoring is the one we would advise. For patients to change dietary and physical activity, it is critical that they know what they are eating and how much they are exercising. Raising self-awareness is absolutely necessary. We require that patients keep food records. They are asked to write down what they eat during the day and look up the calories. We also ask them to keep track of the minutes they exercise or the number of steps they take each day if they are using a pedometer.

Meal Replacements.
Meal replacements have become a significant tool for helping manage body weight over the long term. There are many published peer-reviewed studies documenting the role that meal replacements play in long-term weight loss and maintenance. Substituting 2 meals with a meal replacement for weight loss and substituting 1 meal for weight maintenance has shown excellent efficacy with no significant safety concerns.

Managing Stress.
Stress is a major predictor of relapse from healthy lifestyle patterns. A discussion of stressful life events may help patients identify problems that need to be handled to make it easier to manage their lifestyles. Teaching a patient how to manage stress can be particularly helpful. Increasing physical activity is an excellent tool for managing stressful situations because it significantly improves well-being. Meditation can help. Progressive muscle relaxation, a technique that involves muscle tensing and relaxing, can be learned quickly and lead to rapid stress reduction.

Social Support.
Support from others has been shown to be valuable in both weight loss and weight maintenance. Ideally, a family that eats the same healthy foods together and exercises together is the perfect support group. Other support groups may include friends or groups of similarly minded individuals. Support groups work by providing role models, allowing self-acceptance, and serving as an outlet for the emotional issues that patients sometimes experience during a weight-loss intervention.

Article from Medscape Today

Turn those Negative Thought Around

Is your mind overrun by negative thoughts? These thoughts, which are often irrational and exaggerated, are not harmless but they may contribute to depression and anxiety. It's easier to substitute these ingrained ideas with more realistic and positive thoughts once you become aware of them.

All or nothing. If you do not perform flawlessly, you consider yourself a complete failure.

Overgeneralization. One negative event, such as a fight with your spouse or an encounter with a dishonest merchant, fits into an endless pattern of dismaying circumstances and defeat. For example, you might think, "He's always cold" or "You can't trust anyone."

Mental filter. One negative episode, such as a rude comment made to you during an otherwise enjoyable evening, shades everything like a drop of food coloring in a glass of water.

Ignoring the positive. Positive input, such as an affectionate gesture or outright praise, just doesn't count. Self-deprecation deflects all compliments. You might say, "It's no big deal."

Leaping to conclusions. You draw negative conclusions without checking to see if they have any foundation in fact. You may be mind reading: "My friend seems upset, she must be mad at me." Or you may be fortune telling: "I just know the results of my medical test aren't going to be good."

Magnification or minimization. You exaggerate potential problems or mistakes until they snowball into a catastrophe (as in the lab results example in Recognizing Your Distortions). Or you minimize anything that might make you feel good, such as appreciation for a kind act you did or the recognition that other people have flaws, too.

Emotional reasoning. You feel sure that your negative, emotional view of a situation reflects hard and fast truth. For example: "My husband drops his socks on the floor just to aggravate me."

"Should" statements. You adhere to a rigid set of beliefs and internal rules about what you "should" be doing and feel guilty when you get off course.

Labeling. Rather than describe a mistake or challenge in your life, you label yourself negatively: "I am a screw-up." When a friend's behavior bothers you, you pin a global label on him or her: "He's so controlling."

Personalization. You blame yourself for triggering a negative event that occurred for complex reasons or for something that was largely out of your control. "If I had taken care of myself properly, I never would have gotten cancer."

Other clues can also help you identify distorted thinking. Sentences that include the words "must," "should," "ought," "always," and "never" are often harsher than necessary and reflect rigid thinking that could stand to be softened.