Behavioral changes and discipline needed to lose weight

Loyola University Health SystemDec 29 2012

Losing weight and saving money are perenially the top New Year's resolutions made by many Americans. But both require behavioral changes and a certain amount of discipline.

"People need a motivation to lose weight and the new year is an opportunity to start fresh," said Dr. Jessica Bartfield, internal medicine and medical weight-loss specialist at Gottlieb Memorial Hospital, part of the Loyola University Health System.

"Maybe it was the shock of seeing oneself in recent holiday photos, or not being able to fit into desired party attire that causes a vow to lose weight, and for many more it is a medical event such as a heart attack, the threat of diabetes or high blood pressure," she said.

Bartfield is part of the Loyola Center for Metabolic Surgery & Bariatric Care that offers non-surgical as well as surgical weight loss programs for patients. Patients in both programs benefit from a dedicated team of medical professionals in psychology, nutrition, exercise physiology and more with an expertise in bariatrics.

"Behavior change is the cornerstone of healthy, successful weight loss and it takes about three months to establish a new behavior," said Bartfield. "Just as you learn to play a musical instrument from a skilled teacher, you need to learn how to lose weight from professionals. You need to practice and make mistakes until you get it right. At Loyola, a team of tried-and-true medical experts can teach you the skills you need to achieve and maintain behavior change."

According to the Centers for Disease Control, one-third, or 35.7 percent, of American adults are obese. "We are a large nation," Bartfield said. Despite a huge, billion-dollar weight-loss industry, it's estimated only 20 percent of Americans who try to lose weight successfully keep it off after one year.

"Changing behavior is tough - it is actually a skill and needs to be approached that way," Bartfield said. "When you learn to play the piano, you expect that you will hit the wrong notes a couple times and are prepared to try again and keep playing; you need to have the same expectation with weight loss and to plan accordingly."

The National Weight Control Registry (NWCR) consists of about 4,000 Americans who have lost, on average, about 30 pounds and have maintained this loss for five years. "This registry provides a tremendous source of information about the behaviors associated with successful weight-loss maintenance. I often help my patients identify and incorporate these same behaviors into their own lives," Bartfield said.

What to do - Top weight-loss behaviors from Dr. Bartfield and the NWCR

• Eat breakfast - "Eating within one hour of awakening can boost your metabolism up to 20 percent for the rest of the day," Bartfield said. Seventy-eight percent of NWCR members start the day off with breakfast. "Eating something is better than eating nothing, but ideally try to incorporate protein for longer-lasting fuel."

• Weigh yourself once per week - "Monitoring your weight on a weekly basis provides a fairly accurate weight trend and, more importantly, an early detection of any weight regain, which allows you to adjust behaviors accordingly," Bartfield said of the 75 percent of NWCR members who weigh in weekly.

• Get in one hour of moderate physical activity each day - "Snow shoveling, vacuuming, taking the stairs - you don't have to run like a hamster on a wheel for 60 minutes. Take three, 20-minute brisk walks, or compile the one hour based on a series of activities," Bartfield said. More than 90 percent of NWCR members engage in one hour of moderate exercise daily.

• Watch fewer than 10 hours of TV per week - "Many argue they don't have time to exercise, but when I ask them to count the hours they spend watching TV or surfing the Net, they are able to find the time for activities where they are moving instead of sitting," Bartfield said. Sixty-two percent of NWCR members watch fewer than 10 hours per week.

What not to do - Weight-loss pitfalls to avoid from Dr. Bartfield and the NWCR
• Overestimate amount of physical activity -"Park your car farther away, take the stairs, manually change TV channels - these are all simple ways to get more physical activity and you need to write them down as they are performed to keep yourself honest," Bartfield said. "Also wearing a pedometer can help accurately document and track your progress."

• Underestimate caloric intake - "Keep a food journal and then look up the calories for what you eat," said Bartfield. "Compare that to the caloric recommendation for losing weight and you will likely be surprised at how much you are overeating."

• Set unrealistic goals - "Patients often set vague and outcome-related goals such as "weigh 150 pounds by summer" or "exercise more." Goals need to be specific and attainable. Instead of trying to get to a certain weight, start by trying to lose 10 percent of your weight - that amount has been shown to have a statistically significant improvement in health and reduction in risk of obesity-related disease.

• Lack of consistency - "Eat at regular intervals seven days per week," she said. "Being 'good' on the weekdays and then splurging on the weekend creates a harmful cycle that discourages weight loss."

• Failure to plan for setbacks - "When you learn to drive, or learn a sport or musical instrument, you make mistakes and you have an experienced instructor - maybe even several - to help correct the mistakes and prevent repeats. Enlist a trusted friend, or enroll in a program to learn and master the rules of weight loss," Bartfield said.

And for teens who want to lose weight? "Treating child and adolescent obesity needs to be a family effort; families need to change behaviors," Bartfield said. "Research shows that families - and even couples - who change behavior together are the most successful."