To achieve weight loss, create individual plan

Motivation must be personal to achieve change

Cookie-cutter approaches to weight loss don’t work for everyone. While one person may find a written meal plan helpful, others may prefer to eat less by skipping the second helping or eating smaller portions.

Therefore, each person who wants to lose a few pounds should first conduct an assessment to determine what is right for him or her, says Rita Jones, RD, LD, CDE, MEd, a patient education specialist at the Mayo Clinic in Rochester, MN. This assessment begins with the question: "Am I ready to make a change?"

People need to be motivated to commit to a lifetime change in eating habits and exercise patterns. Health problems such as high blood pressure or diabetes often are not motivation enough. They need to lose weight because of something they value, such as obtaining good health so that they will live to see their grandchildren grow up, she explains.

When people are not sure if they are ready to commit to a lifestyle change, Jones has them list the pros, or the benefits of losing weight, and the cons, or reasons that they would not put the effort into it. "They must look at the list and decide for themselves that the benefits outweigh the barriers. They need to personally come to the decision to change," she says.

When people determine that they are ready to make changes in their lifestyle to obtain a more healthy weight, the next step is to determine a method. "I ask where they have been successful before and have them analyze why they were successful," Jones explains. They need to look at what they did and apply it to weight loss, building upon what they already know.

For most people to change behavior, they need to be successful up front. When they aren’t they often become frustrated and quit. Jones helps people by having them focus on one change at a time. For example, they may determine that they are willing to add exercise to their daily routine such as walking three times a week for half an hour. Once they have reached success with their first goal, they can build on it or tackle another one.

"Many times, people establish these huge goals, and I try to get them to break it into smaller pieces," says Jones. When goals are grand, her question to the person making them is, "How realistic is that?"

Often, people who are considerably overweight look at behavioral changes as deprivation or punishment. Therefore, Jones suggests that they add something to their lifestyle rather than take something away. For example, instead of giving up sweets, they may decide to eat more fruits and vegetables. As a result, they may be too full to eat as many sweets as before.

Plan for success

Once an assessment of their readiness to change has been made, an action plan is put into place to help them achieve the goals that they have set. For example, if a person is willing to walk for exercise, he or she must determine the details such as how often, how long, and at what time of day.

It often helps to be accountable to someone, says Jones. When she determined to attend water aerobics classes at the YMCA during the winter months, Jones hooked up with a friend. On those evenings after work when it was cold and she did not want to leave the house, the fact that her friend would be at aerobics and she had promised to support her motivated Jones to stick with it.

If items such as cookies and potato chips in the pantry were determined to be too tempting during the assessment phase, then the plan should include a discussion with family members to ask them not to bring such snacks into the house.

Patient education managers might offer options for people trying to make lifestyle changes for a healthier weight that they may include in their action plan. Often a support system is helpful. This may be a support group for weight management or the opportunity to meet with a dietitian once a month or quarterly.

The next step after a plan of action is created is to implement it, however this is not the final step. People need to evaluate the action plan periodically to see what has worked and what hasn’t, says Jones.

Frequently a reward system will keep people on track but it isn’t always good to focus on loss of weight as the reason for receiving a reward. That’s because people may start an exercise program and begin building muscle. Although they are becoming slimmer, muscle weighs more than fat and the scales may not reflect the change, says Jones. A more appropriate reward system may focus on commitment to certain exercise goals such as walking for 30 minutes, three times a week.

The issue of maintaining a healthy weight is complicated. Sometimes people select foods with concentrated calories; other times, they eat more because the food tastes good. Often people eat the right foods, but just too much of them. Currently, carbohydrates are getting blamed for weight gain in the press, but they are the body’s primary body fuel. It isn’t that they are bad for people; it’s just that often too many of them are consumed in a day.

"On the flip side, it isn’t that people eat too much but that they aren’t burning it off because they don’t get enough physical activity. Our society is very convenience-oriented," says Jones. 


For more information about creating a program to help people make lasting behavioral changes to achieve a more healthful weight, contact:

• Rita Jones, RD, LD, CDE, MEd, Patient Education Specialist, Section of Patient Education, Mayo Clinic, Siebens SL 200, First St. S.W., Rochester, MN 55905. E-mail: