Have you ever tried to ride a bicycle with one flat tire? Chances are, you didn’t get very far. If your clients are seeking weight loss but focusing only on exercise, they too will have a difficult time making progress. Anyone can try to diet, but your clients will enjoy more success if you teach them how to change their behaviors for good.
Losing weight is not rocket science. For weight loss to occur, energy in has to be less than energy out. But what can revolutionize your clients’ lifelong struggle with weight management is teaching them how to take in less energy. Here’s the skinny.
Problem: Clients don’t
understand what an
appropriate serving looks like.
Many of your clients may not be aware of what constitutes an appropriate portion size. In today’s age of “burritos the size of your head,” calories can add up very quickly. Research has shown that portion sizes have increased over the last several decades to 2–3 times the recommended serving sizes (Centers for Disease Control and Prevention [CDC] 2006; Nielsen & Popkin 2003). Coincidentally, the prevalence of overweight and obesity has also increased (CDC 2006; Nielsen & Popkin 2003). More importantly, however, studies have shown that when given larger portions, people consume more and do not compensate by eating less of other items during the meal or throughout the day (Diliberti, et al. 2004; Levitsky & Youn 2004; Rolls, Morris & Roe 2002; Rolls, Roe & Meengs 2006). Other studies indicate that subjects consumed 30% more food when given larger portions, but did not feel any fuller (Rolls, Morris & Roe 2002).
Strategy #1: To help clients eat less, teach them to identify and reduce their portion sizes. Conduct individual or group sessions on portion size awareness. Use common equivalencies (see “Understanding Portion Control” on page 75), along with tools like scales and measuring spoons, to “readjust” a client’s eye to appropriate portion sizes.
Christopher R. Mohr, PhD, RD, a weight management expert in Louisville, Kentucky, suggests having clients bring in their own serving bowls, plates and spoons to portion awareness sessions. “You can get the point across so much more easily by having clients serve themselves a usual amount of cereal or pasta and then weigh and measure to compare a typical serving vs. recommended servings. Many are shocked to learn [that] they regularly supersize when eating at home.”
Strategy #2: Proper portion plates and placemats that can help clients visualize exact portion sizes are now available online (see “Additional Resources” on page 77). These tools decrease the likelihood of overeating because the plates or placemats are divided into appropriately sized sections. There are many other tools available to use with clients, including plastic food models, daily meal-planning programs and food scales for measuring out portions. It is important to work with each client to
select the best educational tool for his or her particular preferences and lifestyle.
Problem: Clients rely on
the wrong signals to
Research conducted at the Cornell Food and Brand Laboratory at Cornell University found that people rely on how much food remains on a plate or in a bowl to determine when they have eaten enough (Wansink, Painter & North 2005). Researchers designed bottomless bowls that could refill without the subjects’ knowledge. Subjects who unknowingly ate from the self-refilling bowls consumed 73% more soup than those who ate from normal bowls. Yet those who ate more soup did not believe they had consumed more and did not feel any fuller than those who ate from normal bowls. Thus, the size of the plate or bowl can greatly influence the number of calories consumed, as people tend to use their eyes to “count” calories.
Strategy: Teach clients the value of using smaller plates and serving utensils at home. For drinks, suggest they use tall, narrow glasses. Research indicates that decreasing plate and glass sizes may make people believe they are getting a larger portion simply because their dish or glass is full (Wansink 2004). Also, eating everything on a plate (even a smaller one) indicates to the brain that it is the end of an eating episode. Clients may assume they have eaten enough and stop eating before consuming too much (Wansink, Painter & North 2005). This simple act of using smaller dishes at all meals may help clients decrease their portion sizes without feeling that they are eating less food.
Our Toxic Environment
Problem: Clients eat for the
activity rather than for hunger.
We eat while we work, while driving and while doing household tasks. Too often, we combine eating with relaxation when watching TV, reading or attending sporting events. However, research has shown that coupling events with eating increases calories consumed (Hetherington et al. 2006). In one study, women consumed significantly greater amounts of food when listening to an audio book compared with when they were just eating
or eating while focusing on the quality of the food (Bellisle & Dalix 2001). Once distracted, we become unaware of the amount we have consumed and do not feel fuller by eating more. Rather than serving any physiological need for food, eating becomes merely an activity.
Strategy: Teach clients to avoid distractions, such as watching television, reading or using a computer, while eating. These types of distractions can cause clients to start an eating episode when not hungry; they can also obscure the amount of food consumed during an eating episode or extend the duration of the eating episode (e.g., “I’ll put the chips away during the next commercial”).
Problem: Clients are a
product of their environment.
We are all heavily influenced by our surroundings: sight, smell, sound, people. In the area of behavior change, how we respond to stimuli is known as stimulus control. Stimulus control refers to environmental cues that encourage us toward specific behaviors. These cues can be subtle (a picture of pizza on a billboard, or a TV commercial for our favorite snack food) or blatant (the smell of chocolate-chip cookies baking in the oven). Over time, if we eat when we experience cues in our environment, then the association becomes paired, and eventually a learned habit forms. For example, if a client always rewards herself with a pint of Häagen-Dazs® ice cream when she’s had a bad day, then a stressful day at the office will prompt her to overeat. While we can’t change all the negative cues in our environment, clients can learn how to decrease the impact of cues by gaining control over their personal environment. This is done by taking an honest look at their home surroundings: Is there junk food left out on the countertops? Is food kept in other rooms besides the kitchen? Do they snack while watching TV?
Strategy: Discuss and identify major negative stimuli that are affecting your clients. Teach them to eliminate or replace negative cues with more positive ones. Suggest these tips:
- Reduce the number of places you tend to eat (e.g., no more eating in the car or the family room).
- Replace negative food cues (e.g., candy jars) with positive cues (e.g., bowls
- Eliminate the junk food cabinet, or move the contents out of reach; then replace the junk food with spices or storage containers, as a conscious reminder to change mindless snacking habits.
- Establish one designated eating place (DEP) at home and at work. Ideally, this location should be a kitchen or dining room table and should be free from distractions. (Teach clients to eat all their snacks and meals in the DEP. This strategy is effective because many clients don’t necessarily want the snack itself, but rather the activity of snacking.)
Problem: The deli down
the street has clients’ orders
prepared before the clients even order them!
Eating out can present a significant challenge when clients are trying to lose weight, because restaurant portions are excessive and there are limited healthy food options on menus, especially in fast-food restaurants (Nielsen & Popkin 2003). Furthermore, research has connected the frequency of eating out with increasing body mass index (McCrory et al. 1999).
Strategy: Since never eating out at a restaurant or fast-food establishment again is probably out of the question, here are simple strategies for managing “on-the-go” eating.
- Order half-size portions if available.
- Split a meal with someone else.
- Skip the bread basket and the chips and salsa. When extremely hungry, order vegetables with hummus and/or salsa or a side salad as an appetizer.
- Have half of your meal put in a to-go box before the food is served to the table.
- Avoid consuming high-calorie drinks, such as sodas, juices or alcohol, with meals.
- Order an appetizer rather than a full meal.
- Choose broiled or baked entrées.
- Ask for all dressings and condiments to be put on the side, and then dip the salad into the dressing cup using a fork.
- Remain aware of how much you are eating throughout a meal. Put your fork down between bites, and sip water often to give yourself time to feel full.
Your Clients’ Just Desserts
Changing behaviors doesn’t have to be overwhelming. Small, consistent changes maintained for long periods can have dramatic effects on weight management efforts. In addition, these changes don’t have to mean deprivation and restriction.
You can help your clients change their eating behaviors by sharing these strategies. Teach them to become aware of eating behaviors (when they snack, how frequently they eat out, etc). Inform clients about portion awareness by sharing magazine articles like this one or by offering weight management sessions at your club. Provide strategies on making less food available, being more purposeful about eating choices throughout the day and navigating those challenging environmental cues.
Centers for Disease Control and Prevention (CDC), Division of Nutrition and Physical Activity. 2006. Research to Practice Series No. 2: Do Increased Portion Sizes Affect How Much We Eat? Atlanta: CDC.
Diliberti, N., et al. 2004. Increased portion size leads to increased energy intake in a restaurant meal. Obesity Research, 12 (3), 562–68.
Hetherington, M.M., et al. 2006. Situational effects on meal intake: A comparison of eating alone and eating with others. Physiology & Behavior, 88, 498–505.
Levitsky, D.A., & Youn, T. 2004. The more food young adults are served, the more they overeat. Journal of Nutrition, 134, 2546–49.
McCrory, M., et al. 1999. Overeating in America: Association between restaurant food consumption and body fatness in healthy adult men and women ages 19 to 80. Obesity Research, 7, 564–71.
Nielsen, S.J., & Popkin, B.M. 2003. Patterns and trends in food portion sizes, 1977–1998. Journal of the American Medical Association, 289 (4), 450–53.
Rolls, B.J., Morris, E.L., & Roe, L.S. 2002. Portion size of food affects energy intake in normal-weight and overweight men and women. American Journal of Clinical Nutrition, 76, 1207–13.
Rolls, B.J., Roe, L.S., & Meengs, J.S. 2006. Larger portion sizes lead to a sustained increase in energy intake over 2 days. Journal of the American Dietetic Association, 106, 543–49.
Wansink, B. 2004. Environmental factors that increase the food intake and consumption volume of unknowing consumers. Annual Review of Nutrition, 24, 455–79.
Wansink, B., Painter, J.E., & North, J. 2005. Bottomless bowls: why visual cues of portion size may influence intake. Obesity Research, 13 (1), 93–100.
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