Effective behavior strategies

One of the most effective strategies to facilitate behavior change and promote long-term weight maintenance is self-monitoring. Patients may track their food intake, physical activity, and, when appropriate and agreed upon, body weight throughout treatment. The practice of writing things down helps the patient make observations and be more mindful about choices. Through detailed observations, patients and clinicians may detect patterns and habits in need of change. Tracking diet also supports accountability and restraint. Self-monitoring is therefore essential to complete the weight history, identify needed dietary changes, and monitor progress toward goals.

Establish ISMART goals

The most useful approach for lifestyle treatment is to recommend changes that are practical, achievable, and goal oriented. Negotiate goals that are ISMART for best results. Put them into writing to help create commitment and accountability.

Inspiring

Specific

Measurable

Achievable

Relevant

Time specific

Note

If patients are currently sedentary, they may benefit from an action plan to initiate progressive physical activity. Set incremental actions to achieve a larger ISMART goal, such as engaging in a combination of aerobic and resistance exercise for at least 2 hours and 30 minutes each week.

Other lifestyle recommendations

Manage stress levels to maintain hormonal balance and sustain motivation for healthy behaviors.

Walking for 60 minutes most days of the week will help with stress.
Work with an interdisciplinary health care team, as no one professional can provide all the skills and support necessary for weight-management goals. Familiarize yourself with weight-management programs in the area.
Engage a personal support network and avoid negative influences.
Expect setbacks; consistency and routine can support progress during periods of low motivation.
Consider using one of the many available tracker and inspiration apps.

Meal planning is very helpful in weight management. With nutritious alternatives planned and available, you are less likely to consume convenience foods that are typically highly caloric and processed. In addition, regular meal patterns may help promote satiety. Keys to planning ahead include:

Structure meals to include healthy protein and sufficient fiber.
Carry a healthy snack and a water bottle everywhere.
Review a restaurant menu prior to making reservations or arriving for a meal.
Plan to eat light later in the day to manage circadian rhythm.

Sleep helps to maintain a healthy balance of hormones that control hunger and satiety. Keys to sleeping better include:

Make time to sleep for 8 hours each night (7 to 9 hours are needed for adults) and go to bed and wake up at the same time every day.
Complete screening for obstructive sleep apnea as appropriate.
Spend time outside every day, if possible, and be physically active.
Avoid nicotine and caffeine.
Avoid heavy or large meals within a couple hours of bedtime.
Avoid alcoholic drinks before bedtime.
Use the hour before bed for quiet time.
- Avoid exercise and bright light.
- Stop using phones and other electronic devices at least 30 minutes before bedtime.
- Try reading a book instead.
Take a hot bath or use relaxation techniques before bed.
Keep your bedroom quiet, cool, and dark.

Put theory into practice

Encourage all patients who want to lose weight to engage in a high-intensity lifestyle program, which includes:

Referrals

Behavioral programs

Counseling with a registered dietitian nutritionist trained in weight management.

Mental health provider

Psychologist or a health coach may also be helpful in enhancing motivation and modifying lifestyle and behavior.

Guidelines emphasize a multidisciplinary team approach that incorporates registered dietitian, exercise physiologists, and others into care plans.

Healthy diet and regular physical activity not only promote weight loss but also reduce adiposity-related health risks. When patients are ready and supported, long-term behavioral strategies can improve health and quality of life. To partner with patients on their weight-management goals, use shared decision-making skills to engage patients in setting goals and establishing a management plan.

Physical activity

Knowledge check

Table of Contents

Establish ISMART goals

Other lifestyle recommendations

Put theory into practice