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Archive for July, 2010

Wishes are for birthdays and genies.  Goals are meant to be worked towards.  A french writer once said “a goal without a plan is just a wish.”  I whole-heartedly agree with that quote, especially in regards to weight loss.

More times than I care to estimate, patients will come to me with a “goal” of weight loss without any thought of how they might achieve this goal.  This is like me saying that I am going to run a marathon without having a training plan.  We need to come up with a training plan for weight loss. 

Usually the conversation goes something like this:

Me: So what brings you here today?

Client: I want to lose weight.

Me: Alright, so what are your goals surrounding weight loss?

Client: Weight loss IS my goal. (Client usually has a very confused look on their face as if I did not hear them the first time.)

Me: Okay, I understand you want to lose weight.  How can I help you with this?

Client: Well, that’s why I came to you.  (At this point, I imagine they are expecting me to get out my wand or spell book and cast a incantation that will allow them to lose weight right here and now….sounds simple, right?  I may or may NOT have a spell book or magic wand.  However, if I did, I most definitely haven’t figured out how to get rid of excess weight with it…if I had one, that is….hmmm, will consult Mr. Potter.)

Me: Okay, but have you thought about what YOU are going to do to achieve this goal?

Client: Well, that’s why I came to you.  You are the dieitian, you tell me.  (Aaaah…this always makes me laugh.  As if, whatever I say, they will do.  If  that was the case, then why didn’t the last 15 diets they followed work?  The books and the group leaders tell them exact ly what to do.  What happened there?  And, if I had such power, why isn’t my husband doing my laundry? )

Okay, I know most of you are thinking, well, isn’t that your job, Eve?  Well, yes it is, but I need some participation.  I do assist clients in goal making, but, in my experience, it is usually the clients that come in with a plan that are more likely to succeed.  I can help them make their plan more managable.  I am not saying that if they don’t have a plan that they won’t succeed, but it’s certainly less likely.  And, it is even more unlikely that they will succeed if I am the one making the goals for them.

I try to work with clients to make smaller goals that lead them to their ultimate goal of weight loss.  They need to focus on behaviors and actions that they can DO.  Weight loss is not something that one does, exercise is something that one does.  Okay, now after this has all been said, back to the conversation:

Me: So, what goal do you want to make to support your weight loss?

Client: I am going to eat healthier.

Me: Okay, what does that look like for you? (I ask this because people have such extremely varying ideas on what “healthy” eating entails.)

“Eating healthy” is about as good a goal as “weight loss.”  There is no plan.  We then discuss that we need to make specific goals that deal with behaviors.  Now maybe they’ll understand.  I give them examples.  Back to the conversation:

Me: So, let me help you a little with this. You told me that you drink four 12oz regular sodas per day.  Is this something that you would like to change?

Client: I don’t know.  I guess that would help me lose weight if I cut it out, huh?  But, I really like my cokes.

Me: It sounds like you don’t want to give these up completely just yet.  Would you be willing to work on cutting back?  (Here I acknowledge that she really likes her cokes and have sensed her apprehension to give them up completely.  I am giving her a way to ease into these changes.)

Client: I think I could at least start to cut back.

Me: Okay, great.  Do you think limiting to two 12oz cokes per day is doable?

Client: Yes, I CAN do that!

Me: See, now we have a goal that you can DO and is measurable!  Goal #1: Limit cokes to 24oz per day.

And, then our discussion stems into making more goals that deal with behaviors and are measurable.  Many times clients think these very small goals are silly and not significant enough to make a difference.  But, if this client were to only make this goal and nothing else, and assuming that she was able to achieve this, she could, theoretical, lose up to 30lbs in 1 year by cutting her coke intake in half, which reduces her calorie consumption by 300 calories per day.  Small changes do add up, but only if they can be maintained.

Making goals is hard, making achievable and measurable goals is even harder.  Assisting clients in focusing on behavioral-centered goals is what I do, then its up to them to do the rest.  Weight loss is NOT a behavioral-centered goal.  Examples of behavioral-centered goals might include:

  1. I will include some protein with each meal and snack. (We will formulate a list of things for the client to choose from.)
  2. I will drink 48oz of water daily.
  3. I will do some activity for 10 minutes daily, 4-5 days per week.
  4. I turn off the TV during dinner.

So, the moral of this, whether the goal is weight loss or a marathon, a plan is needed, or its really just a wish.

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