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Being Sensitive to Weight Loss Patients’ 'Bad Habits'



How do you get patients to stick with the plan?
Compliance to a medical treatment can be challenging, to say the least. Patients want to be healthier, more active, and more energetic. Yet time and time again, they fall off the wagon and resort to going back into the same old habits that don’t support their progress. Why? (Click here for a flashback on 5 Bad Habits that Lead to Weight Gain)

For health care providers, it can be frustrating to check in with a patient and hear that their diet or exercise plan isn’t going so well. But it can also help to understand how habits form so you can not only help set realistic expectations for your patient, but also for yourself.

Studies on habit formation have shown that habits form as part of a three-step process. First, there’s a cue, or trigger, that tells your brain to go into automatic mode and let a behavior unfold (i.e. hunger). Then, there’s the routine, which is the actual behavior that we associate as being the “bad habit.” The third step is the reward: Something that your brain likes that helps it remember the “habit loop” in the future. In the case of overweight patients, the pleasure of enjoying “off-limits” food can be their reward. (Learn more about this physiological pleasure connection for those suffering from food addiction in our free white paper.)

Neuroscience has shown that habitual behavior and conscious decision-making are handled by two different parts of the brain, and the area of the brain that controls habits can often supersede and shut down the decision-making area. So when patients revert back to old habits, it is not that they are just battling low motivation or self-control. Their brains are hardwired to return to the behavior that it is used to, even when they no longer benefit from it.

So what can health care providers do?
First off, be patient with your patients. It’s not that they are less committed to their goals; for many it can just be that they require a little more time to relearn healthier habits. Studies show that it can take anywhere from 18 days to 254 days for people to form a new habit. And there will be trips along the way.

Secondly, don’t stress too much about when they mess up. Researchers have found that “missing one opportunity to perform the behavior did not materially affect the habit formation process.” In other words, it doesn’t matter if you mess up every now and then. Reassure your patients that an occasional binge is not the end of the world and encourage them to get back on the horse.

Third, understand that old habits are not forgotten, but replaced with new ones. We can’t magically expect patients to stop a damaging behavior without providing an easier alternative. For overweight people who have an unhealthy relationship with food, there can be a benefit to introducing something like meal replacements. Rather than expecting patients to completely change how they relate to food, they can replace their normal food habits with an easy shake or bar and make it part of a new routine that is easier to implement.

Dr. Valerie Sutherland of Rainier Medical Weight Loss and Wellness notes, “[Patients] typically report that taking food away for a period made a huge difference, even if only for a month. Since food can be addictive for some people, taking it away completely can be crucial for long term change, which is the opposite effect that you may be warned about by some critics of a short term rapid weight loss program that is ‘unsustainable.’”

For a more help on helping patients set realistic goals they can stick with, instantly download our free Short Term Goal Helper Worksheet!

Sources: NPR, MIT News, HuffPost


Blog written by Vanessa Ramalho/Robard Corporation


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A 'Mental Diet' for Weight Management



Getting healthy and losing weight is not an easy endeavor — especially, if you are not following a mental diet. So much energy and focus tends to go into the physical components of weight management, but the mental aspects are just as vital. I would like to propose a “Mental Diet” to go along with the physical aspects of weight management.

For Breakfast
The morning can be a critical compass to direct your focus for the day. Even if you are not a “morning person” that is full of energy, it is important is to start your day off with intention. This means that you will set aside time for self-care before too many responsibilities or distractions consume your morning. The morning is actually the best time for exercise or meditation, even if it is for five minutes, as you will have less excuses/distractions and more “willpower” in the morning. As the day progresses, we deplete our “willpower tank” which tends to result in an inability to tackle difficult tasks in the evening. So, the ingredients for a good mental breakfast include: At least five minutes of exercise or meditation, self-focus, gain insight and perspective on the day and start the day after taking care of yourself first.

For Lunch
It is important that you schedule time to break for lunch. If you are the type of person that gets busy and easily distracted, you will want to set an alarm to remind yourself to take a break. We are such as fast-paced society that we may not pay attention to how much and how fast we are eating. It’s not uncommon for people to engage in “mindless” eating while sitting at their desk, in front of the TV or driving — suddenly you realize that the food is gone and you have not paid attention to satiety. Instead of just go through the motions of putting food in your mouth, focus on eating slowly and truly paying attention to each bite and monitoring how we feel. The ingredients for a healthy mental lunch include: 15-30 minutes to recharge by refueling with a calm, mindful meal or shake.

For Dinner
You need to have a moment to digest the day. It is important to recognize that “emotional eating” and cravings may increase toward the end of the day. Unfortunately, you may have used most of the energy from your “willpower tank” and begin to want sweets or snacks after dinner. After a long day, “rewarding” yourself with unhealthy foods may sound like the perfect way to unwind. However, indulging in unhealthy foods will only leave you craving more and potentially feeling guilt and remorse. Instead of trying to “eat” your emotions, talk it out or journal your thoughts and feelings. As you prepare for sleep, limit your time with “screens” such as TV, phones and computers and start to focus on relaxation. So the healthy mental dinner includes: Reduce the mental weight of the day by writing down three things that went well for the day and if there is anything that you might need to do for the following day.

Behavioral change and extensive patient education materials are interwoven into all of Robard’s weight loss programs. If you’re a medical provider and would like more information, click here.

Blog written by Devin Vicknair, Ph.D., LPC, Behavioral Health Coordinator at Gwinnett Medical Center: Center for Weight Management.




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Is Food Your Friend or Enemy?




Frequently, patients tell me they want to “change their relationship with food.”  This lofty-sounding desire is often expressed after significant weight loss following a diet, after a life-changing event or during recovery from disordered eating. Some refer to it as making “peace” with food, as if they have been at war with it all their lives. And perhaps they have.

How we change that (food) relationship — or not — greatly depends upon how we view food. Merriam-Webster.com (medically) defines food as: “Material consisting essentially of protein, carbohydrate, and fat used in the body of an organism to sustain growth, repair and vital processes and to furnish energy.” Food is, first and foremost, the important fuel that keeps the body alive. So, it makes sense that quality “fuel” put into the body would produce a healthier-running organism.

But beyond being a source of macro and micro-nutrients, food also provides pleasure. Nature could have permanently provided us earthly inhabitants with some bland-tasting, gray-colored sustenance to meet our nutritional requirements for survival. Instead, nutrition is packaged in a plethora of delightful colors, smells, tastes and textures. Along with man-made food preparation methods, we now have a phenomenal multiplicity of choices. “Extreme variety” —with food available almost as soon as we can imagine it — is both a blessing and a curse. And one could argue that the availability of today’s super palatable convenience foods doesn’t help. So, we need to know how to reasonably combine nutrition and pleasure, calories and nutrient density. We need balance.

Next, if we want to truly improve our food relationship, we have to slow down, learn to savor and listen to our bodies. When we dismiss our bodies’ hunger signals (usually pretty discernable) and satiety signals (sometimes more like a whisper), our food behavior can move us quickly from starved to stuffed — neither of which is a positive or pleasurable experience. And while we also need to learn that mild hunger is not something to be feared (most of us are blessed enough not to experience food insecurity) our concern with seeking food and thoughts about food also should not interfere with daily life.

Lastly, food really needs to be food. It can’t substitute for or squelch our emotional expression on a regular basis. If our “default” is to eat when an emotion arises, we are no longer nourishing ourselves as intended. Food is not a persona — not our “friend” or our “enemy.” To put food back in its place, people often initially need some structure. Planning meals and snacks at regular intervals, eating a wide variety of plant foods, lean proteins, whole grains, healthful fats, drinking enough water and tracking intake are some sensible ways to start. And because food attitudes, just like emotions, can be contagious, having a good “food mentor” is not a bad idea.

So improving one’s food relationship — just like a relationship between people — involves the desire/willingness to change, which takes times and effort. There is no room for self-blame or blaming others for our personal food history because, as adults, we are each responsible for the food we put in our mouths. There is only room for learning and growing, one day at a time — one meal at a time. Sometimes we can do this on our own and sometimes, as with relationships, we need outside help. And it takes patience. But the rewards of improving one’s food relationship are very rich, and go beyond weight management to include health, a sense of gratitude, confidence, and a growing appreciation for nature. It’s never too late to start the process.


Blog written by By Rosemary Mueller, MPH, RDN, LDN, Advocate Medical Group — Advocate Weight Management



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