Category Archives: Changing Behaviors

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How Is Obesity Defined?

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Body Mass Index (BMI) is a measure calculated from a person’s weight and height. It provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. BMI is calculated by dividing your weight in kilograms by your height in meters squared. That number should be between 18.5 and 24.9. The National Institutes of Health has defined certain classifications of weight based upon the BMI:

Classification

BMI Range

Underweight

Less than 18.5

Normal

18.5 – 24.9

Overweight

25.0 – 29.9

Obese

30.0 – 39.9

Extreme Obesity

Greater than 39.9

According to a report released on July 7, 2011 by the Trust for America’s Health and the Robert Wood Johnson Foundation, two-thirds of all adults and about a third of all children and teenagers in the United States are overweight or obese.  In fact 16 states have obesity rates over 30%.  Colorado has the lowest rate at 19.8%.  Twenty years ago no state’s obesity rate exceeded 15%.  Indeed we have an epidemic!

You should discuss with your physician whether your goal should be to attain a normal BMI. For people with a lot of muscle mass, such as trained athletes, a healthy BMI may actually be somewhat higher than what the table would indicate. For most people, however, these categories are a useful guide.

Another body measurement that is related to health risk is the waist circumference. It seems that the location of fat makes a difference as far as health risk. Fat in the waist carries a greater health risk than fat in hips or thighs. Scientific studies have shown that people whose waists exceed the targets in the table below have a higher risk of health problems.

Gender

Healthy Waist Circumference

Men

Less than or equal to 40

Women

Less than or equal to 35

In my next post I’ll talk about the health risks from being overweight.

For Your Health – Dr. Bob

Challenges Along The Way

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It’s important to set expectations early in your behavior change plan.  Whether you are trying to quit smoking, start an exercise program or lose weight, be prepared for some challenges along the way.  It is very common to make some progress and then go backwards from time to time.  It’s what you do when that happens that will determine whether you will ultimately reach your goal.

These challenges should be viewed as learning opportunities.  When they occur, accept them for what they are, situations that caused you to deviate from your plan temporarily. They don’t mean that all is lost.  You need to step back, look at the situation and understand why there was a lapse.  Once you understand that, you can devise a plan to use when those circumstances occur again.  For instance, three weeks into your healthier eating plan, you go to an all you can eat buffet and can’t resist the temptation.  You wind up gaining 2 pounds after that.  Instead of giving up your eating plan entirely, you should learn from this.  Next time, avoid those buffets or, if you must go, fill up on water, fruits and vegetables beforehand so you won’t be able to overeat.

So, remember that it is common that the path to success is not straight or smooth when changing your behaviors.  When you get stuck or move backward, learn from the challenge and, above all, don’t use it as an excuse to give up.  Keep moving forward!  Remember two steps forward and one step back is still one step forward.

For Your Health – Dr. Bob

More About Milestones

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I had a few more thoughts on milestones that I wanted to share.  When setting targets for your weight loss milestones you don’t necessarily have to use weights.  Since a weight loss program combines making changes in your eating habits and your activity level, there are many none weight targets that you can use.  In fact many people find that concentrating on changing the behaviors that will lead to reaching their goal weight to be a better strategy than just focusing on their ultimate weight loss goal.  After all, attaining a 50 pound weight loss will take time, but a milestone tied to changing some aspect of your eating habits can be reached much sooner.  For instance, let’s say that snacks are your downfall, and you typically eat 6 unhealthy snacks every evening while sitting at the computer or watching TV.  A milestone for you could be to eliminate 1 evening snack per week for the next 5 weeks.  By the end of those 5 weeks you will have decreased your snacks to one each evening and hit that milestone.  At the same time you need to improve the healthfulness of the snacks and not increase the amount of each snack.

Once you reach your milestone, you reward yourself.  This brings up the other point I wanted to make about using milestones.  You can choose any reward except food.  So, buy a new pair of shoes or go out to a play or movie, but don’t go out to dinner or have an extra slice of pie for dessert.

Finally, it should be obvious that when you use the attainment of a changed behavior as a goal as in our example, you need to continue that behavior and build on it.  Most experts say that you need to work at maintaining that behavior change for at least six months before you can consider it part of your lifestyle.  With that in mind, you may want to set monthly milestones that you will maintain the new healthier behavior that you adopted in order to prevent backsliding.  And that brings us to the topic I’ll talk about next time – backsliding.

Meanwhile be sure to set attainable milestones for your behavior change program, whether for weight loss or smoking.  It’ll make it more fun as you chart your progress towards your goal.

For Your Health – Dr. Bob

Making Milestones Work For You

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Usually when we are making changes to our lifestyle behaviors we have set a goal for ourselves that won’t be attained for many months.  Once we reach that goal we usually reward ourselves.  In fact, often the attainment of our goal is the reward in and of itself.  The sense of accomplishment is powerful.  Very often, our goal is related to getting a benefit or reward.  For example, a woman losing those 50 pounds she set as her goal may enable her to feel more attractive and confident when she attends her college reunion.

But if we just tie a reward to attaining our ultimate goal, we can lose the value of some motivational opportunities along the way.  This is where the concept of milestones comes in.  When writing out your plan it is a smart idea to identify some milestones along the way & link them to some small reward.  For instance, for the woman in our example, she may want to set up 10 pound milestones as she works toward her 50 pound weight loss goal.  She would tie a reward for every 10 pounds she loses.  It may be going to a movie or buying a new blouse or sweater.  Whatever reward she values would work as long as it doesn’t involve straying from her eating plan.  Ideally you should tie a due date to each milestone to help you stay on track.

So be sure to harness the power of milestones.  After all, we all respond to rewards.

For Your Health – Dr. Bob

Barriers to Your Success

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Whenever you take steps to change your lifestyle behaviors, whether to stop smoking, eat healthier or begin an exercise plan, it pays to take some time and identify the barriers to your plan.  These are the roadblocks to your success.  They are usually easy to list since they are often related to your list of Cons.

So if we consider the healthy eating plan that must be followed to lose weight, barriers might include:

  • Not knowing what to eat and what to avoid
  • Not knowing what are proper portion sizes
  • Not understanding food labels
  • Having difficulty finding the time to do some research on proper nutrition
  • Being tempted by unhealthy snacks at work
  • Being a frequent snacker
  • Eating out frequently, possibly due to business travel

Barriers to starting an exercise program to help lose weight and for its other benefits often include:

  • Having difficulty finding the time to exercise
  • Not having access to a place to exercise
  • Being embarrassed to exercise in front of others due to self consciousness about being overweight
  • Physical limitations

These are the potential reasons why you may fail in your plan – if you don’t determine how you can overcome them.  So when you make your list of barriers, you need to list next to each barrier what you will do to counteract them.  This way, when you are faced with the barrier, you will know how to respond.  For instance, if you are unsure of what to eat and what to avoid as well as appropriate portion sizes, you need to do some research online or at the library.  To help with portion sizes, you may need to buy a scale and measure all your portions.  When you take the time to identify your barriers you can usually strategize how to eliminate them before you are faced with their challenges.  Including barriers and their solutions in your plan preparation can help assure your success.

Next time I’ll talk about a few more important parts of your healthy lifestyle behavior change plan.

For Your Health – Dr. Bob