Sustainable Weight Loss Plan, Research Paper Example

Introduction: Clarification of the Problem

It goes without saying that overweight is one of the major problems with health the contemporary community faces. Thousands of people are suffering from overweight, using multiple ways to improve their shape. On the one hand, it is possible to say that the overweight problem has been largely exaggerated recently because of many people using diets and physical exercises to approach the ideal formed by the mass market tools. Indeed, beauty has become the synonym of slimness, which in its turn has come to mean health for vast groups of population. On the other hand, thoughtless pursuit of slimness does not take physiological and medical peculiarities into consideration and sometimes only worsens the individual’s state of health instead of improving it.

Unfortunately, one of my family members also suffers from the overweight problem. This is why the present paper will focus on using a combination of psychological skills and techniques to help my aunt who is overweight and has hypertension to achieve and maintain weight loss. She has been trying to lose weight by changing her diet and attending a group workout in the gym, but she still cannot achieve her goal. Hence, I will design a series of strategies based on the steps of implementing a behavioral plan that will help her achieve her goal in the long run.

According to the US Department of Health and Human Services (2003), weight problems are highly dangerous as they increase chances for development of other diseases, namely heart diseases and hypertension:

“Overweight and obesity are also risk factors for heart disease. And being overweight or obese increases your chances of developing high blood cholesterol and diabetes—two more risk factors for heart disease” (US Department of Health and Human Services, 2003, p. 4).

Judging from the realm of potential threats that await people with obesity, one should first of all initiate the wish for change. It may be extremely hard for different reasons: people either do not want to change their lifestyle and refuse from habits in nutrition and physical activity for the sake of their health (this usually comes from underestimating the risks of overweight) or feel unable to do this because of weak willpower or absence of visual results. The main task at the stage of initiating the intervention is to find reasons and motives for the person suffering from overweight to get engaged in long-term weight loss programs.

Roberts and Ashley (1999) have conducted a study with patients who were engaged in weight loss programs to find out the reasons that made them decide to do so. The first and the most influential factor was the threat to health that became evident with the development of hypertension, heart disease, high level of cholesterol in blood etc.:

“In more than half of the interviewed SWL group the crucial initiating event was either an explicit warning from doctor or nurse, or the discovery of a risk factor on screening and receiving medical advice appropriate to this” (Roberts & Ashley, 1999, p. 25).

However, the process of decision-making about weight loss is much more complicated than plain reacting to medical warnings about potential or evident health problems. At times the person suffering from overweight has to go through some stages that lead him or her from only understanding the problem to taking real action:

“It could be seen that a certain amount of anxiety might produce movement from `precontemplation’ to `contemplation’ and to action, in the Prochaska and diClemente model. The appropriate amount of ‘cognitive dissonance’ may have to be created for change to be started” (Roberts & Ashley, 1999, p. 25).

For this reason Roberts and Ashley (1999) state that there is no use for doctors or relatives to initiate talks about weight loss before the patient gets to the particular stage of the Prochaska and DiClimente model of behavioral change (this model was used by researchers to identify stages of behavioral change).

These findings are highly significant for the present study, especially taking into consideration the large number of negative effects on health that overweight and especially obesity has. Hypertension is one of the most common consequences of overweight; it leads to atherosclerosis, increases the potential of stroke occurrence and contributes to the emergence of congestive heart failure, kidney disease, and blindness (US Department of Health and Human Services, 2003). These threats are likely to persuade any person wishing to live longer to start losing weight. In addition, the study of Hankey, Leslie and Lean (2002) reveals that health considerations are the dominant factor for male patients to start losing weight. All these findings suggest a firm health-related ground for weight loss programs for the overwhelming majority of people.

Formulation of Goals for Consultation

According to the comprehensive study of Locke, Saari and Latham (1981), there is a set of preconditions that make the process of goal setting efficient and ensure their successful accomplishment by the individual at who the intervention is targeted. The authors argue that clearly set goals direct the patient’s attention at the issue, mobilize his or her effort, increase persistence and motivate strategy development (Locke, Saari & Latham, 1981). They also argue that complicated, challenging but specific goals contribute seriously to the patient’s performance, increasing his or her commitment to change.

Goal setting actually represents the stimulus control; therefore, the main task of the doctor or any other controller is to identify the number of stimuli that affect the patient in the process of change and have the most influence, shaping his or her attitudes and behaviors. Once this is done, the controller can design the strategy of change that will possess a much higher potential for success (Locke, Saari & Latham, 1981). According to the authors’ inferences, goal setting is a motivational mechanism that includes such elements as direction setting, amplitude (effort) and duration (persistence). Feedback and supportive attitudes from the controller are also significant both in the choice of the intervention plan and its successful accomplishment. One more element to increase performance seen by Locke, Saari and Latham (1981) is to reduce anxiety of patients by providing them with all necessary information about the intervention, ensuring their knowledge about what they are going to do, and adjusting the complexity of goals to their abilities.

The present analysis of goal setting principles will give the research additional theoretical soundness and systematic approach to the subject. It is logical to assume that losing weight is a serious and complex program; one should also understand that weight loss and sustenance of results are different goals, so they should be approached in a different way. So, the basics of goal setting will be applied in the next section that presupposes the design of a weight loss program and maintenance of results for a long period of time. Hypertension and overweight are the problems of the discussed patient; in addition, the female object of research has an unsuccessful experience of weight loss, thus it will be necessary to fight not only physical but psychological barriers in her.

Design of Target Behaviors

Design of target behaviors occupies the central part in the weight loss program because it is the tool for the motivation mechanisms formation, commitment to the weight loss program and its goals. The aunt suffering from overweight is a person who it will be hard to motivate because of her previous failure. But as it comes from the study of Locke, Saari and Latham (1981), she used to try to lose weight according to the “do your best” principle, which proves no significance during the evaluation of results. The present weight loss program will rely on the clear and understandable goals that can be easily measured and assessed, which in the long run promises to become a strong incentive for the patient to continue the program.

The findings of Klem, Wing, McGuire, Saagle and O’Hill (1997) can be highly helpful for the design of target behaviors necessary for the introduction of a sustainable weight loss program for a woman with overweight and hypertension. The researchers have conducted an experiment following loss weight programs of a target group, identified the most successful patients who managed to sustain their results for a long-term period and outlined the factors that contributed to their success. According to their estimates, successful patients managed to adopt correct nutrition patterns, conducted systematic physical exercises and underwent professional consultation in the process of losing weight. There were different variations in methods applied by respondents, i.e. some of them trained at home and others did it with a group or a friend; some successful patients measured consumption of certain groups of products while others measured the quantity thereof. However, the main unifying criterion is professional guidance and stability of target behaviors – here is what pattern the aunt needs to achieve more success with weight loss.

Applying the principles that have just been discussed, it is possible to identify some peculiarities of the aunt’s previous weight loss experience and its reference to the present weight loss plan. She might have combined the approaches to weight loss in the wrong way and her physical status was not appropriate for the workout she chose. She suffers from hypertension, which may make physical activities extremely challenging. In addition, hypertension should be addressed by gradual increase of physical activities together with the diet that helps normalize blood pressure.

Hence, it is necessary to identify the kind of workout the woman needs. It goes without saying that dealing with obesity by only dieting is impossible with the proper regard of hypertension and its effect on the whole organism. The US Department of Health and Human Services (2003) has identified the key guidelines for people who want to normalize their blood pressure and have included the moderate-level physical activities as a must for those wishing to achieve long-term success. Medical specialists state that physical activities should not necessarily be done in the gym and contain sporting elements. Sometimes even household chores may become a truly efficient workout, especially for elderly people whose state of health does not afford sporting activities. According to their estimates, people with hypertension should undertake sports activities for 30 minutes for the major part of the week.

The US Department of Health and Human Services (2003) has made a list of recommendations for elderly people with hypertension, which can be quite useful for my aunt. They include such household chores as washing windows and floor, raking the leaves, gardening, washing and waxing the car etc. These activities may be absolutely appropriate for anyone not wishing to attend workout classes or not having enough physical strength to go in for sports. However, these activities possess a high potential for people with hypertension in case they are conducted every day. Surely, they will not give visual results within a month or two – a systemic approach to conducting these chores for half a year or even more will be more efficient in the long run. Besides, the respondents who showed success in sustained weight loss have been doing the systematic workout for several years (about 3-4), managing to preserve the achieved weight loss results only this way (Klem et al., 1997).

Food preferences are another target behavior to be addressed in the course of formulating the treatment plan for a woman with overweight and hypertension problems. It is not enough to refuse from certain foods for a limited period of time – a new, healthy approach to nutrition should be adopted in the long run, informing the individual about harm of certain products and their effect on his or her organism. Food should not become the field of deprivation, suffering and tension for the person undergoing a weight loss program. Healthy food can also be tasty, and a positive, creative attitude to cooking is vital in this respect. Here again the rules of goal setting outlined by Locke et al. (1981) are highly helpful – the aunt can start studying the properties of spices that she never used before, the alternatives to unhealthy foods she used to like and the potential of fruit and vegetables that are extensively included in the diet. As soon as complex but achievable goals are set, the woman will need clear measures according to which she will assess her progress – the amount of unhealthy food reduced every week, or the number of new dishes she invented following her healthy diet etc. These target behaviors have proven to possess extremely high potential in long-term weight loss.

Identifying Maintenance Conditions

It is rather hard to initiate the change in a person suffering from overweight, making him or her act. However, the hardest task is to arrange maintenance conditions that would enable the patient to sustain the weight loss and to go on with the workout as well as with the diet on a long term basis to preserve results of the program. The fact that sustainable weight loss is next to impossible has been noted by many researchers (Roberts & Ashley, 1999; Rippe, 2004), so maintenance conditions become as necessary as the weight loss program itself.

Rippe (2004) offers an efficient comparison to help physicians and patients distinguish between the successful weight loss and maintenance thereof. The author outlines the following characteristics of reaching a weight-loss goal:

• Attendance at a program
• Weight loss early in the program
• Sticking with it
• Social support
• Regular physical activity
• Behavior modification techniques
• Self-monitoring
• Goal setting

These are the elements that have already been discussed throughout the present paper, and their exceptional importance in the weight loss issues has already been proven. However, Rippe (2004) distinguishes this set of elements from the one that a person should pursue after completion of the first stage to sustain its results and proceed to a more long-term weight loss program as a part of a lifestyle and not only an effort taken by the patient and limited in time:

• Regular physical activity
• Self-monitoring weight and food-related behavior
• Positive coping skills
• Keeping in contact with people who helped with weight loss
• “Normal” eating patterns

Health improvements

So, as it comes from the comparison shown by Rippe (2004), the main factors for the success of weight-loss in the long run area positive lifestyle change and a supportive atmosphere the patient creates with the help of his/her friends, relatives or acquaintances. As soon as the patient is able to pursue the healthy lifestyle on a regular basis without perceiving it as a limiting interference or tension, the long-term success may be guaranteed.

Designing the Treatment Plan

Now it becomes possible to divide the sustained weight loss program for my aunt into four essential components according to goal setting perspectives offered by Locke et al. (1981): healthy diet, physical activities, positive feedback in addition to supportive environment, and medical intervention to reduce the negative impact of hypertension. Each of them will be discussed further in detail.

Healthy diet. The US Department of Health and Human Services (2003) outlines the main guidelines for those wishing both to lose weight and to address the hypertension issue at once. The specialists from the Department offer the DASH program that stands for “Dietary Approaches to Stop Hypertension”, which in fact is also highly helpful for weight reduction. It includes “whole grains, poultry, fish, and nuts, and has low amounts of fats, red meats, sweets, and sugared beverages” (The US Department of Health and Human Services, 2003, p. 8). Active elements used in DASH are “potassium, calcium, and magnesium, as well as protein and fiber” (The US Department of Health and Human Services, 2003, p. 8).  These elements can essentially help to reduce blood pressure, thus coping with hypertension effects. Those whose aim is losing weight can use the low-calorie variant of DASH upon the Department’s recommendation.

Some other pieces of advice given in the guidelines produced by the Department are keeping a diary of eating habits to reinforce motivation and record the clearly assessable results of the diet, losing weight slowly not to harm the organism and to be able to sustain the results in the long run. They also notice that a normal pattern of weight loss should not exceed ½ – 2 pounds a week (The US Department of Health and Human Services, 2003). One more tip they offer is to look after not only what the patient eats during the diet, but also how much is eaten. The size of servings is also essential in the process of keeping to a diet, and some people who have switched to a healthy nutrition model may eat much more than it is necessary to lose weight, even if the food is healthy (which may also be true about the aunt  – she also kept to a diet without visible results).

Physical activities. Following the guidelines of the US Department of Health and Human Services, tips offered by Rippe (2004) and Klem et al. (1997), inclusion of physical activities is of vital importance for the success of a weight loss program. Despite the fact that the aunt already has some unsuccessful experience of workout, it is possible to suppose that she used the weight loss elements not coherently, so the new carefully structured and planned program is more likely to be of certain help. Thus, she should conduct physical activities for minimum 30 minutes a day no matter what. According to the experience of a dieter described by Spangle (2006), the most common failure is that dieters do exercises as often as they want, while they have to do them under any circumstances. As she is a woman suffering from hypertension, she can choose lighter workout patterns such as bicycling, household chores, gardening or some swimming (not much). Systematic approach to physical exercises will surely contribute both to weight loss and hypertension decrease levels.

Positive feedback and supportive climate. The importance of positive feedback is stressed in the work of Roberts and Ashley (1999) as the way to radical change in thinking about weight loss, about one’s appearance etc. The authors state that positive feelings about oneself, visual improvement of one’s appearance and change in perception of a healthy lifestyle become the most powerful stimuli for long-term weight loss. In addition, Rippe (2004) also emphasizes the influence of positive environment and continuation of communication with those people who helped the patient lose weight. It is a powerful factor stopping them from returning to their destructive lifestyle. Spangle (2006) states that keeping to a weight loss plan means persuading oneself that he or she is different and has to live in a different way – here one can assess the importance of self-talk and reinforcement in the overall weight loss process.

In general, self-motivation is very powerful in the process of weight loss. Even business sources emphasize intrinsic motivation acting much more effectively than the largest monetary rewards. For this reason Spangle dedicates her work to studying the importance of imagery and self-talks in the process of keeping to a diet. She shares many tips that can help the aunt sustain weight loss for a long period of time and overcome crisis periods when it seems that no results have been achieved. Keeping a reflective journal, modifying the limits of the nutrition diet beyond the imposed borders to release the burden of deprivation, keeping interest and motivating one’s own commitment are the key elements of success of any diet in the long run (Spangle, 2006). Using these pieces of advice and formulating goals clearly according to Locke’s guidelines, the aunt will be quipped with all necessary tools to be motivated about the diet and to assess the progress in a clear and optimistic way.

Medical intervention. In case hypertension is the main factor that prevents the aunt from doing exercises and moving on with her diet, increasing the risk of stroke or heart disease because of the additional load she takes, the necessity of using drugs that may relieve her from hypertension effects may arise. Among some drugs recommended by doctors one can find diuretics, vasodilators, beta-blockers etc. However, before taking any drugs the aunt should certainly consult her doctor to find out whether they suit her and whether they will be of any help in solving her problem.

Implementation of the Plan and Evaluation of Results

Once the plan is implemented, the aunt will surely need some external help that should first of all come from close people and family, and the professional consultant who will monitor her progress as well as the changes in her health. The key task of people who constitute the aunt’s environment is to encourage and motivate her, conduct physical exercises together or help cook healthy food. Motivation to go on with the weight loss plan is likely to come from the enhanced assessment plan that can be worked out on Locke’s recommendations – it will help the aunt clearly state quantifiable goals and assess their completion. Keeping a reflective journal will be an additional reinforcement due to which she will keep track of her progress and which will keep her from getting back to the ordinary style of living.

Results will be evaluated both by the aunt independently and by the physician who will guide her progress. Healthy food in proper servings connected with sound physical activity is likely to give results in the long run. It is vital that the aunt’s commitment grows, her awareness of negative effects of flashing back to the former style of living is clear and her diet does not impose unbearable and unacceptable boundaries on her. As soon as she accepts the new lifestyle and manages former habits constructively, she will see her progress; once this happens, she will visualize the success of her healthy lifestyle and will become highly motivated to pursue it on a steady basis, which is the initial aim of the present project.

References

Hankey, C.R., Leslie, W.S., & Lean, M.E.J. (2002). Why lose weight? Reasons for seeking weight loss by overweight but otherwise healthy men. International Journal of Obesity, No. 26, pp. 880–882.

Klem, M.L., Wing, R.R., McGuire, M.T., Seagle, H.M., & Hill, O.J. (1997). A descriptive study of individuals successful at long-term maintenance of substantial weight loss. The American Journal of Clinical Nutrition, No. 66, pp. 239-246.

Locke, E.A., Saari, L.M., & Latham, G.P. (1981) Goal setting and task performance: 1969-1980. Psychological Bulletin, 90, 125-152.

Rippe, J.M. (2004). Weight Watchers: Weight Loss That Lasts. John Wiley and Sons.

Roberts, A, & Ashley, G. (1999). What are the characteristics of overweight and obese patients who achieve weight loss and what factors are most helpful? A quantitative and qualitative study of patients and interventions in a rural general practice. Journal of Human Nutrition and Dietetics, 12 (Suppl. 1), pp. 20-27.

Spangle, L. (2006). 100 Days of Weight Loss: The Secret to Being Successful on Any Diet Plan. SunQuest Media, Inc.

Your Guide to Lowering Blood Pressure (2003). The US Department of Health and Human Services. Retrieved April 19, 2010, from http://www.nhlbi.nih.gov/ health/public/heart/hbp/hbp_low/hbp_low.pdf