By Kathleen Goodwin, RD

Read the following pages/chapters in your text, Dieting For Dummies this week: Chapter 5, pages 45-54, Chapter 21, pages 251-254

Summary

Now that you know how to eat more nutritiously and how to include more exercise, you must learn the "whys," or the behavioral reasons, that cause you to gain weight or overeat. Many people know how to lose weight, but it's following through on it that becomes a problem. Behavioral choices and internal and external cues greatly influence our eating habits. This week, you will explore behavior modification, which are "techniques used to change an unwanted or destructive behavior." This week's lesson and exercises help you identify your personal behavioral problems and cues for overeating. You will explore the value of the food and exercise diary, and you will learn to keep one. You will also review the steps involved in creating realistic, achievable goals that will help you change your eating behavior problems.

Topic outline for Part Four:

Monitoring eating behavior with a Food Diary

Why it's important to keep a food diary

1. Research shows keeping a food diary is one of the most important determinants in whether lost weight will be kept off. The food diary is one of the most powerful proven aids for weight control. Many studies show that persons who keep a food diary not only lose more weight than those who do not keep one, but they also keep the weight off longer. The results of one study of thirty-eight participants who had been following a weight loss program showed the following patterns:

   Those who were most consistent about keeping a food diary lost an average of seven pounds more than what they had already lost before the study.

   Those who were not as watchful about their record keeping gained back an average of three pounds.

2. You learn to identify your personal vulnerable situations and emotions that may trigger overeating, such as loneliness, boredom, stress, or even the mere sight or smell of a particular food. A food diary also helps you identify your personal food weaknesses or "trigger foods."
3. You transform previously unconscious behaviors into conscious choices. Usually when we eat, it is a mindless, unconscious, conditioned response to a vast mixture of cues, hardly any of which have to do with true biological hunger. For example, until you write it down, perhaps you didn't realize that you unconsciously eat a half a bag of cookies while you watch TV several nights a week. By writing down everything you eat, you transform unconscious behaviors into full awareness. Then, the next time you go for the cookies, you can make a better, more conscious decision about whether you will have them and how many you will have.
4. You can better evaluate the nutritional balance in your diet. Perhaps before starting to keep a food diary, you honestly felt that you included a good number of fruits and vegetables in your diet. Then, after reviewing a week of entries, you realize you took in only 2 servings of fruits and vegetables per day on average. Now, you know to make corrections that add better balance the nutritional adequacy of your diet.
5. You will naturally attain greater self-discipline with your food choices. Are you really going to have that second scoop of ice cream if you have to write it down later and face it point blank?
6. A food diary allows you to keep track of your exercise and activity (or lack thereof) and re-examine your fitness goals.
7. You become more in tune with your body's cues and signals of biological hunger. You can also differentiate whether you eat because of hunger, because of emotions, or because of your appetite.
8. You create personal territory for 100% non-judgmental exploration of feelings. A food diary is one of the few places where you can really be alone with yourself and make previously unknown personal discoveries. You can use it as a place to explore feelings and thoughts you usually keep hidden. When you journal, you can really delve into your deeper emotions and things you may not be fully aware of on a conscious level. Writing out your feelings is an effective tool to identifying the emotional reasons behind overeating, as well as coping with the emotions that drive us to overeat in the first place.

What to monitor in a Food Diary

Important things you should track in your food diary:

• Every food and beverage you consume throughout the course of the day
• The amount of each food and beverage you consume (as specifically as possible)
• Your hunger level on a scale of 1-5 when you ate or drank each food or beverage. Ideally, you eat something at #2-3 and stop eating at #1:
  • 0=Stuffed/uncomfortably full
  • 1=Comfortable/satisfied
  • 2=Slightly hungry
  • 3=Moderately hungry
  • 4=Very hungry
  • 5=Famished
• Any feelings or emotions before or while eating:
  • Bored
  • Lonely
  • Sad
  • Depressed
  • Angry
  • Stressed
  • Guilty
• • The time of day
  • The location where you ate
• Any exercise you did that day
• Your personal goals and any changes or strategies for the following day

A food diary might have the following columns as well as a space at the bottom for recording your exercise and other goals:

• Food/beverage
• Amount
• Hunger
• Mood
• Time
• Location

A food diary can demonstrate eating patterns and eating problems

After keeping a food diary for several days you might begin to see patterns emerging. You might be able to pinpoint some significant problems that have kept you from losing weight, eating more healthily, or exercising in the past. What can you identify? For instance, you might note the following traits:

• Skipping meals
• Snacking too often between meals when you're not hungry
• Eating unconsciously while you read or watch TV
• Eating in response to moods or emotions - which moods and emotions?
• Eating when you are still full from your last meal
• Waiting until you are famished before you have a meal and then you overeat
• Not drinking enough water
• Falling short on your exercise goals this week
• Eating too many sweet snacks and not enough nutritious snacks
• Eating more around a certain friend than when you're alone or vice versa

Find some solutions to these eating problems

After you have targeted your problem areas, you can determine some solutions that will keep you from repeating the behavior. This is where goal setting comes in. In the next section, you will review the steps necessary to identify and set long- and short-term goals. Also, in the first exercise this week, you will begin to keep a food diary and track all the information discussed above. From your food diary, you can pinpoint your problem areas. In the second exercise, you will establish goals to combat your problem behaviors by completing the following goal setting steps.

Introduction to Goal Setting

Weight loss: It is important to set the right goals

Most people who wish to lose weight focus on just that one goal: weight loss. In order to succeed at this very broad goal, you must focus on creating the smaller dietary and exercise changes that will lead to that long-term weight change. Successful weight managers select two or three goals at a time that they are willing to take on and that meet the following criteria of useful goals:

Useful goals are:

• Specific
• Attainable
• Forgiving (less than perfect)

"Exercise more" is a commendable idea, but it's not specific.

"Walk five miles everyday" is specific and measurable, but can you do it if you are just starting out?"

"Walk 30 minutes every day" is more attainable, but what happens if you're delayed at work one day, or if a thunderstorm takes place during your walking time another day?

"Walk 30 minutes, five days each week" is specific, attainable, and forgiving. In short, it's a great goal!

Steps to establishing diet, exercise and behavior goals:

1. Specify your long-range or "outcome" goals. These goals are very broad do not involve the specifics of how you will achieve them:
   • Exercise goal: To finish a 3-mile race
   • Weight goal: To lose 60 pounds
   • Behavioral/Psychological goal: To deal with unpleasant emotions effectively without using food to cope
2. After maintaining a food diary for several days, review it and try to identify some very specific problem areas. Identify several small, specific eating, behavior, or exercise problems that might keep you from achieving the goals above.
3. Find some very specific, measurable solutions to each of your problem areas that will help you to achieve your big goals above. These are known as short-term goals:

   Examples:

   • Exercise: I started out too hard and then gave up on exercise. This time, I will take it more moderately and pace myself. I will start by walking 20 minutes, 3 days a week.
   • Diet: Instead of buying high-calorie, sugary snacks from the vending machine, I will take the time each day to pack some fruit and low-fat yogurt to snack on when I feel hungry.
   • Behavior: I overeat at night after a long, hard day. I eat because I'm still stressed. I will learn to identify when I'm reaching for food because I'm stressed. I will then go do something that really does make me feel better and less stressed, such as meditation, a long walk or writing in my journal.
4. Learn to pace yourself and give up perfection. Choose only a few goals to work on at once. Don't set yourself up for failure by overdoing it or trying to take on everything at once. Changing behavior is a long process. After all, you took a lifetime to learn the behaviors you do now! You must unlearn them just as slowly. Do not punish yourself or feel you are a failure if you do not achieve your short-term goals immediately or each day. Realize it is a long slow process open for re-evaluation at any time. Don't ever give up on yourself and your ability to achieve your big goals. You can do it!
5. Reward yourself when you accomplish your short-term goals, but not with food. Take time to write down some things that would be great prizes to you. Perhaps you'd like a new book, a manicure, a magazine, or a massage. List some things you can reward yourself with to give yourself a big pat on the back for a job well done. Establish a reward for each goal you will accomplish, and make the reward's size consistent with the achievement.
6. Monitor your progress at regular points in time. Ask yourself how far you've come towards accomplishing your initial short-term goals. After things are going well, say in a month, you might not have to put as much effort into the goals you selected. If things aren't going well, you might need to rethink the strategies you are using and try something different.
7. Set new short-term goals. When you feel you've mastered the previous short-term goals you set for yourself, create some new ones. Remember this is a journey, not a destination. Accomplishing any goal, whether it's weight loss or anything else in life, requires a lifelong commitment. You will always have to set new goals and work on new areas even when you accomplish your big long-term goals. For instance, after you lose the 60 pounds, what goals do you have to work on to maintain your weight?

Behavior modification strategies that can help you lose weight

Note: These are only suggestions. You must determine what works for you.

• Don't engage in other activities while eating such as watching T.V. driving, reading, or talking on the phone

• Concentrate on the pleasures of the food you eat - the sight, the smell, and the taste. Don't allow eating to be a mindless, unconscious behavior.
• Choose one room for eating, and don't eat while standing or walking around. Sit at a table and make it attractive.
• Spend at least 20 minutes eating your meals to allow your brain to trigger a fullness sensation to your stomach. Take small bites or even try chopsticks!
• Don't always leave a clean plate. Pay more attention to your hunger. It's OK to leave something if you feel satisfied before you're finished. Put it away for tomorrow if you want.
• If you can't eat "just one" of certain foods, don't buy that food.
• Don't go grocery shopping on an empty stomach, and shop from a prepared list.
• Buy foods that require preparation. Ready-to-eat foods that you desire will constantly call your name.
• Incorporate small bouts of exercise into your daily routine. Try taking the stairs, parking far away, walking to the grocery store, or hand-washing your car.