Moving from Weight Loss Toward Healthy Living, One Conversation at a Time
By Nikki Elbertson
As health professionals, we work hard to enhance the health and well-being of those around us. Whether it’s a personal training session with a client or a casual conversation with a family member, we want to be telling the right story, sending the most effective messages out into the world. But, how do we challenge people to look past the magazines, billboards, commercials, and even the advice of medical professionals telling them to join a gym, go on a diet, lose weight?
As a society, we tend to connect physical appearance to healthy behaviors. We aim to look like underwear models, have ripped abs…look good. How’s that working for us? In a country where over two-thirds of adults, a quarter of children under five and one-third of school-age children and adolescents are overweight or obese (Ogden, Carroll, Kit, & Flegal, 2014), the answer is probably: not so well.
So, what works?
Interestingly, a lot of research shows that valuing longer-term outcomes of exercise, such as weight loss, may motivate people to start exercising or begin eating better. However, valuing the actual experience of healthy lifestyle changes (in other words, enjoying a particular activity or food) and having a better quality of life from day to day is what keeps people active and eating well. This value of the in-the-moment experience may come in the form of the social engagement (like tossing a Frisbee with friends), the challenge (such as climbing to the peak of a mountain or beating a time in a race), or skill development (like learning how to scuba dive). Based on the evidence, immediate rewards motivate healthy behavior more than hopes for distant payoffs (Segar, Eccles, & Richardson, 2011; Teixeira, Carraça, Markland, Silva, & Ryan, 2012). When applying this to working with clients, research also supports the use of motivational interviewing that focuses on:
- Helping individuals to identify their intrinsic goals and values,
- Assisting them in weighing their own perceptions of the costs and benefits of behavior change, and
- Reinforcing those goals, values, and cost-benefit analyses that are most likely to mobilize behavior change (Lundahl, Kunz, Brownell, Tollefson, & Burke, 2010; Rollnick & Miller, 1995).
What might that look like? While it’s fine to allow individuals to discuss their goals to lose weight or look better in a swimsuit, it’s probably helpful to try to shift the focus of the conversation to incentives that go beyond body shape and attractiveness—incentives that are more likely to motivate long-term, healthy lifestyle changes. These types of conversations may take a variety of forms, depending on the characteristics of the individual. Below are suggestions for possible conversation starters:
- What have been your favorite ways to be active or eat healthy throughout your life? Have you ever had any goals related to those activities (like joining a sports team, taking a healthy cooking class, growing your own vegetables, participating in some sort of physical competition or recipe contest)? What goals could you make now?
- Can you recall specific times in your life when you’ve just moved your body because it felt good (like dancing to a favorite song or taking a bike ride on a nice day) or because it’s the only place you wanted to be (like walking through autumn leaves or playing with a child at the park)? What similar things could you incorporate into your life to add more enjoyment to your days?
- What whole, fresh, natural foods do you already enjoy? How could you add more of these into your life?
- Is there any activity you’ve always wanted to try? What about a new food or recipe? Where could these fit into your life now?
- Is there anyone close to you who may want to partner with you in your healthy changes? What could you start doing together?
- Are you strong enough to perform your day-to-day activities at home and work? For what things would you like to be stronger? What kinds of activities may help?
- Do you experience any pain on a daily basis? Have you noticed that certain types of activity or eating habits help with the pain? How can you fit those activities/habits into your current lifestyle?
- Are you satisfied with the amount of energy you have throughout the day? Have you noticed the impact of certain activities or food choices on your energy levels? What changes could you make now to increase your energy?
One other piece of behavior change is self-efficacy. For individuals to feel motivated to make a change, they must feel confident in their ability to do it. Thus, identifying barriers to healthy behaviors, such as physical limitations or competing demands on time, helping to keep individuals’ action plans realistic and achievable, as well as providing encouragement, also should be part of the conversation (Teixeira, Carraça, Markland, Silva, & Ryan, 2012).
Changing societal values, challenging people’s long-held beliefs connecting physical appearance to health and fitness, and ultimately motivating healthy behaviors, would be quite a feat. However, with the right scripts, we can chip away at these goals one conversation at a time.
Are you a fitness instructor, a personal trainer, a health coach, or another health professional? Or, are you someone who simply wants to be more physically active or to eat healthier but who has always focused on weight loss? Move your body in ways that feel good to you. Eat a variety of whole, fresh foods that taste good. Why? Because being active and eating well make life better.
What do you think about these messages, this mindset? Try it on, see what happens, and let us know.
Nikki Elbertson is the training manager for the Yale Center for Emotional Intelligence. For over a decade at Yale, she has contributed to the design and publication of research focused on the development, implementation, and evaluation of social, emotional, and health interventions. She is a certified group fitness instructor, personal trainer, and health coach, and the co-author of several articles, papers, and book chapters.
Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2010). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 1-25.
Ogden C. L., Carroll, M. D., Kit, B.K., & Flegal K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311, 806-814.
Rollnick, S. & Miller, W.R. (1995). What is Motivational Interviewing? Behavioural and Cognitive Psychotherapy, 23, 325-334.
Segar, M. L., Eccles, J. S., & Richardson, C. R. (2011). Rebranding exercise: closing the gap between values and behavior. International Journal of Behavioral Nutrition and Physical Activity, 8, 1-14.
Teixeira, P. J., Carraça, E. V., Markland, D., Silva, M. N., & Ryan, R. M. (2012). Exercise, physical activity, and self-determination theory: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 9, 1-30.