Developing a plan for lifestyle change: A case study

Last week I went over the 5 things that a person should have when beginning to implement a Paleo diet. One of those things, and likely one of the most important, is a solid plan.  In this blog I will go over how I helped a client develop one of these plans and some strategies we used to get her on her way to living a healthier.  Below the steps of our plan, I'll use italics to define the thought process I used to come up with them.  I have changed her name to protect her anonymity.

Vicky is 38 year old stay at home mom with a very busy lifestyle.  She drives all of her kids to school and since the schools all start and end at different times and they are all in sports, she is constantly picking someone up or dropping them off.  Her diet is a Standard American Diet based on convenience and snacks all day long, but she doesn't mind spending a little time cooking meals.  She doesn't, however, like eating vegetables, especially cooked ones.  Other than that she will eat pretty much anything.  She states that she feels she gets enough physical activity rushing around taking the kids everywhere, she is just looking for an exercise program to help her burn off the 20 lbs she has put on over the past 2 years.  She has done P90x, Insanity, and T25 and has a history of mild shoulder issues.  She has Type 2 diabetes and gets IBS occasionally when she eats raw or undercooked vegetables.  She is completely cleared for exercise, but her movement assessment showed her to have insufficient flexibility and poorly working glutes.

1)Eat at least 1.5 cups of vegetables at every meal

After further discussing her distaste for vegetables, I learned that she doesn't like the texture of cooked vegetables.  She was instructed to begin making her 1st and 2nd meals the day before and place them in the fridge.  While she didn't like the texture of cooked vegetables, refrigerated ones were fine.  Since we started, she has begun eating more vegetables and the diversity in her diet is growing.

 

2)Remove grains, legumes, and dairy from the diet

Vicky's IBS and Type 2 diabetes lead me to believe she has a problem in her gut.  Grains, legumes, and dairy all contain proteins that humans don't digest very well, leaving protein to interact with the bacteria in the gut and potentially cause GI distress(I discussed this here).  I instructed her to remove these things from her diet for at least a month to see if that would help with either condition.  After 4 weeks both issues had improved greatly and she decided to limit her exposure to these foods.

 

3)Begin tracking your activity

I had Vicky purchase a Fitbit activity tracker and wear it for 3 days to get an idea of how much physical activity she was getting.  I told her not to worry about trying to get as many steps as possible because I wanted to see how active she was previously, which turned out to be about 60% of what she should be doing.  I told her to begin working to get more steps and to track her progress with the Fitbit.  She should increase her daily average by 1000 steps each week until she averages 10,000 per day.

 

4)Begin foam rolling and stretching 3 times per week

While Vicky wanted to jump right in on an intense training program, I informed her that this would be a bad idea.  Her lack of mobility and proper glute firing indicate that the activity she wanted to engage in would be detrimental to her goals at this time.  To get her ready for more intense exercise, we are working to restore proper movement mechanics by increasing her mobility and strength in the areas where she needs it.  While she wanted to dive right in, I made her realize how this would negatively impact her progress.  She was happy to hear that she could still see substantial progress towards her goal by simply being on her feet more and getting 10,000 steps per day in addition to changing her diet.  I informed her that this would be better for her goals down the road because when she plateaus we can add in more intense activity when it is safer.

Conclusion

Vicky's problems are very similar to those I see often, but it isn't the solution to the problems that is important.  The fact that she is addressing them and has a solid plan of attack to tackle her own personal hang ups when they come up is what is important.  Having general guidelines isn't helpful because they allow wiggle room which leads to making decisions that compromise attaining your goals.  While Vicky didn't all of a sudden begin following all of these letters to a T, she knew when she was doing something that would compromise her goals and that gave her a level of satisfaction, even if she did cheat from time to time.  There were other issues we had to address but the specific issues don't matter, we identified her strengths and weaknesses and developed a plan that used her strengths to help overcome her weaknesses.  Even if you can't completely solve the issues, realizing that they are there can allow you to avoid situation where they come up.

How to lose weight the Synergy Wellness way: Part 8: Mapping your quest

During the initial assessment I have with clients, most of them rate losing weight as one of their biggest life goals.  It only makes sense that they would list this in the top 3 since most of them are coming to me to lose weight, so this doesn't take me by surprise.  Their response to my next question, however, never ceases to amaze me.  When I ask them how they plan to do that, very few people ever have a specific answer.  While they know they want to lose 20lbs, they have absolutely no idea what they are going to do.  Sure, the standard answer of exercise more and eat less may come up, but how do they plan to do that?  Those aren't specifics, and most people are terrible at following general advice without specific parameters because it doesn't give them direction.  Let's take a look at how to properly set out on your goal to lose weight.

Breaking down goals

If one of your goals was to go on a vacation this year, you would have to do far more than just proclaim you want to go on a vacation this year.  How are you going to pay for your vacation?  Where would you like to go?  What time of year do you want to go?  How are you going to get there and back?  These are all very good questions that need to be answered in order for you to take that vacation. Sure, you've set your initial goal of going on a vacation, but once you do that you need to script the critical moves to actually be able to go on your vacation.  Most people understand this when looking at taking a vacation, why would planning for weight loss be any different?  Sticking with the vacation analogy, let's look at scripting the criitical moves to taking a vacation.

First, let's pick a destination.  I am a fan of warmer climates and the beach, so let's go to the beach.  Being in New Jersey, I have access to the beach and nice weather here from May to September, but I'd like to get out of town.  Since I normally get a little bit of cabin fever during the mid-winter months, I'd like to go somewhere that's warm and has a beach during late January or early February.  I will obviously have to fly wherever I want to go so that will be my mode of transportation.  I could go further with this analysis but it's not necessary.  As you can see, as I begin to script the critical moves the pieces fall in to place.  I have specifics and I can work with those specifics to get the plans to my vacation set.  My plans are falling in to place and I have narrowed down all of the general parameters in to specific critical moves that I can use to attain my goal.  I have a plan, let's set it in to action.  Let's see how a similar plan may develop for someone trying to lose weight.

Scripting the critical moves

Let's assume your goal is to lose 30 lbs in 4 months.  What do you think keeps you from attaining this goal?  Given that I get a good look in to many of the factors that prevent people from losing weight, let's make a fictional person with most of these problems.  First off, let's say you normally skip breakfast because you wake up late, drive 45 minutes to work, sit for 3 hours, have a tiny lunch, sit for 4 more hours, drive home in heavy traffic for 45 minutes, and finally get home to gorge on a huge dinner because you feel like you're starving, plopping on the couch for the rest of the night.  Despite a large dinner, you normally end up eating a carb heavy snack right before bed.  Let's script the critical moves within the framework we've laid out over the last 7 blogs to learn how to lose weight.

1)Begin eating breakfast so that blood glucose levels remain stable and you don't eat so much at dinner.
2)Listen to something funny during your commute to and from work to lower stress.
3)Find ways to organize your work so you can get up and move throughout the day.
4)Have a filling lunch.
5)Make a habit of going for a walk after dinner to increase physical activity and prevent the boredom associated with sitting on the couch that can lead to snacking.
6)Make a rule that you don't eat anything after dinner.

This is a pretty good start and scripts most of the critical moves.  There is not a significant amount of detail in the six moves we laid out, but there is enough detail to determine whether you are being successful at accomplishing them or not.  One of the biggest problems with being too vague about your moves is that it normally leaves wiggle room.  Trust me; if you leave wiggle room, you'll wiggle your way right out of accomplishing your goals.  Merely saying you're going to be "good" on your diet and exercise is too subjective to be an effective move.  In addition, having moves this vague may lead you to overvalue the progress you are making and cause you to "celebrate".

Your critical moves should be process moves, they shouldn't be weight targets.  Process moves are specific changes you are going to make to get you from point A to point B.  Notice how there is no mention of specific weight targets you want to hit.  Most people feel that a good plan would be to set weight numbers you want to hit each week, but this is a mistake because you are paying attention to numbers ather than what is getting you those numbers.  First off, if you set the target based on the final goal of losing 30lbs of weight in 4 months, the logical step is to say you need to lose about 2lbs per week.  The problem with this is that people who lose more will reward themselves with something that will tend to work against their long term goal.  Secondly, most people don't realize that progress is fast in the first few weeks then slows down considerably thereafter.  This means that while it will be easy to hit your numbers early on, later on you may regret giving up the extra progress you made early for a little bit of instant gratification.  Finally, our goal is to lose fat because water weight normally fluctuates with carbohydrate content and hydration status.  If you lose 5lbs of weight in the first week, most of this will not be long term weight loss, it will be water weight that will just fluctuate throughout the 3 months.  Even if you are using a scale that monitors body fat, they are far too inaccurate and swayed by hydration levels to give you a good idea of how much fat you are losing.  By sticking to process moves rather than weight targets, you can get a firm idea of whether your moves are getting you closer to your goal.

Implementing your moves

When making changes, especially major lifestyle changes, it's good to implement change in an incremental fashion.  Rather than changing every aspect of your lifestyle in one swoop, go after the low hanging fruit first.  Maybe your first move is to take a 30 minute walk after dinner every night since it's pretty easy to accomplish.  In addition to being one of your critical moves, it could help with a couple of your other moves.  Not only could it reduce or prevent you from snacking after dinner by regulating appetite, after a couple of days the reduced consumption of food after dinner may cause you to be hungry enough in the morning to begin eating breakfast.  Always implement moves that can help with other moves first, that way they become easier to implement as time goes by.

Once you decide the order of implementation, you'll want to come up with a schedule of implementation.  Most people love competition, so we make our implementation schedule a personal competition.  The critical moves are broken up in to 3 categories and you implement a new move every 3 days.  After you have implemented all 3 moves, you have to maintain those moves for 7 days to "graduate" from that level.  If you are on day 4 of implementing all of the level 3 moves and you mess up on a level 1 move you don't start back at level 1, but the 7 day clock on the level 3 moves restarts at zero.  You don't need to do it this way specifically, but you want to make sure it's structured in a way that is simple, keeps you engaged, and taps in to your competitive spirit.  You also want to have specific parameters for progress so you don't wiggle your way out.

Conclusion

When trying to attain a goal, whether it be to go on vacation or to learn how to lose weight, it is very important to break down your goal in to critical moves that will get you closer to reaching that goal.  Your critical moves should be specific enough to eliminate any wiggle room you may try to give yourself, and your critical moves should be process moves that are changes that will get you to where you want to be.  When trying to lose weight, most people just try to figure out how much weight they need to lose each week which is of no value if you don't know how to lose weight in the first place.  Finally, once you've identified your moves you want to look at how and when you want to implement these moves to reach your goal.  Arrange the moves in a way that makes sense and makes it easier to implement change.  Probably the best advice you can get if you want to lose weight is to make being healthy your primary goal, identify the critical moves you need to get there, set up a schedule to implement these moves, and just do it.