Behavior Change Strategies

Behavior Change Strategies

Role of Psychology in Fitness and Wellness

• Nutritional science and behavior-change strategies are crucial for Nutrition Coaches.

• Psychology is the study of the mind and behavior, encompassing:

  • Brain functions.

  • Emotional and motivational influences.

  • Learning and reasoning processes.

• Psychology relies on qualitative inquiry, observing behaviors, and assessing individuals through communication.

• Communication involves:

  • Asking the right questions.

  • Listening to answers.

  • Observing non-verbal cues (body language, tone of voice, facial expressions, gestures).

• Psychologists study how situations affect behaviors.

• Nutrition Coaches should understand:

  • Appropriate scope of practice.

  • How and why people change behavior.

  • Signs indicating the need for referral to medical professionals.

• Psychology complements behavior change in exercise, eating behaviors, and lifestyle adjustments.

• Key strategies include motivation, education, goal-setting, behavior adoption, and lifestyle adherence.

Motivation

• Motivation drives a person to take action; it can be:

  • Intrinsic: Internal drive for competence or success; valuing the learning process.

  • Extrinsic: Driven by rewards and recognition; focusing on outcomes.

• Clients often exhibit both types of motivation.

• Motives related to food choices include:

  • Liking

  • Habits

  • Need and Hunger

  • Health

  • Convenience

  • Pleasure

  • Traditional Eating

  • Natural Concerns

  • Sociability

  • Price

  • Visual Appeal

  • Weight Control

  • Affect Regulation

  • Social Norms

  • Social Image

• Motivation involves:

  • Defining client goals.

  • Identifying behaviors to achieve goals.

  • Client valuing potential outcomes and believing in their ability to change.

• Explaining the relationship between behavior and outcome is crucial

Communication

• Communication involves delivering and receiving verbal and nonverbal messages.

• Key to effective communication is empathy, understanding another person’s feelings.

• Be a good listener

• Keys to empathetic communication:

  • Gathering information.

  • Avoiding bias.

  • Appropriate empathy level.

  • Awareness of personal actions.

• Nonverbal communication includes posture, eye contact, gestures, facial expressions, tone of voice, and body position.

• Be mindful of client's nonverbal communication and how you may affect the overall trainer–client relationship.

• Biases are preconceived opinions; avoid assumptions and gather information before forming opinions.

• Too much empathy can lead to loss of objectivity.

• It is important to understand and convey that understanding to the client.

• By becoming empathetic build trust and improve communication, which will ultimately strengthen the relationship.

Quality of Life

• Good quality of life involves physical, mental, and social well-being.

• Physical well-being: overall health and ability to perform daily activities.

• Mental well-being: self-esteem, body image, and positive feelings.

• Social well-being: personal relationships and support.

• Quality of life should be a motivator for behavior modification.

• Monitor quality of life to determine the effectiveness of behavioral change.

Stages of Change Model (Transtheoretical Model)

• Focuses on individuals valuing the outcome of changing behaviors.

• Includes Precontemplation, Contemplation, Preparation, Action, and Maintenance.

• Employ specific strategies at each stage.

• Precontemplation:

  • Client is unaware of the need to change.

  • Focus on supportive environment and dialogue initiation, discuss benefits of losing weight.

• Contemplation:

  • Interest in changing but no specific steps taken.

  • Help prioritize behaviors, discuss motives, and identify barriers.

  • Assess food preferences, habits, and past attempts at dieting.

  • Reinforce benefits to change behavior.

• Preparation:

  • Firm plan established.

  • Find healthy recipes, create grocery lists, identify lower-calorie options.

  • Prepare for barriers and strategize reactions.

  • Account for time needed to implement change.

  • Be supportive, encouraging, and take small steps toward the behavior change.

• Action:

  • Accountability to changes and overcoming barriers.

  • Remaining positive and supportive will help keep the client excited about the changes and the progress being made.

• Maintenance:

  • Consistent behavior for 6+ months.

  • Address potential relapses and avoidance strategies.

  • Continue being supportive and holding client accountable.

• Relapse:

  • Focus on why the relapse occurred and get back on track.

• Match strategies to the client's stage for the best chance of success.

• The Stages of Change should be implemented for dietary modifications.

• Address other aspects of changing behavior, including self-esteem, self-efficacy, overcoming barriers and poor relationships with food, and other triggers to eating.

• Determine a person's stage by asking if he or she has ever thought about changing eating habits.

• If no, the stage is precontemplation.

• If yes, follow up with asking if they have taken any steps toward changing.

• If no steps have been taken, then they are in contemplation.

• If steps have been taken, determine if they are in the preparation or action stage.

Psychology of Body Image and Low Self-Esteem

• Variables to consider:

  • Body reality (measurable attributes).
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  • Body ideal (how people think they should look).

  • Body image (how someone perceives their body).

• Body image is not based on facts and can change based on perceptions and emotions.

• Traditionally body image is linked to self-esteem, how an individual views themselves with regard to worthiness and abilities.

• Low self-esteem and poor body image feed into each other in a negative feedback loop.

• Confidence is one’s belief in their ability to do something.

• Self-efficacy is the confidence that a person has that he or she can successfully engage in the behaviors required for a certain outcome.

• Self-efficacy is influenced by:

  • Mastery experiences (past experiences).

  • Social modeling (vicarious experiences).

  • Social persuasion (encouragement).

  • Physical and emotional responses.

Profile of a Weight Loss Client

• Weight-loss clients have varying motives and barriers.

• Personal training and Nutrition Coaching should be individualized.

• A client profile includes demographics, attitudes, beliefs, lifestyle, and personal history with weight loss.

• Determine why clients want to lose weight and how important it is for them to achieve that goal, as it is linked to how committed they are to making the necessary lifestyle changes.

• In individuals who have successfully lost weight and kept it off, the motives for doing so include health concerns, appearance, social pressure, self-esteem, improved social life, feeling physically uncomfortable, and improved energy.

• The Health Belief Model involves the relationship between a health issue and whether or not to change behavior as a means to addressing the health issue.

Real-Life Struggles

• Acknowledge real-life struggles.

• Diagnosable conditions such as food addiction or binge eating disorder need treatment from a medical professional (a physician or psychiatrist).

• Balancing work, family, exercise, and proper eating requires prioritizing tasks and behaviors.

• Controlling emotions is believed to be a large contributor to weight-loss success, as emotional eating is considered a top barrier to eating healthy.

Combating Stigma

• Anti-fat bias refers to placing a negative judgment on overweight and obese individuals.

• Reasons for anti fat bias:

  • People tend to identify with groups of people they feel they are similar to.

  • Weight is controllable and fat people simply choose to not control their weight and are, therefore, viewed as lazy.

  • An explicit bias exists where most people, regardless of their personal shape or size, generally prefer thin people.

• Anti-fat bias is associated with low self-esteem and poor body image by those who perceive it.

• Identify and acknowledge personal biases toward potential clients.

Barriers to Diet and Exercise

• Common barriers include:

  • Time constraints

  • Lack of willpower

  • Family and friends with different habits

  • Lack of knowledge or expertise
    Lack of time is a commonly reported barrier, but each have 24hrs a day and the nutrition coach should empathsize to provide support to client overcome issues.

• Barriers specific to healthy eating:

  • Strong taste preferences

  • Cost of food

  • Portion sizes when eating out

Social Influences

• Social support refers to the ways in which someone is supported by others.

  • Emotional support: Encouragement, being a good listener, and being empathetic.

  • Informational support: Informing someone with information that will assist them in making decisions

• Social networks are interactions with groups of people and can be in person or over the Internet.

• The media also influences behaviors with constant exposures to images and messages.

Willpower

• Willpower is the ability to control impulses.

• For those who indicate they are challenged by willpower, they need to be coached regarding how to overcome the need for the instant gratification they get from eating certain foods.

• One way to combat lack of willpower is to minimize exposure to foods and situations that make it difficult to stay on track.

Eating Behavior

• Eating behaviors can be defined on a spectrum that ranges from positive behaviors and healthy outcomes to negative behaviors and unhealthy outcomes.

• When eating behaviors result in poor nutrition or compromised health, it may: chronically under-eating, over-eating, binge eating, not consuming enough high- quality foods.

Disordered Eating

• Disordered eating: abnormal eating patterns that do not meet the criteria for diagnosis of an eating disorder.

• A major underlying concern of disordered-eating behaviors is that they can develop into an eating disorder, which can have serious health consequences up to and including death.
  Triggers to Disordered Eating Stress, depression, environment and situations to psychological challenges.

• Distress is a known trigger to eating and it has been demonstrated that when individuals are faced with a stressful situation, such as not being able to solve a problem, they consume more high-calorie, unhealthy foods.

• Depression is a mood disorder characterized by a persistent feeling of sadness and loss of interest in everyday life.

• A health-and-fitness professional should never attempt to diagnose or treat a client with depression.

Eating Disorders

• Disorders such as anorexia nervosa, bulimia nervosa, and binge-eating disorder can only be diagnosed by a qualified medical professional based on the DSM-V criteria.

• Anorexia nervosa: intense fear of fatness, distorted body image, and restriction of calories, bulimia nervosa: recurrent episodes of binge eating followed by inappropriate compensatory behaviors (e.g purging, laxatives, diuretics, fasting, excessive exercise)

• Warning Signs:

  • Noticeable changes in weight (increase or decrease)

  • Muscle weakness

  • Feeling dizzy on standing

  • Dressing in loose clothing to hide weight loss

  • Reports of not sleeping well

  • Becoming overly concerned about calories, carbohydrates, fats, or specific foods or food groups

Modifying the Eating Environment

• Modify approach to home environment, work environment, and social gatherings.

• Shift from mindless to mindful eating habits.