Great new research article from Biosocial Medicine, a very cool open source journal. Anyone who has ever worked with those trying to lose weight or get healthy know that the issue often is not knowledge but adherence.
Most educated people know what is healthy, but the problem is actually doing it. I see so many of my clients who know how to eat healthy, and know they need to come into the gym five days a week (or at least exercise five days a week), but actually doing it is where things fall apart.
The primary skills, see below, being taught are "long- and short-term goal setting, annotating incremental progress, thought-stopping, cognitive restructuring, stimulus control, self-reward, preparing for specific types of barriers, and recovery from lapses."
These would seem to be the ideal skills for use with clients, and I use many of them. Perhaps what is needed is a more focused session of training around this skills during the first three months of training.
The method is essentially a CBT intervention, but anything that works is useful. [Use of the food pyramid is crap, but any good nutrition theory would work.]Relations of self-regulation and self-efficacy for exercise and eating and BMI change: A field investigation
BioPsychoSocial Medicine 2010, 4:10doi:10.1186/1751-0759-4-10
Abstract (provisional)
Objectives: This study aimed to assess relations of self-regulatory skill use with self-efficacy for exercise and appropriate eating, and the resulting change in weight associated with participation in a nutrition and exercise treatment supported by cognitive-behavioral methods.
Methods
Adults with severe obesity (N = 95; mean BMI = 40.5 +/- 3.9 kg/m2) participated in a 6-month exercise and nutrition treatment emphasizing self-regulatory skills. Changes in self-regulatory skills usage, self-efficacy, overall mood, and BMI were measured. Relations of changes in self-regulatory skill use and self-efficacy, for both physical activity and appropriate eating, were assessed, as was the possibility of mood change being a mediator of these relationships. Indirect effects of the variables associated with the present treatment on BMI change were then estimated.
Results
For both exercise and appropriate eating, changes in self-regulation were associated with self-efficacy change. Mood change partially mediated the relationship between changes in self-regulation for appropriate eating and self-efficacy for appropriate eating. Self-efficacy changes for physical activity and controlled eating, together, explained a significant portion of the variance in BMI change (R2 = 0.26, p <>
Conclusion
Findings suggest that training in self-regulation for exercise and eating may benefit self-efficacy and weight-loss outcomes. Thus, these variables should be considered in both the theory and behavioral treatment of obesity.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
Procedure
Participants received access to a YMCA wellness center and were enrolled in a nutrition and exercise treatment based on tenets of self-efficacy theory. The exercise support portion of the treatment consisted of 6 one-on-one meetings of 45-60 minutes each, with a trained wellness specialist over 6 months (5 meetings in the initial 3 months, with thefinal meeting being a review), conducted primarily in a private office and supported by a computer program [20]. Instruction in an array of self-regulatory methods (eg, long- and short-term goal setting, annotating incremental progress, thought-stopping, cognitive restructuring, stimulus control, self-reward, preparing for specific types of barriers, recovery from lapses) was the primary focus of the initial 12 weeks. An orientation to available exercise equipment and facilities was also given. Cardiovascular exercise plans were based on each subject’s preference and tolerance, but uniformly progressed from 20 minutes at a light-moderate to moderate intensity 3-4 days per week [21].
The nutrition portion of the treatment consisted of 6 1-hour sessions over the initial 3 months [22]. They were lead by a wellness specialist in a group format of approximately 15 subjects. Examples of program components were (1) understanding macronutrients, (2) using the US Food Guide Pyramid, (3) developing a plan for meals and snacks, and (4) use of self-regulation methods. The self-regulation skills taught were similar to those in the exercise component, but focused on managing eating behaviors.
Wellness specialists were blind to the purposes of the investigation. For both the nutrition and exercise segments of the treatment, the development of self-regulatory skills and selfefficacy was emphasized. Compliance with treatment protocols was assessed by YMCA wellness administrators under the direction of a study investigator. Assessments were administered in a
private area at baseline, week 12, and week 24.
No comments:
Post a Comment