1. Precontemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

6. Termination

There are specific tasks that need to be accomplished in each stage before progressing to the next. Intervention techniques differ for each stage. Hence, coaching a person towards change or improvement entails clearly understanding where he/she is on this progression. Most often, well-meaning advice is not processed because that piece of information is geared towards a specific stage (e.g., active phase) whereas the person does not acknowledge the extent of his problem (i.e., he/she is on the Precontemplation stage). Research also shows that this is not a simple linear progression. More often than not, a person cycles repeatedly between stages, getting stuck at a specific phase without much progress.

In weight loss coaching, whether you are working with an external coach or practicing self-coaching, understanding where you are (and knowing the appropriate “intervention” for each stage) is the key to success.

“Why go to a lot of trouble, and use a lot of time and energy, just feeding the body? By keeping foods and meals simple and easy, the tasks may be so shortened that there is little labor involved. Keep frills and fanciness to a minimum. Keep fundamentals in the foreground. Try to get the most nourishment for the least effort. Learn what foods the body requires – the vitamins, minerals and proteins for good functioning. Find the natural right diet and stick to it.”

“I believe the work of feeding people could be simplified to such a point that it would take less time to prepare a meal than to eat it, whereas now it is usually the other way around. Perhaps that might be the test for rational eating. If you eat for half an hour, or an hour, put only that much (or less) time into preparation; no more. Then you would be closer to living simply on simple food.”

“. . . Eat with one dish or bowl. Eliminate all nonessentials in tools and utensils as well as elaboration in food preparation.”

“Nutritional value should come before taste value: so should economy and ease of preparation. Our menus are simple, but vary within the daily pattern; some fruit or fruit juice and our own herb tea for breakfast; a hearty vegetable soup, with boiled grains, peanut butter, honey and apples for lunch; a big salad, some cooked vegetable from the garden and a fruit dessert for supper. Every day the soup can be different. The grain can be millet, buckwheat, oats, wheat or rye. The salad need never be the same. The vegetables vary with the season. Our dessert can be any of many fruits, raw or cooked. But the general pattern remains, so that the diet is uninvolved and the preparation uncomplicated.”

I really like this approach to eating, food choices, and food preparation. It’s all about simplification of process and minimizing our attachment to sensory stimulation. Its really about developing habits that limit and simplify the strategies and activities for nutritional excellence.

I believe that an effective strategy doesn’t have to be complicated. One can develop a working pattern (e.g., a “daily menu” that one sticks to) and still have the variation within that system to prevent boredom (which can backfire) and to ensure micronutrient diversity and coverage.

One of my new clients has been running 5 days a week for 45 minutes to an hour for about a year, before he approached me for help. He wanted to build more muscle, and control his blood sugar.  In my initial meeting with him it appeared that his diet was a little bit off. We tweaked this a little bit. I also gave him a fifteen minute dumbell workout (20 lbs each) that he did 5 days a week.

Six weeks later, he called me and reported that he lost 16 pounds (he’s now 135 pounds on a 5′6” frame), and most importantly also lost two inches off his waist. He’s extremely excited because his six-pack abs is in sight. Most importantly, his blood sugar is now normal – with no medication — simply from the slight diet modification and weight training routine I gave him.

Moral of the story: A high nutrient diet, plus an intelligently designed weight training program can really turbo charge your health and weight loss goals.

Exercise did not significantly changed the levels of low-density lipoprotein (LDL cholesterol). Duration and intensity of exercise did improve levels of high-density lipoprotein. Low amount/moderate intensity exercise significantly lowered levels of triglycerides, which is correlated to a person’s risk for diabetes and heart disease.

I think that “intense” exercise (e.g., interval training) has its role in a well-balanced fitness program. It increases a person’s anaerobic energy system, and creates a margin of safety from a functional standpoint. IMHO, one is better able to handle the occasional physical stresses in daily life much more effectively. Strength training would also be a necessary component in creating an optimal exercise routine.

The research indicates that even half hour of walking done three time as a week has some effect of pressure and waist/hip measurement to affect the risk factors related to cardiovascular mortality.

Personally, I think it all comes down to creating a positive habit of engaging in even mild to moderate exercise on a daily basis. I think it’s easier to form daily rituals compared to a “3 to 4 times a week” exercise routine. It’s better to pick a modest goal, of say 15 to 20 minutes brisk walking on a daily basis, then stick to it for a few months. Only when this ”minimum habit” is solidly in place can one then think of increasing intensity and/or duration.

Watch your thoughts, they become words.

Watch your words, they become actions.

Watch your actions, they become habits.

(To this we can add:

Watch your habits, they become who you are. Weight loss, health, and fitness is really just a matter of structuring our actions consciously and consistently so that we develop habits that create a healthy life

• processed foods
• sweets, and other “foods” containing sugar
• white bread and pasta (substitute whole-grain varieties instead),
• foods with a high percentage of calories from fat,
• alcoholic drinks.

In this approach you simply become more conscious of those items that change you body and brain chemistry, more aware of controlling portion sizes, while simultaneously adding more vigorous exercise (a total of 2 to 3 hours a week) to the mix.

In this moderate, “sensible,” watch-what-you-eat approach, you gradually replace poor food choices with healthy ones. You’re likely to decrease overall caloric intake, and with the addition of regular cardio and strength exercises several times a week, you’ll naturally enter into a caloric deficit.

In my opinion and experience, this conservative approach could be effective in slightly overweight people wanting to lose around 5 to 10 percent of their body weight. There is a tremendous payback for this strategy, since even a 10% loss of excess fat (especially if it’s in the abdominal area) yields tremendous health benefits.

Dr. Roth. If I understood you correctly, a lipid load in the duodenum reduces subsequent meal size.
Dr. Schwartz. Correct.
Dr. Roth. So, I don’t mean to be flippant, but it strikes me that if you started every meal with a shrimp tail and a handful of macadamia nuts, perfect Atkins strategy, and waited 20 minutes to load your duodenum, you would reduce subsequent meal size and enhance the efficacy of the diet. These are Atkins maneuvers that would be perfectly reasonable, and now you make a scientific rationale for reducing subsequent meal size.
Dr. Schwartz. In rodents, protein and fat infusions in the duodenum are much more efficacious in reducing subsequent food intake than equally caloric loads of carbohydrate. They are also particularly good secretogogues of CCK. So mechanistically speaking, it’s not unreasonable to imagine that preconsumption, if you will, increases the availability of nutrient secretogogues of the satiety peptides that are mechanistically important in regulating the subsequent meal size.
Dr. Feinman. Do carbohydrates, more particularly sucrose, have an effect? In particular, would vagal stimulation be repressed by the presence of sucrose?
Dr. Schwartz. An individual macronutrient may have different behavioral and neural effects at different gut– brain sites. At an oral site, it has been shown that sucrose can promote the release of dopamine in the forebrain nucleus acumens, part of the neuranatomic basis of reward. Duodenal infusions of carbohydrate solutions can promote increases in vagal afferent activity, yet these infusions also reduce subsequent meal size.”

You got to admit, that’s pretty good stuff. How do you apply this bit of knowledge if you have a tendency to overeat?

One can eat a small handful of mixed nuts (e.g., 10 grams of almonds & walnuts) prior to a main meal take the edge off. I suggest drinking cup of plain hot tea with it. Then wait for 10 – 15 minutes, after which one can proceed with the rest of the meal. The calories would be minimal — about 60 calories, but it would definitely help manage one’s hunger after a long day at the office.