Ch 14: Psychology of Weight Control and Behavior Change Flashcards
The study of the mind and behaviors; How Motivations and Emotions influence behaviors;how individuals learn and reason
Psychology (exercise psychology, sport psychology, and health psychology)
Focuses on variables that can be directly measured and assessed.
Quantitative Research
Focuses on people in terms of how situations and experiences are perceived and how people interact and utilizes interviews and observations where the results are grouped together by themes that have emerged.
Qualitative Research
Communication is an important aspect of psychology as the right questions need to be asked, answers need to be heard, and non-verbal cues need to be observed (such as body language, tone of voice, facial expression, and gestures).
Behavior Change and Psychology
Psychology compliments behavior change across several health and fitness areas, including exercise, eating behaviors, and other health-related lifestyle adjustments. Many of the strategies used in one area can easily be applied across disciplines.
Changing any behavior
There has to be motivation, education, goal-setting, adoption of new behaviors, and adherence to a new lifestyle.
Most important role as their nutrition coach
Good Communicator; listen, educate, and support
Active Listening
Try paraphrasing what the speaker has said and ask for confirmation that you have received the correct message
Influencing someone to change their habits
Education and Proper Motivation
Reasons that drive a person to take actions
Motivation
Rewards and Recognition
Extrinsic Motivation
Internal drive to be competent or successful, these people are fulfilled when they master a skill or behavior change
Intrinsic Motivation
Why People Eat What They Do
Liking, Habits, Need and Hunger, Health, Convenience, Pleasure, Traditional Eating, Natural Concerns, Sociability, Price, Visual Appeal, Price, Weight Control, Affect Regulation, Social Norms and Social Image
First Step in determining Motivation
Clearly define the client’s goals
Steps in determining motivation
- Clearly define the client’s goals
- Identify all behaviors that will accomplish the goals.
- Client must value the potential outcomes and believe that changing their habits will accomplish their goals
Explain the relationship between a behavior and a specific outcome
When someone identifies with another person’s feelings, attitudes, or thoughts. A simple way to describe itis the ability to put yourself in someone else’s shoes.
Empathy
- Starts with being a good listener
- Being able to correctly interpret what people are saying as well as what their body language is indicating
Keys to being an empathetic communicator
- Gathering information
- Avoiding bias
- Having an appropriate level of empathy
- Being aware of personal actions
Opinions people have that are preconceived or unreasonable and are typically described as stereotypes
Biases
- One way to avoid bias is to not make assumptions about people or situations. This goes back to gathering information before forming opinions
Nonverbal Communication
Posture, eye contact, gestures, facial expressions, tone of voice, and body position
Involves overall physical, mental, and social well-being
Quality of Life
Mental well-being
Self-esteem, body image, and the amount of positive versus negative feelings
Benefits of healthy eating related to quality of life
Weight loss, weight control, improved physical functioning, increased energy, and overall mental well-being
Common component of theories and models that describe how people go about changing their behavior
Focus on the outcome from changing behavior(s) being valued by the individual
Transtheoretical (Across Theories) Model
Stages of Change Model
Stages of Change Model
- Precontemplation Stage
- Contemplation Stage
- Preparation
- Action
- Maintenance
- Relapse
Stages of Change Model: Relapse
Reverting to previous behaviors
- Identify to which stage the client has regressed and coach them back to maintenance
Stages of Change Model: Precontemplation
When an individual is not thinking of changing , has no intention on changing, not ready to change. It is during this stage that a call to action may occur
Stages of Change Model: Contemplation
When an individual is likely aware of the benefits associated with changing the behavior.
- They may be thinking of implementing the change, but has not yet thought about how to go about it
Stages of Change Model: Preparation
When individuals are actively taking steps to prepare them to finally take action.
- In theory, this should be quick
- Defined as the intent to take full action within 30 days
Stages of Change Model: Action
When the behavior is finally happening, but has not lasted for 6 months
- At this stage, clients are particularly vulnerable to barriers and setbacks
- Will need continuous Monitoring, Support and Encouragement
Stages of Change Model: Maintenance
when the behavior has been consistent for 6 months without Relapse or Setback
- Leads to a Stable Lifestyle
Strategies: Precontemplation Stage
The Nutrition Coach should focus on creating a supportive environment to start a dialog about behavioral change. This should include discussing the many benefits of losing weight, including improved health and overall quality of life, finding out what the client knows about the process of losing weight, and discussing the negative impact that not changing eating behaviors will have on long-term health and quality of life.
Strategies: Contemplation Stage
The Nutrition Coach should focus on helping the client determine which behaviors need to be changed and prioritize them. This is a time to discuss motives to change and also identify potential barriers. Also, assessing things such as food preferences and current daily habits (including work schedule, eating schedule, leisure time, etc.) and understanding any past attempts at dieting. By gathering information during the Contemplation stage, a personalized approach can be designed. Throughout this stage, the Nutrition Coach should reinforce the overall benefits to changing behavior.
Strategies: Preparation Stage
A firm plan should be established in terms of exactly how the client will change behaviors. This can include finding healthy recipes to try, creating grocery lists, and identifying lower-calorie options at favorite restaurants. Preparing for potential barriers and strategizing about how to react to them when they arise is key in the Preparation stage.
This is also a time for small steps to be taken by the client toward the behavioral change. Because the client may not be very confident in their ability to successfully change, it is also a time to be supportive and encouraging
Strategies: Preparation Stage
This is a time for accountability to the changes being implemented and also helping them overcome barriers as they are encountered. Remaining positive and supportive will help keep the client excited about the changes and the progress being made and increase their confidence.
Strategies: Action Stage
It is an important time to address the possibility of relapses and how to avoid them. Continuing to be supportive and holding the client accountable to the behaviors will help reduce the chance of a relapse back to old habits
Strategies: Maintenance Stage
How an individual views themself with regard to their worthiness and abilities.
Self-Esteem
The confidence that a person has that he or she can successfully engage in the behaviors required for a certain outcome.
Self-Efficacy
How to start the Stages of Change Model
Start by determining which stage a person is in by first asking if he or she has ever thought about changing eating habits. If the answer is no, then the stage is precontemplation and a call to action will need to occur to move the client to contemplation. If the answer is 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. Making lifestyle changes is not black and white and it is possible for some action to be occurring while preparation for future changes may be underway. No matter which stage a person is in, it is likely that accurate information and support are both needed by the client.
Based on a person’s measurable attributes such as height, weight, body-fat percentage, and waist circumference.
Body Reality
Refers to what a person believes or wishes their own body looked like.
Body Ideal (National Eating Disorder Association)
How someone perceives his or her body to look, which may not be how the person actually looks.
Body Image (Tied to Self-Esteem)
How an individual views themselves with regard to their worthiness and abilities
Self-Esteem
A feeling about or a belief in one’s abilities or attributes.
Confidence
Confidence In terms of healthy eating
Comes from believing in one’s ability to make the right decisions about food intake at home, work, social gatherings, and restaurants. Low confidence is problematic regarding eating behaviors because it can lead to making bad decisions on a daily basis. Additionally, having high levels of confidence in the absence of accurate and credible information may also lead to poor decisions.
Self-Efficacy Influence
Self-efficacy has a strong influence over what a person chooses to do, how much effort will be put into a given behavior, and how much a person remains committed to a behavior, especially when faced with challenges
Levels of Self-Efficacy Variables
Mastery experiences (Most Influential), social modeling, social persuasion, and physical and emotional responses
When something is experienced through another person’s actions or behaviors.
Vicarious Experiences (Social Modeling)
Social Modeling
Someone else successfully models a behavior. This might mean sharing meals with people who share the same opinions and values surrounding healthy eating, which could also be considered a form of social support. Social modeling can also be simply observing someone (who is viewed as similar) engaging in healthy eating behaviors. This would translate into the positive thought, “If they can do it, I can do it!”
Verbal encouragement either from a person with credibility or status regarding the targeted behavior or from family, friends, or co-workers.
Social Persuasion. Social persuasion can be positive or negative.
In terms of increasing self-efficacy, the health-and-fitness professional has the most influence via?
Social persuasion
- Encouragement, empathy, and being positive are crucial
- Accountability
A high degree of excess body fat, a BMI greater than 30.
Obesity
Client Profile Variables
Demographics, attitudes, beliefs, lifestyle, and personal history with weight loss
Health Belief Model: Individual Perceptions
Perceived Susceptibility and Severity
Health Belief Model: Modifying Factors
- Age, Sex, Ethnicity, Personality, Knowledge Socioeconomic
- Perceived Threat
- Cues to Action
Health Belief Model: Likelihood of Action
- Perceived Benefits Minus Perceived Barriers
- Likelihood of Behavior
Reveals a lot about barriers they have faced and how the client reacted to challenge.
Failed Attempts
One aspect of the Health Belief Model that distinguishes it from other models of behavioral change
Cue to Action (describes an event that has pushed a person toward a lifestyle adjustment)
Mark of disgrace associated with a particular circumstance or quality.
Stigma
Placing a negative judgment on overweight and obese individuals.
Anti-Fat Bias
Anti-Fat Bias Beliefs
- People tend to identify with groups of people they feel they are similar to; therefore, people who are within the normal-weight range may see themselves as distinctly different from overweight and obese individuals.
- 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
Any behaviors, such as sitting or lying down, that require little energy expenditure.
Sedentary Behavior
Barriers to Diet and Exercise
1 Time constraints
2. Lack of willpower
3. Family and friends with different habits
4. Lack of knowledge or expertise
Strategies to Overcome Barriers: Time Constraints
- Prepare larger quantities of healthy meals and snacks and store in appropriate serving sizes.
- Purchase snacks in pre-portioned sizes.
- Identifying recipes that are not time-consuming and easy to prepare.
Strategies to Overcome Barriers: Lack of Willpower
Identify the types of foods and situations that are most difficult to deal with and create plans on how to overcome the lack of willpower or minimize its effects.
Strategies to Overcome Barriers: Family and Friends with different Habits
Express to friends and family what the specific goals are and how healthy eating will help achieve the goals.
Suggest social interaction that does not include food such as going for a walk.
Strategies to Overcome Barriers: Lack of Knowledge or Expertise
Seek information from credible sources and ask questions when in doubt.
Strong Taste Preferences
The cost of food, and portion sizes when eating out
- Strong taste preferences can manifest in several ways, including not liking foods like fruits and vegetables or craving sweets or fried foods.
- When preferences are available, it will be difficult to avoid eating unhealthy choices unless strategies are in place such as how to order a healthier version, limiting portion size, or choosing a healthy alternative all together.
All the ways that someone is supported by others, including emotional support, providing information, or assistance.
Social Support
Providing encouragement, accountability, or empathy to another person.
Emotional Support
Providing facts and educating others.
Informational Support
Social structure made up of various interactions or relationships between groups of people.
Social Networks
The ability to control impulses.
Willpower
- Subset of self-control and having a strong willpower to achieve positive behaviors and avoid negative behaviors will likely result in success
Negative and Unhealthy Eating Behaviors
Chronically under-eating or over-eating, binge eating, or simply not consuming enough high-quality foods
Patterns of abnormal eating behaviors that do not meet the criteria for diagnosis of an eating disorder.
Disordered Eating
The experience of negative feelings, such as anxiety, sorrow, or pain.
Distress
Disordered eating includes:
Behaviors such as binging, purging, food restriction, prolonged fasting, and use of diet pills, diuretics, and laxatives
Triggers to Disordered Eating
Environment (Social Situations) to long-term psychological challenges
Stress and Depression
A mood disorder characterized by a persistent feeling of sadness and/or loss of interest in everyday life.
Depression
Eating disorder characterized by extremely low BMI.
Anorexia Nervosa
Eating disorder characterized by recurrent episodes of binge eating followed by inappropriate compensatory behaviors, including purging, use of laxatives or diuretics, fasting, or excessive exercise to avoid weight gain.
Bulimia Nervosa
Eating disorder characterized by frequent consumption of an unusually large amount of food along with a feeling of loss of control and/or the inability to stop eating.
Binge-Eating Disorder
Binge-Eating Disorder binge eating episodes are associated with three or more of the following:
- Eating much faster than normal
- Eating until uncomfortably full
- Eating large amounts of food when not hungry
- Eating alone and feeling embarrassed
- Feeling depressed or guilty after consumption
A diagnosis would include the behavior occurring, on average, at least once a week over the past 3 months
Symptoms of anorexia nervosa
Intense fear of fatness, distorted body image, and restriction of calories
Severity of Anorexia Nervosa
Based on body-mass index, which is a height to weight ratio calculated by body weight (kilograms)/height in meters squared (m2)
Mild Anorexia Nervosa
BMI of
≥ 17.0
Moderate Anorexia Nervosa
BMI of 16.0 to 16.9
Extreme Anorexia Nervosa
BMI of 15.0 to 15.9
Extreme Anorexia Nervosa
BMI of < 15
The severity of bulimia nervosa is based on?
Frequency of inappropriate compensatory behaviors
Mild Bulimia Nervosa
1 - 3
Moderate Bulimia Nervosa
4 - 7
Severe Bulimia Nervosa
8 - 13
Extreme Bulimia Nervosa
≥ 14
Other Eating Disorders
Pica, rumination disorder, Avoidant/Restrictive Food Intake Disorder (ARFID), Other Specified Feeding or Eating Disorder (OSFED), and Unspecified Feeding or Eating Disorder (UFED). The category Eating Disorder Not Otherwise Specified (EDNOS) has been removed.
Warning Signs of Eating Disorders; When to Refer to Medical Professional
Noticeable changes in weight (increase or decrease)
Muscle weakness
Feeling dizzy on standing
Feeling cold
Dressing in loose clothing to hide weight loss
Reports of not sleeping well
Being ill more often
Becoming overly concerned about calories, carbohydrates, fats, or specific foods or food groups
Caloric restriction
Cutting out certain food groups
Having strict rules about exactly what to eat, how much to eat, and when to eat
Being obsessed with calories, body weight, or any perceived physical imperfections
Eating without attention to or awareness of the food being consumed.
Mindless Eating
Paying attention to the food being eaten, acknowledging hunger and satiety signals, and adjusting food intake accordingly.
Mindful Eating
One of the most important strategies when changing behaviors
Modifying the Eating Environment
Home Environment Challenges for Eating
No accountability for some, having a household that does not support healthy eating, or a general lack of willpower
Top barrier to healthy eating
Emotional Eating
Most influential variable over self-efficacy
Mastery experiences
Telling a client about the positive benefits of eating more fruits and vegetables
Social Persuasion
