OLNEY MEDICAL ASSOCIATES – WEIGHT LOSS PROGRAM
WEEK SIX: BEHAVIOR MODIFICATION TECHNIQUES
‘Standard’ approaches to behavior modification in weight control programs
includes the following:
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Cue control (AKA, Environmental control, Stimulus control)
Record keeping
Goal setting
Let’s examine these one at a time to understand them better.
I.
Cue control
 Means controlling the cues that make you overeat
 ‘Environmental’ control means controlling your food environment, at home
and at work, to make it a safe place to eat low-calorie and healthfully.
Examples:
 (-) not leaving food out on the countertop
 (-) not bringing high-cal foods into your home that you find tempting
 (-) not going to restaurants that tempt you to overeat (buffets, ones with
limited selections of healthy foods)
 (+) making sure your ‘frig is loaded with low-cal, healthy foods you like
 (+) bringing low-cal, healthy foods with you when you leave home
What happens if we fail to control our food environment?
Failure to exert control over your environment will translate into you being at the mercy
of the exterior environment – which is geared towards selling you tasty, high-calorie food
for a profit. (Obesity experts call America an ‘obesogenic’ environment).
You will find that most of what’s for sale is over 100 calories per ounce: cheese,
crackers, fast foods, dry snacks, etc., compared to what we are trying to eat more of for
weight control (foods that are 2 to 30 calories per ounce). And every time you fail to
bring low-cal foods with you (or call ahead to make sure these are available) you will
gain or re-gain weight.
DON’T ASSUME A HEALTHY FOOD ENVIRONMENT –
CREATE ONE!
- OR CALL AHEAD TO MAKE SURE ONE IS WAITING FOR YOU!
II. RECORD KEEPING/SELF-MONITORING
Record keeping involves recording the type, quantity, and prep style of what you eat,
along with the calories – the key piece of info. The idea is to look back at the end of the
day and week to see if you’re meeting the goals you set for yourself. This helps you to
come up with solutions to various issues that may be making your intake too high.
Record keeping is a form of self-monitoring. This is generally a characteristic of adults,
who are able (as we grow from childhood to late adolescence and onward) to look at
ourselves from the outside, ask ourselves questions about our thoughts and behavior, and
make changes that are in line with our goals (“I’ve been sitting too long…I need to get up
and get some activity” [or] “I’m eating too fast..I need to slow down.”)
Other ways to use records:
 Keep track of your exercise calorie output
 Combine both food records with exercise output: if you do so, you will wind up
with a fairly precise number of calories that you need to lose weight or maintain.
 Track daily or weekly goals (for fruit and veg intake, fat, etc)
 Record how your mood relates to your eating (e.g., eating more when happy or
depressed, bored, anxious, stressed, and so on) (*)
Record keeping is NOT a ‘homework assignment’ to hand in to the ‘teacher’. So, you are
free to track fruit of whatever you feel is important to your weight.
Benefits of Record Keeping
 Studies show: keeping food records = more success with weight loss
 Same as a checkbook, but in reverse: going over = [fat] DEPOSITS! Going under
estimated calorie needs = weight LOSS!
 Never be in doubt! Record keeping is the best way to know if you will lose or
gain weight on any given day or week.
 Great way to determine if you are eating a diet low or high in calorie density
(examples: eating small amounts of food total up to hundreds more calories than
expected; or, eating large amounts of food somehow winds up being a fraction
of the calories you thought it would be)
 Allows you to manipulate your calorie intake so that you can save your calories
up for special meals in advance
RECORD KEEPING MAY NO LONGER BE NECESSARY AFTER YOU HAVE
ACQUIRED THE EATING HABITS YOU NEED TO KEEP WITHIN A
CERTAIN CALORIE LIMIT EVERY DAY.
(*) if these moods dictate your overeating, no diet in the world will keep your weight off
– you will need counseling, medication, or both.
III. GOAL SETTING
Goal setting in weight loss is important for several reasons. There are many kinds of
goals that you can set; for weight, calorie intake, attainment of certain habits, exercise
output, progress with reducing overeating for emotional reasons, and so forth. In addition,
several small-scale interim goals can (and probably should) be set.
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A main reason for setting goals is to have something worthwhile to
aspire to.
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An important reason for setting small-scale, interim goals is that
‘ultimate’ goals are too hard to imagine ourselves doing. When we break up large
goals into small, do-able tasks, we make it seem easier.
Psychologically, setting and accomplishing small goals builds our
self-esteem; make bigger, more distant goals seem easier and not so far away
Examples:
High-level goal:
Intermediate-level goal:
Lower-level goal:
Sub-goal:
“I want to lose and keep off 100 lbs.” (starting at 250 lbs)
“I can do this in a year if I lose 2 lbs. per week.”
“I can lose this much weight if I reduce my daily intake by
1,000 calories. I can do so with 1 hour of walking (500
calories) and replacing 500 calories of protein and fat in my
usual intake with 5 more servings of fruits and vegetables.”
“I can do that replacement by shopping for fruits and
vegetables twice each week and bringing some of these to
work so I don’t eat from the vending machine.”
Some advice re: behavior modification strategies:
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Behavior mod tools work great when we use them, but many people
don’t continue to in the long run.
You can advise someone that there is a very efficient tool they can
use to get a certain job done. However, if they either don’t want to work on the
job or have another tool they prefer to use, they will not take your advice.
This may be because people have a ‘self-determination’ aspect to
their nature, one in which the desire for autonomy (to lead our own lives without
being directed) takes priority over anything else – even at the expense of our
health.
In order to benefit from these tools, you have to incorporate these
into your life – meaning, making them part of yourself, rather than keeping these
at a psychological arms’ length.