Georgine Leung

© BRITISH NUTRITION FOUNDATION 2012

Georgine LeungBehaviour change


In this presentation, we will look at:

-10 key facts for behaviour change;-factors which affect behaviour change;-resources to support behaviour change.


Background

Current obesity rates: 1 in 4 adults in the UK are obese.

A wide range of variables have been identified to influence obesity.

It is very complex to reverse the obesity epidemic and important to look at a solution ‘across the board’.


The obesity system map

Foresight, 2007


1. Before trying to change behaviour it is vital to try to understand the nature of the behaviour you want to change in a real-life context.


2. The characteristics of healthy eating and physical activity behaviours are quite different; healthy eating involves being able to restrain and hold back our natural preferences for energy dense foods, while increasing physical activity involves more proactive ‘doing’ behaviours. This needs to be taken into account if trying to change both behaviours in a single intervention.


3. When talking to people about their behaviour, health professionals need to listen, eliciting what is important to that person in relation to the behaviour in question and what they think about the potential for change. When they are ready they can then be encouraged by the health professional to define their specific goals for potential change.


4. How much a person talks positively about changing behaviour can predict actual behaviour change, as can the level of empathy in the health professional. Motivational interviewing techniques can be used to encourage this ‘change talk.’


A) HP: If you did morephysical activity itwould be good foryour weight.

Patient: You don’t understand, Isimply don’t have time.

B) HP: If you did decide todo more physicalactivity how mightyou benefit.

Patient: I know I’d lose weightand I’d feel moreenergetic too.


5. Obesity can be defined as a chronic relapsing condition. Weight loss produces physiological changes in the body which tend to push individuals to regain the lost weight. The behaviours required to successfully maintain weight loss are different to those needed to lose weight and include high levels of physical activity and low levels of TV watching.


6. There is a large emotional component underlying obesity and weight control. Emotional support needs to be part of weight loss interventions in order for them to be successful.


7. Development of taste preferences begins very early in life during breast feeding and weaning into early childhood. Children who have not developed ‘taste bridges’ from our innate preferences for sweet, energy dense foods to non-sweet nutrient-rich foods with a lower energy density (e.g. vegetables) can struggle to develop healthy eating patterns. However, although it is ideal to establish healthy eating patterns during early life, all of childhood can be a window for change.


8. Adults make about 200 decisions about food each day but only a small proportion of these are under conscious control (14 on average). This means that interventions that encourage change on a conscious level will be limited by the fact that so many of these choices are made on an unconscious level.


9. It is important that those in the fields of physical activity and nutrition science also involve psychologists when planning strategies to change behaviour.


10. The threat system in the brain, which is designed to protect us from potential harm, can dominate and lead to unhealthy self-criticism and low self-esteem, hampering attempts at behaviour change. Encouraging a more compassionate approach to oneself and learning to deal positively with failure can help to alleviate negative, self-critical feelings which prevent change and support healthy behaviour change.


Supporting resources

Interviews with conference speakers available at:

www.nutrition.org.uk/nutritionscience/behaviour/behaviour-interviews

Panel discussion available at:

www.nutrition.org.uk/nutritionscience/behaviour/behaviour-discussion


SOCIAL

More Less Help from professionals – talk to your GP or join a reputable weight loss group

Community activity – get involved with a local sports activity

Family activity – set aside time for a family activity

Feeling time-poor – combine activity with everyday errands e.g. walking to the shops or part-way home from work (15 minute walking at a moderate pace burns approx. 60kcal)

Inactive leisure time – have a ‘screen free’ evening every week

Isolation - get friends involved in a regular activity (e.g. 30 mins of bowling can use 100kcal)


PSYCHOLOGICAL

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Food literacy – find out about diet from responsible sources: e.g. NHS choices, BBC health, the British Nutrition Foundation

Conscious control - keep a diary of your weekly diet and exercise

Realistic goals and targets - set daily goals (10 mins walk can use 35 kcals)

Stress – de-stress with a walk, jog or exercise class

Going it alone – involve friends, family and colleagues in your activity and healthy eating goals

Emotional eating - keep healthy snacks with you, so you’re not tempted by high fat snacks (can save 160kcal)


EATING AND DRINKING

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Eating slowly – pause between mouthfuls to chew and enjoy

Low energy density foods – at least two thirds your plate should be plant foods (can save about 400kcals per meal)

Big portions – don’t eat straight from large packs, measure out small portions of foods like crisps or biscuits (can save 130kcal)

Ready-made foods – don’t rely on ready-meals, double what you cook from scratch and freeze half

Excessive food restriction - have a little bit of what you fancy each week


PHYSICAL ACTIVITY

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Activity at work - walk around the office at least every hour (can use 120 kcals)

Using active transport - check if your workplace supports bike loans or cycle-to-work schemes (30 mins of cycling can use up 290 kcals)

Sedentary activities – spend more time outdoors (gardening can burn 260 kcals an hour)

Long periods of sitting - hide the remote control and get up to change TV channels (can burn 15 kcal over an hour )

Sedentary parenting - lead by example and get kids moving (playing with children can burn 140kcal in 30 mins)


OUR ENVIRONMENT

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Places to be physically active - check out your local leisure centre (aerobics burns up to 400 kcals an hour)

Physically active society - start a group at work to get active

Cost of physical exercise – go for a run or take a neighbour’s dog for a walk, both are free!

Sedentary work – have at least one ‘active lunch time’ a week , take a walk or an exercise class

Motorised transport – drive half-way and walk the rest, or take the bus and get off one stop early


PHYSIOLOGY

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Fighting hunger pangs - choose high protein and high fibre foods as part of meals: lean chicken or fish; wholegrain bread or brown rice

Body muscle - try a few sit ups or push ups each day (use 160 kcal in 15 mins)

Healthy pregnancy and infancy – be aware that what you eat and drink is being fed to your unborn baby too

Tendency to be inactive – don’t accept that you’re not an active person, be determined and make a few small manageable changes every day

Measuring health by weight – use a tape measure to keep a check on your waist size. Build physical stamina and fitness too

Lack of sleep - try going to bed half an hour earlier each weekday


MEDIA

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Support from on-line communities – get involved in a forum that interests you

Web-based weight-loss resources – try a reputable on-line weight loss resource that helps you track your progress

Active gaming - choose active video games not sedentary ones (can burn 130 kcals in 30 mins)

Excessive TV time – make a list of a few shows you want to watch and stick to only those

Positive self-image – remember nobody looks like the pictures in magazines – not even the models themselves most of the time!


To download, visit: www.nutrition.org.uk/healthyliving/behaviour/behaviour-change-and-obesity


British Nutrition FoundationHigh Holborn House52-54 High HolbornLondon WC1V 6RQTelephone: 020 7404 6504Fax: 020 7404 6747Email: [email protected]: www.nutrition.org.uk www.foodafactoflife.org.uk

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Georgine Leung