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[View the story "#aicrchat: From ‘Knowing’ to ‘Doing’ for Weight Loss" on Storify]#aicrchat: From ‘Knowing’ to ‘Doing’ for Weight LossWhat does it take to guide people from “I know” to “I do”?Storified by · Wed, Mar 20 2013 08:58:34Love this from @elisazied: encourage people 2 think of world as a gym...#aicrchat last niteKaren CollinsEveryone needs access to affordable, hlthy food and less exposure to high calorie junk and super sized portions. #aicrchatAICR Everyone needs access to affordable, hlthy food and less exposure to high calorie junk and super sized portions. #aicrchatAICR Here's a slideshow w/wt loss tips to share w/pts. http://bit.ly/XonF9P #aicrchatAICR Good night all and keep up the great work. #aicrchatAICR Thanks to everyone for participating! Check out http://aicr.org for more info & our pubs for pts. #aicrchatAICR Here's a slideshow w/wt loss tips to share w/pts. http://bit.ly/XonF9P #aicrchatAICR I think AICR brochure "more food, fewer calories" (on calorie density) can be big help as starting pt. #aicrchatKaren Collins@aicrtweets Agreed, ultimately using an indiv approach that focuses on AICR's msg: eating less, moving more, the right foods #aicrchatSonja GoedkoopEveryone needs access to affordable, hlthy food and less exposure to high calorie junk and super sized portions. #aicrchatAICR Everyone wanting to lose wt should have access to HPs like you all! #aicrchatAICR Everyone needs access to affordable, hlthy food and less exposure to high calorie junk and super sized portions. #aicrchatAICR You all said you meet ppl where they are & help them take the next step. Whether ambitious or modest goal - move forward. #aicrchatAICR @KarenCollinsRD very true. a food can trigger a binge; resisting that food can also trigger a binge. physiology/psychology collide #aicrchatSuzanne Dixon MPH RDLots of gr8 ideas & strategies. Helping ppl lose wt - it takes hard work, motivation & environmental support. #aicrchatAICR MT @NoNutritionFear what abt "trigger foods?" Avoidance helps some, but for some the reason it's a trigger is cuz it's forbidden. #aicrchatKaren CollinsYes MT @CancerRD: We make many subconscious choices re: junk fd - imposs to always say no. @BrianWansinks work on improving odds. #aicrchatAICR @CancerRD right. knowledge (that you're being manipulated) is power. that can help. #aicrchatSuzanne Dixon MPH RDdo any of you advise people to avoid "trigger foods?" #aicrchatSuzanne Dixon MPH RDWe have to make many subconscious choices re: junk food it's impossible to always say no. @BrianWansink's work on improving odds. #aicrchatR. Brannon MS,RD,CSO7 strategies from NWCR 4 how many ppl have lost & successfully kept off. Maybe good to share w/pts.http://bit.ly/Y2beGB #aicrchatAICR @SonjaGoedkoopRD starting at home is gr8. that is within control. #aicrchatSuzanne Dixon MPH RD@KarenCollinsRD great example. don't treat your body like a garbage disposal. treat with respect by nourishing it. #aicrchatSuzanne Dixon MPH RD@NoNutritionFear I rec making changes in their own food environment (e.g. eliminating junk food in the household) #aicrchatSonja Goedkoop@aicrtweets agreed. the less you eat junk, the less appealing it becomes. it's important to break that cycle. #aicrchatSuzanne Dixon MPH RDAll the junky food? When just cuz it's there, I try to reframe as "I am not a garbage can". Fight the automatic eating at lst. #aicrchatKaren Collinshave to put ourselves in others' shoes. empathy is key. "fat bias" is rampant. people face many barriers to change. #aicrchatSuzanne Dixon MPH RDMaybe most important is getting ppl used to eating hlthier food, so less tempted by junk. Can reduce swt tooth. #aicrchatAICR Tough for me & I don't even usu like! MT @NoNutritionFear: how do you all help ppl cope w/all junky food in our faces? #aicrchatAICR Just standing more/sitting less has benefits RT @aicrtweets How abt reframing? Does it help to talk about moving more vs exercise? #aicrchatElisa Ziedhow do you all help people cope with all the junky food that is in our faces at every turn? #aicrchatSuzanne Dixon MPH RDGr8 ex. of moving frm knowing 2 doing. MT @NoNutritionFear: must combine advice on portions,etc w/ skills 2 cope w/ food envmt #aicrchatKaren CollinsHere are some ideas for finding hlthy convenience food on a budget. http://bit.ly/XomQxS #aicrchatAICR @MarylandHunger very true. must help people w/ access to good food. obesity tracks with poverty, which is not a coincidence. #aicrchatSuzanne Dixon MPH RDMT @MarylandHunger: For low-income individuals, fed nutr programs are key to addressing hunger & obesity http://ow.ly/jendA #aicrchatAICR plants nearly always win out for volume w/o calories. #aicrchatSuzanne Dixon MPH RDEmphasize that restaurant portion sizes are generally better suited to share than eat solo. #aicrchatR. Brannon MS,RD,CSO@KarenCollinsRD #aicrchat I encourage people 2 think of world as a gym, 2 do activities they enjoyed as a kid + simply move more/sit lessElisa ZiedFor low-income individuals, the federal nutrition programs are a key to addressing hunger and obesity http://ow.ly/jendA #aicrchatMD Hunger SolutionsAsk pts to measure at home on their own plates, cups, & bowls. Seems easier then remembering if it was a baseball or tennis ball. #aicrchatR. Brannon MS,RD,CSO@aicrtweets gr8 suggestion. also don't give up. try activity. don't like? try another. try again and again to find what you like #aicrchatSuzanne Dixon MPH RDYep - think of at least 2/3 plate with plant foods; 1/3 or less with animal foods. Simple & visual. Also need portions. #aicrchatAICR must combine practical advice (portion sizes, etc) with skills to cope with toxic food environment in which we live. #aicrchatSuzanne Dixon MPH RDI believe focusing on short term goals should be the emphasis. Realistic can be too subjective for some #aicrchatStephanie Harris @aicrtweets I rec changing dinner plates from 12" to 7" or 9" plates #aicrchatSonja GoedkoopMT @alisonnryan: #aicrchat Hulu, Netflix an YouTube a gr8 way to try free or low cost exercise videos at home. No weather excuses! #aicrchatAICR @aicrtweets portion sizes. "The New American Plate" #aicrchatRenee, RD, LDN@aicrtweets They work great. #aicrchatRuth Frechman@KarenCollinsRD #aicrchat I encourage people 2 think of world as a gym, 2 do activities they enjoyed as a kid + simply move more/sit lessElisa ZiedFor portion sizes - recommend cups, spoons etc or do u use visuals like handful, baseball size or other ideas? #aicrchatAICR I start w/ eating chng + activity only as tool for energy/stress. Takes pressure off "enuf" exercise to make diff in wt. #aicrchatKaren CollinsRT @elisazied: You can see portions, but not calories! #aicrchatSuzanne Dixon MPH RD#aicrchat Hulu, Netflix an YouTube are a great way to try free or low cost exercise videos at home. No weather excuses!alison ryan@aicrtweets For those who really struggle with portions I rec volumizing meals with lots of added veggies #aicrchatSonja GoedkoopRT @RuthFrechman: @elisazied @aicrtweets If they hate PA, I start with eating less. #aicrchatAICR Portion distortion pics from NHLBI often nice to show ppl why we eat so much: http://1.usa.gov/Zr8fa2 #aicrchatAICR @elisazied @aicrtweets If they hate PA, I start with eating less. #aicrchatRuth Frechman@KarenCollinsRD night eating may be tied to deranged metabolism that occurs with lack of sleep. #aicrchatSuzanne Dixon MPH RDif we let people know it is challenging, that's more honest, and may help them develop resilience and succeed #aicrchatSuzanne Dixon MPH RDwe must acknowledge how challenging this is. fad diet industry fosters unrealistic expectations: 3 easy steps to skinny, etc. #aicrchatSuzanne Dixon MPH RDYou can see portions, but not calories! RT @aicrtweets For wt loss....Do u focus on portion sizes or calories to eat less? #aicrchatElisa Zied@elisazied, you are known for move it or lose it. How do you get ppl to try new things? #aicrchatKaren Collins@aicrtweets @KarenCollinsRD @NoNutritionFear How often do you see pts first chng eating for wt loss, and incr activity l8r? #aicrchatSonja Goedkoop@aicrtweets hard to find anyone who is willing to count calories. #aicrchatRuth FrechmanAgree @SonaGoedkoopRD But my most exercise resistant pts translate "activity" as "exercise" anyway due to bad hx. #aicrchatKaren CollinsSometimes talking about movement vs. exercise is more approachable for patients. The gym can be intimidating for some. #aicrchatR. Brannon MS,RD,CSOFor wt loss, eating less is important. Do u focus on portion sizes or calories to help eat less? #aicrchatAICR I tell people "you will be thwarted at every turn b/c you couldn't design a more obesogenic enviro than US." #aicrchatSuzanne Dixon MPH RD@aicrtweets I prefer the terms "moving more" or "active" to exercise. 'Exercise' often brings about negative feelings for pts #aicrchatSonja GoedkoopHelp them find smthg they enjoy-think outside box! RT @aicrtweets How do u work w/ those who don’t like being physically active? #aicrchatElisa ZiedPpl vary. For some, reframe as activity works well. Many chronic dieters I've wrked w/ become "exercise resistant". Challenging! #aicrchatKaren Collins@aicrchat don't know if my example would inspire anyone, but having once been overweight, I feel great empathy. it's tough. #aicrchatSuzanne Dixon MPH RDSuccessful physical activity routines fit into daily life and should be fun most of the time! #aicrchatR. Brannon MS,RD,CSORT @RuthFrechman: @aicrtweets Find something that they used to enjoy doing. #aicrchatAICR @aicrtweets Find something that they used to enjoy doing. #aicrchatRuth FrechmanHow abt reframing? Does it help to talk about moving more vs exercise? #aicrchatAICR @aicrtweets if pt wants to go to a gym, helpful to have 1-2 sessions with a trainer to get ideas and feel more comfortable #aicrchatSonja Goedkoop@KarenCollinsRD you're right. many health behaviors are "contagious." Sedentary behavior becomes the norm. #aicrchatSuzanne Dixon MPH RDRT @KarenCollinsRD: They need to hear story of @NoNutritionFear as example! :-) #aicrchatAICR RT @CancerRD: important to assess how ready for change pt is when deciding gradual vs drastic lifestyle changes. #aicrchatAICR They need to hear story of @NoNutritionFear as example! :-) #aicrchatKaren Collins@CancerRD excellent point. we can give tools, but the person has to do it for his/herself. #aicrchatSuzanne Dixon MPH RDPhys activ change? Need role model that ppl can feel “like me” who lives active lifestyle. Hard to chng self-image. #aicrchatKaren CollinsChnging phys activ one of hardest things; most have friends also inactive. #aicrchatKaren Collins@RuthFrechman @aicrtweets @KarenCollinsRD another reason to promote more physical activity. #aicrchatSuzanne Dixon MPH RD@aicrtweets @NoNutritionFear @KarenCollinsRD #aicrchat Getting older makes losing wt a lot more challenging.Ruth Frechman@aicrtweets I think it's important to assess how ready for change pt is when deciding gradual vs drastic lifestyle changes. #aicrchatR. Brannon MS,RD,CSOPedometers are a great way for pts to see sm. success when they incr steps if they don't like the gym/formal exercise #aicrchatSonja GoedkoopHow important is brkfst content? Once ppl start w/breakfast do u have recs for what to eat? #aicrchatAICR @aicrtweets worked for me. lost 45 lbs in 2 months. 12 years ago. haven't gained back 1 lb. anecdotal, and may not work for all!! #aicrchatSuzanne Dixon MPH RDWelcome! We're excited to discuss w/ you how to help pts move from 'knowing' to 'doing' for wt loss. #aicrchatAICR How do you work with those who just don’t like being physically active? What do you suggest? #aicrchatAICR Agree from what I see. Excited by the big goal/then quit. MT @RuthFrechman: Life keeps getting in the way & they quit. #aicrchatKaren Collins@aicrtweets Yes, not always, but for some. I try very hard to steer pts away from a 'dieting' mentality that is too restrictive #aicrchatSonja Goedkoop@aicrtweets Not my clients. too overwhelming. #aicrchatRuth Frechman@aicrtweets @SonjaGoedkoopRD Life keeps getting in the way & they quit. #aicrchatRuth FrechmanDo you ever see really ambitious goals do better than incremental steps for pts? #aicrchatAICR @SonjaGoedkoopRD yes! that's the health focus I think we must advocate. move away from "looks" and toward wellness. #aicrchatSuzanne Dixon MPH RDRT @SonjaGoedkoopRD: Important to focus on other health improvements too - reduced BP, imprvd cholesterol, etc. not just wt loss #aicrchatKaren Collins@KarenCollinsRD very true. people want to reach their "ideal." we need to move focus from cosmetic to health. #aicrchatSuzanne Dixon MPH RDImportant to focus on other health improvements too - e.g. reduced BP, improved cholesterol, etc. not just wt loss #aicrchatSonja GoedkoopAs in Biggest loser? RT @SonjaGoedkoopRD: Sometimes making more drastic chngs helps pts get more motivated when they see wt loss #aicrchatAICR @aicrtweets @KarenCollinsRD Stress 2 them. Not a diet. Is a lifestyle. They feel better about it. #aicrchatRuth FrechmanWhen you aim 4 big changes, do ppl continue, or use as "jump start" and then you work on a longer-term compromise behavior? #aicrchatKaren CollinsRT @NoNutritionFear: @KarenCollinsRD need 2 also focus on maintaining current wt & moving more - prev further gain #aicrchatAICR Sometimes making more drastic chngs helps pts get more motivated when they see wt loss #aicrchatSonja Goedkoop@NoNutritionFear I think that can be a powerful goal - stop the gain. But so hard 4 ppl to accept; not what they want 2 hear. #aicrchatKaren CollinsJ Cawley, Health Affairs "The most cost-effective way to prevent youth obesity is CATCH program." pg 367 http://content.healthaffairs.org/content/29/3/364.full.pdf+html #aicrchatDr. Steve Kelder@aicrtweets Goals should be realistic. Most want to lose 20# a month. #aicrchatRuth Frechman@KarenCollinsRD I think we need to also focus on maintaining current weight and moving more - prevent further gain - for some. #aicrchatSuzanne Dixon MPH RD@KarenCollinsRD How do u manage then? #aicrchatAICR RT @ruthfrechman: @aicrtweets Most of my clients aren't physically active. They seem motivated to start. #aicrchatAICR @KarenCollinsRD agree. despite conv wisdom to make small changes, some people do best with drastic overhaul. it's tough either way #aicrchatSuzanne Dixon MPH RDQ2 Ppl I have worked w/ often more excited abt big goals, but seem less able to continue them & then r convinced they can’t do it. #aicrchatKaren CollinsWe often recommend ppl use apps to make behavior change. Do u think they are helpful for sleep, diet, PA? #aicrchatAICR @RuthFrechman @aicrtweets @KarenCollinsRD another reason to promote more physical activity. #aicrchatSuzanne Dixon MPH RDBut Ornish grps offer fabulous support netwrk to help ppl make big changes. Not something I’ve been able to do in priv practice. #aicrchatKaren CollinsI’ve heard Dean Ornish say he finds ppl do better making drastic change than something too close to their usual. #aicrchatKaren Collins@KarenCollins society's rhythms unkind to night owls. but just because someone stays up, they can eat bulk of calories earlier. #aicrchatSuzanne Dixon MPH RD@aicrtweets @NoNutritionFear @KarenCollinsRD #aicrchat Getting older makes losing wt a lot more challenging.Ruth FrechmanQ2: Recent publication in NEJM says this is myth: “setting realistic goals is important for wt loss.” Do u focus on realistic? #aicrchatAICR How do you get ppl to agree to earlier bedtime & be successful at it? #aicrchatKaren CollinsBreakfast should be quick & easy, with protein & fiber. Important to find a routine that fits into hectic mornings! #aicrchatR. Brannon MS,RD,CSO@NoNutritionFear I agree - the importance of sleep is so often overlooked! Stress management very important for wt loss as well #aicrchatSonja GoedkoopAgree. For many pts who had claimed 'brkfast just makes me eat more all day', looking at what they eat gives the answer. #aicrchatKaren CollinsIdeally I rec having some protein and/or fiber at brkfst to keep pts feeling full longer to help curb food craving later #aicrchatSonja GoedkoopSeems all r saying important to focus on phys act as crucial for maintenance & for long term wt loss #aicrchatAICR @KarenCollinsRD night eating may be tied to deranged metabolism that occurs with lack of sleep. #aicrchatSuzanne Dixon MPH RD@NoNutritionFear Any tips for getting ppl who are voluntary night owls to get more sleep? #aicrchatKaren CollinsGood sleep is very underrated in terms of weight mgmt. Check out NY Times article on this: http://tinyurl.com/d4n4ow3 #aicrchatSuzanne Dixon MPH RD@KarenCollinsRD true! esp re: maintenance. I think it's impossible to prevent weight gain as we age without regular phys activity #aicrchatSuzanne Dixon MPH RDAgree, Sonja. Many of my pts find brkfst tough because they are major night eaters. Change late-nite eating & brkfast easier. #aicrchatKaren CollinsHow important is brkfst content? Once ppl start w/breakfast do u have recs for what to eat? #aicrchatAICR Brkfst has to be individualized. Sometimes starting with something sm like a banana is helpful for those who dont like brkfst #aicrchatSonja GoedkoopHow do others help ppl stay realistic or move away from focus on weight as reward? #aicrchatKaren CollinsExpectations make it tough to stick w/ changes. #aicrchatKaren CollinsI think phys activity crucial 4 wt maint & l-term loss. But pt's often w/ unrealistic expectations from small incr in phy activ. #aicrchatKaren CollinsExcited to discuss how to help patients take action for successful wt loss #aicrchatSonja GoedkoopQ1 Natl Wt Cntrl Registry says 4 successful wt loss maintainers daily brkfst & phys act most common strategies. Do these work 4 u? #aicrchatAICR I'll post a question and then please chime in with your wisdom. #aicrchatAICR Hi everyone! This is such an important topic, as hlthy weight touches cancer risk & so much more. #aicrchat #aicrchatKaren CollinsI’m Alice Bender RD with AICR & I’ll be leading chat. Glad to see @KarenCollinsRD & @SonjaGoedkoopRD join us too. #aicrchatAICR Welcome! We're excited to discuss w/ you how to help pts move from 'knowing' to 'doing' for wt loss. #aicrchatAICR
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