Behavior  Change:  There’s  more  to  it  than  

“Just  do  it”

Pam Webster, LCSW

Stark  Reality •  Modern world generally conspires to keep us

sedentary.

•  We have high availability of hyper-palatable, cheap foods, many of which are not nutritious.

•  A long history of stress makes people deposit fat around the middle, putting them risk for obesity related-illnesses, increased comfort eating, and trouble knowing when they are full.

Behavior  change:    short  version

•  Make it fun

•  Do it regularly

•  Become a sleuth and a behavioral engineer!

Stages  of  Change •  Pre-contemplation •  Contemplation •  Preparation •  Action •  Maintenance •  Relapse

Prochaska and DiClemente’s Stages of Change Model

Monitoring  /  Paying  ADention

•  Take a couple days or a week to establish a baseline

•  Record your activities and what you eat without trying to change at first.

Making  an  Action  Plan •  Choose something you want to do. •  Make it achievable—something you can do this

week. •  Make it action-specific (losing weight is not a

behavior but not eating beyond planned meals and snacks is)

•  What? How much? When? How often? •  Confidence level (7 equals 100%) that you will

complete the contract

(adapted from Living a Healthy Life with Chronic Conditions)

Public  Health  POV •  Knowledge (may be power but does not always

equal change) – “Knowing and Doing gap”

•  Personal effort / discipline (not keeping ice cream at your house, not going to fast food restaurants)

•  Changing the environment / behavioral engineering (seeing a smoker’s black lung in a jar, not having a television, setting up your treadmill so you can jump on with a recorded book … basically changing your environment in a way that will influence your choices or behavior.)

Strong  Women •  You have a lot of exercise options but Strong

Women (light weight lifting) exercises might be the ticket to getting started for many people.

•  This exercise is effective and quickly shows results. It made participants want to do more physical activity.

•  Women in a control group who were limited to 2 40 Strong Women exercise periods COMPLAINED that they couldn’t do more exercise!

Exercise  should  be  fun  and  regular

•  Exercise (usually) starts to feel good once you get the hang of it; start slow so you don’t hurt yourself.

•  A 15 – 20 minute walk improves mild to moderate depression.

•  Start walking gradually just three minutes at first and then increasing by three minutes if out of practice.

•  Strive to exercise 30 minutes (this includes accumulated activity) just about every day.

So… •  Walk with a friend at the Big Dipper •  Get on the treadmill at home with your favorite

soap opera on TV or one of the great books in your ear

•  Walk as meditation (alone) •  Do Strong Women strength training at home from

the book or at a class •  Go swimming or water walking at Mary Siah Rec

Center

Reduce  barriers—make  it  easy  to  do  the  right  thing •  Pack your swim bag (lock, towel, suit, etc.) and

keep it in the car. Buy a punch card.

•  Buy interesting food when you’re not hungry or tired

•  Don’t hang clothes on your treadmill (and don’t fold it up!).

•  Put a CD player and headphones permanently next to the treadmill with a gripping story that you only get to hear when you exercise

Reframing  /  Self-­‐‑talk

•  Is it worth it to make this change? Can I do it?

•  I hate to exercise vs I’m new to exercise

•  Tula: “I volunteer all over town, but this I do for me!”

•  I’ll probably never enjoy exercise, but I’m going to show my young child that it’s a normal thing to do.

•  “Don’t make it work.” It’s got to have a fun element.

Retrain  ADention

•  Practice retrains attention (and related mental and emotional skills).

•  Repeated experiences remodel specific brain connections or add new neurons.

•  Again, the brain’s responses can be altered by experience.

Pay  aDention—Reality  keeps  bringing  you  things •  Feeling blah? 15 – 20 minutes on the treadmill can

ease mild to moderate depression. Diabetics need to be mindful of their food/insulin situation before trying this.

•  Outdoor exercise (even 15 – 20 minutes) adds fresh air and light to the above benefit. You don’t want to get cold (especially your feet). You don’t want to fall (so consider bunny boots or “personal studded tires”). Take snacks and a phone. Don’t go off alone into the woods.

Power  of  Three •  Design three easy, do-able changes that you can

mindlessly make without much sacrifice.

•  Example: Eat out of a bowl instead of the container, use water or broth to saute onions instead of oil, close the kitchen after dinner except for your planned snack before bed.

•  Small changes can add up to major weight loss in the course of a year.

(from Mindless Eating: Why We Eat More Than We Think)

Taste  Bud  Life •  Your taste buds last for a week or two and then you

get new ones.

•  Your taste buds want what they’ve been eating.

•  Take a break from a less healthy food like potato chips for two weeks and you’ll lose your strong craving for them.

•  Then you can substitute a healthier snack (like edamame)

Food  Changes

•  Dr. Neal Barnard of Physicians for Responsible Medicine suggests making fast rather than slow changes in diet to trick the palate.

•  Substitute, substitute, substitute vs. eating around what you really want

•  Move in the direction of…

Kind  and  Consistent

•  Strive for kind and consistent exercise and diet. Both put you in touch with play and the joy of being alive.

•  “While sedentary people may assume that working

out is about looking good, habitual exercisers know that working out is largely about feeling good.”

Krucoff and Krucoff, Healing Moves

Books •  Mindless Eating: Why We Eat More Than We Think

Wansink, Brian, Ph.D., 2006

•  Healing Moves: How to Cure, Relieve, and Prevent Common Ailments with Exercise

Krucoff, Carol and Mitchell Krucoff, MD, 2009

•  Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs

Barnard, Neal D, 2007

Books,  etc. •  Living a Healthy Life with Chronic Conditions Lorig, Kate, RN, DrPH, et al, 2006

•  Strong Women Stay Young, Nelson, Miriam, Ph.D. & Sarah Wernick, Ph.D., 2005

•  Lilias! AM & PM Yoga Workouts for Seniors, 2007

Resources •  Mary Siah Pool Schedule. There’s also a small weight

room

http://co.fairbanks.ak.us/parksandrecreation/Facilities/Aquatics/MSRC.htm

•  Have a disability? You may qualify for $1 swimming. Ask for the form at the Mary Siah office.

•  Ask forLand’s End has great customer service and can help you with finding a suit. Call them at 1.800.963.4816. You can view the catalog at

landsend.com

Resources  II •  Cooperative Extension (474-2450) and Osher

Lifelong Learning (474-6607) offer Strong Women classes. Continuation classes are available at the Senior Center after you take your first SW class. 452-1735. The Senior Center also has yoga classes!

•  The Noel Wien library has exercise videos and diabetes books.

•  Strong Women Stay Young video seems to be out of print, but there are other Strong Women videos .

Amazon.com

Thank  you   • My clients—who keep teaching me things

• Sally Levengood, RN, Public Health Nurse

• Tula (deceased)and other Mary Siah exercisers

• Margi Rogge, Mary Siah Recreation Center Manager