Stages of Change

In my Health Promotion class I learned the "terminology" behind some of what I have learned experientially through my 7 years as a Certified Health Coach. We were studying the "Trans-Theoretical Model of Behavior Change." 

The goal behind any behavior change is to move THROUGH the stages INTO the healthy behavior you are wanting to bring into your life, so that you can be actively living in and maintaining the DESIRED behavior.

I've been in various stages of ALL of these stages in my own 48-year health journey, I'll describe them and you can see where YOU fit in!

Precontemplation: "I won't/I can't"
Contemplation: "I might"
Preparation: "I will"
Action: "I am"
Maintenance: "I have"
Termination: "It's as if I've never lived any differently than how I'm living now"

The following descriptions were taken from the book Health Behavior Theory, Research, and Practice, 5th Edition, by Karen Glanz, Barbara K Rimer, and K. Viswanath,

"Precontemplation:
Precontemplation is the stage in which people do not intent to take action in the near term, usually measured as the next six months. The outcome interval may vary depending on the behavior. People may be in this stage because they are not informed enough about the consequences of their behavior. Or they may have tried to change a number of times and become demoralized about their abilities to change. Both groups tend to avoid reading, talking, or thinking about their behaviors. They often are characterized as resistant, unmotivated, or not ready for health promotion programs. An alternative explanation is that traditional health promotion programs were not ready for such individuals and were not motivated to match their needs.

Contemplation:
People in contemplation intend to change their behaviors in the next six months. They are more aware of the pros of changing than precontemplators and are also acutely aware of the cons. This balance between the costs and benefits of changing can produce profound ambivalence and keep some people stuck in contemplation, a phenomenon characterized as chronic contemplation or behavioral procrastination. These people are not ready for traditional action-oriented programs that expect participants to take immediate action. If contemplators are pushed into such programs, they are not likely to succeed.

Preparation:
In the preparation stage, people intend to take action soon, usually measured as the next month. Typically, they have taken some steps in the past year. They have a plan of action, such as joining a quit smoking health education class, consulting a counselor, talking to their physician, buying a self-help book, or relying on a self-change approach. These are the people who are receptive to and willing to begin an action-oriented program.

Action:
People in the action stage have made specific overt modifications in their lifestyles within the past six months. Because action is observable, behavior change has often been equated with action. In the TTM, action is only one of six stages. Typically, not all modifications of behavior count as action in this model. In most applications, people have to attain a criterion that scientists and professionals agree is sufficient to reduce risks for disease. For some behaviors, such as cancer screening, the criterion may be getting an effective cancer screening test (e.g. a mammogram, Pap test, or colonoscopy) that can reduce the risk of dying from cancer. For smoking, there now is consensus that the criterion behavior should be total abstinence, since other changes do not necessarily lead to quitting and do not lower risks to zero.

Maintenance:
People in maintenance have made specific, overt modifications in their lifestyles. They are working to prevent relapse, and they do not apply change processes as frequently as people in their changes. Based of self-efficacy data, it has been estimated that maintenance lasts from six months to about five years, depending on the targeted behavior. Longitudinal data from the 1990's surgeon general's report (U.S. Department of Health and Human Services, 1990) supported this temporal estimate. After twelve months of continuous abstinence, 43 percent of individuals returned to regular smoking. It was not until five years of continuous abstinence that risks for relapse dropped to 7 percent. The time frame can very for other health behaviors.

Termination:
People in termination report having zero temptation and 100 percent self-efficacy. Whether they are depressed, anxious, bored, lonely, angry, or stressed, they are sure they will not return to their old, unhealthy behaviors. It is as if they had never acquired the behavior in the first place, and their new behavior has become automatic. Examples include adults who buckle their seatbelts as soon as they get in their cars or automatically take their antihypertensive medications at the same time and place each day. In a study of former smokers and alcoholics we found that fewer than 20 percent of each group had reached the criterion of zero temptation and total self-efficacy (Snow, Prochaska, & Rossi, 1992). The criterion may be too strict or this stage may be an ideal goal for the majority of people. In other areas, like exercise, consistent condom use, and weight control, the realistic goal may be a lifetime of maintenance, since relapse temptations are so prevalent and strong. Termination has received much less research and practical attention than other stages, because it typically takes so long for individuals to reach this stage."

So my take as someone who struggled with my weight since 4th grade, and someone who desires to continue to live in health, practicing my healthy habits, is that I want to get IN to "maintenance" and remain there. I am happily in ACTION right now, giving myself a "tune-up," and will continue in action even through and back into maintenance. I look forward to the "termination" phase (no not LITERALLY!)! The stage where I have solidified and mastered all my healthy habits, and living and continuing to thrive in my healthy lifestyle will be as routine to me as breathing!  For today, though, I am satisfied living day-to-day and remaining MINDFUL in "action" and "maintenance". Perhaps "termination" is something that can only be observed as having been entered in hindsight.

But there were plenty of years I lived, before finding our wonderful program, in a state of "pre-contemplation". I didn't want to read or hear anything about "how to get healthy" because it always caused me (I thought) to feel terrible about myself. I preferred to live in ignorant bliss, and my health and quality of life suffered tremendously because of it. Oh sure, I had moved into "action" before, but things hadn't worked out the way I had wanted them to and I'd always regress back into the precontemplative state.

Then there were those times I was in a contemplative state, reading about weight loss-programs, and sometimes even trying them (moving into action), but then ultimately failing and regressing back to precontemplation.

I think of the many years I spent in "behavioral procrastination" with regret. I studied Nutrition to try to understand the metabolic processes, and requirements of the human body, in an effort to understand MYSELF and my situation. I became an expert on theory but was inexperienced in ACTION and RESULTS.

Until I found our program, that is. I was so impacted by the stories of the REAL people who had transformed their health through our program I moved directly from pre-contemplation to action, and I have never looked back. Our community is a community of like-minded people who are LIVING the life they always wanted to live, not perfectly, but perfectly IMPERFECTLY and with grace and love, who have MOVED into action and then into maintenance, and who support each other along the way. 

Here's my own takeaway. I am trying to learn how to better identify WHERE people may be in their OWN journey, and how best I can help them move forward from where they are to where they want to be. 

That's my passion, and that's my heart.

There's a difference between "distraction" and "direction"

Ever notice how being "on plan" with our program feels much easier when we are busy?

When we are at work, or busy on a project, and a temptation comes, we usually we don't have "time" for those thoughts. We certainly don't have time to ACT on them, our minds are so occupied with other things that when the thoughts come we are rapidly "distracted" by the next thing that is required of us, so those temptation thoughts don't germinate and expand.

But during the weekend, evenings, or our downtime those same temptation thoughts come in and seem to grow exponentially, many times resulting in our acting on them in a way which sabotages our plans, delays us achieving our health goals, and making us feel like failures.

What to do?

Well, there is a real difference between "distraction" and "direction".

Distraction is what I mentioned above. It is the DISPLACEMENT of the original thought by necessity of other things taking priority. On the weekends, we can run out of things to distract ourselves, can't we? We can get bored. We can seek entertainment with food or drink.

Direction, however, is intentional. Direction is us taking that thought, that temptation, MINDFULLY, unpacking it for a moment, acknowledging it's presence, and then CHOOSING to say "no" to that because it doesn't forward our long-term agendas, our primary goals, as regards our health.

The "Stop! Challenge! Choose!" method is a very practical way of dealing with those thoughts or temptations in a way which will give us peace of mind, strength of resolve, and momentum in achieving our goals. Dr. Wayne Scott Andersen came up with the "Stop! Challenge! Choose!" method and writes about it in his book "Dr. A's Habits of Health" and also his New York Times Bestseller "Discover Your Optimal Health." It basically goes like this:

Temptation arises.
STOP!
Literally, stop what you are doing or are about to do! Take a few DEEP breaths.
CHALLENGE!
Challenge yourself and ask "will eating/drinking/doing this action take me closer to my health goals, or farther away from them?"
CHOOSE!
Choose the action which furthers your most intrinsic goal of creating Optimal Health in your life.

If we rely on distraction, those temptation thoughts MAY go away for awhile, but when they return they will bring lots of friends with them, or return stronger than they were before. Why? Because we didn't DEAL with the thought or emotion in a cognitive way. Therefore, it can resurface, or bubble up LATER, or EVEN manifest in OTHER ways that are non-food. Those thoughts can show up later as chronic stress, or irritability, or depression, or anger. Ever feel that way?

Ever feel like you've been holding those thoughts at bay ALL WEEK LONG, you've been SO GOOD, and then Friday evening hits and you have all of a sudden "run out of will-power?"

That is a typical pattern of being "on-plan" during the week, when it seems to be "so easy", and then on the weekends we can get so loosey-goosey that no one who might be watching us over the weekend would even think we were the same person as we were Monday-Thursday! We can even surprise OURSELVES at how "double-minded" we seem to be!

It truly is the difference between "Distraction" and "Direction".

So what to do?

When those temptations come during the week, take a moment and think "yes, I COULD choose to have those, but I PREFER to say no to those now so that I can have what I REALLY want eventually, which is OPTIMAL HEALTH." Practice saying that throughout the week. By the end of the week you will find that those thoughts now come more easily when faced with temptations over the weekend. You have created a pattern of mindfulness which, once established, can become your default way of thinking about things that might otherwise set you back were you to indulge in them.

Try it out! Let me know what you think!

Rinse and Repeat!
#OPTAVIA30WOW

Instead of "Preventing Something Awful From Happening" let's "Make Something Amazing Happen!"

The medical and academic culture is rife with trying to discover "things to avoid" in order to "not live an unhealthy life".

I think it's time for a major intervention and paradigm shift in our thinking as a society.

How about instead of "trying to avoid" things that we "don't" want in our lives, we go about the business of CREATING what we DO want in our lives?

Like health.

So much of the literature these days focuses on "what not to do" or "what not to eat", so much so that we could create encyclopedia-length lists of things NOT to do and NOT to eat.

I've decided to live life from a perspective that CREATES my BEST days, which are in FRONT of me, instead of attempting to "mitigate the inevitable decline" of my health or my life.

How do I do that? Why do I do that?

Because people don't make significant life changes based on FEAR, FORCE or FACTS. People make significant sustainable life changes first by finding a group of people or a person or an ideal which inspires them, gives them HOPE that a change is possible. Then they LEARN the habits and skills needed to create and sustain the NEW life or lifestyle, and finally they REMAIN in community with like-minded people who have MADE and sustained that life change.*

It has nothing to do with "preventing illness" it has everything to do with "creating an abundant thriving life which is then a JOY to continue living.

*Concepts from the book "Change or Die" by Alan Deutchmann

Consider the Hummingbird

Six months ago I put small hummingbird feeder on the window next to my kitchen table. I thought it would be nice to see them come and go, to admire their beautiful iridescent feathers sparkling in the sunlight.

The hummingbirds found the feeder relatively quickly, and indeed they do swoop in and out many times a day. In fact, we have several families of hummingbirds now who have built nests and taken up residence in the trees in our front yard!

Throughout the day, as I work from my kitchen table, my peripheral vision will catch movement, I'll stop whatever I am doing, and watch in wonder as these little miracle-birds come for their "fuel".

Here's what I have noticed. They come. They drink the hummingbird food (fuel). Then they fly off to continue living their little hummingbird lives. A while later they will come, drink the fuel, and fly off again to resume doing what hummingbirds do whenever they aren't "fueling up."

Their internal clocks tell them when they are running out of energy and need to re-fuel, and that is when they do it. If I could peek into their brains, I bet I wouldn't see them obsessing about when and where and what their next feeding will be the entire time they are away from the feeder. Having never BEEN a hummingbird, though, I really don't KNOW what they are thinking, I can only guess. They KNOW their fuel will be right there, when they need it, and they plan to return whenever they need it.

They don't take more than they need for the next little while. They don't "camp out" next to the hummingbird syrup, afraid it won't be there the next time they need it. They seem content and at peace with the same routine, the same fuel, day after day after day. They haven't complained about the lack of variety yet! I've also never seen a stout hummingbird.

Just some thoughts for today.

Breaking a Plateau

With my knowledge of metabolism, and my experience as I get my masters degree in Obesity Prevention and Management, I can give you some even BETTER tips!

IF you are experiencing a plateau, which is NORMAL to experience one or two during your weight-loss portion of your journey, (a plateau is 2 weeks of ZERO weight loss...and yes this is normal one or two times, even if you are doing everything correctly!) try some of the following:

Side note here, I know there are some of you out there (including ME) who get frustrated when we see 3 days of NO LOSS on the scale, we freak out and say "It's NOT WORKING ANYMORE!" I'm here to tell you to sit yourself down, and explain to yourself that as LONG as you are following the program as per the Quick Start Guide, the program WILL WORK as intended. Now, our expectations are that it means we will lose 1 pound a day for the next 60 days. LOL. That is not going to happen, nor would it be healthy. Your body will lose at the pace it will lose, and the best thing YOU can do is stick to the Quick Start Guide like GLUE.

So, here are MY tips:

*Are you weighing your protein and measuring your veggies? Now hold on, I know if you are like me you will think "Does that REALLY matter? How can a couple ounces off here or there REALLY effect things in the long run?" THEY CAN. Think of this program as a prescription. Would you alter the dose or the timing of your medication simply because you thought "does it really matter?" The answer is NO! This is a CLINICALLY PROVEN program, and the scientific studies were done with a FOOD SCALE and a MEASURING CUP. So, my first question to someone on a plateau is "are you weighing your cooked protein, and measuring your vegetables with a measuring cup?”

If not, do start.

*Are you adding your required amount of healthy fats?

To burn fat we need to prime the pump and make sure we are consuming an adequate amount of healthy fats every day. If you haven't been keeping track of those, with a MEASURING SPOON, then I recommend you start. Again, would you alter the dose of your medication because you thought it really didn't matter?

Look, here's the skinny. We need to STOP substituting our judgment for the judgment of the experts who formulated this plan. Really, if we were actually experts, we wouldn't need this program in the first place! Yet time and time again, and I know this is true for me too, I think that I know better than the plan, or that this little deviation won't really matter in the grand scheme of things.The fact is, it really DOES matter.

*Are you drinking 90 ounces of pure water ever day?

If not, START. Your body REQUIRES EXCESS WATER to perform the chemical reaction of making your stored body fat available for immediate use as energy. I could explain in detail how H2O is necessary to break the bond of the Triglycerides floating around in your blood stream into 3 Free Fatty Acids that can readily be uptaken by the individual cells so they can use that as fuel for their furnace, and the H2O is USED up in that chemical process. I could explain how if the Triglyceride REMAINS a triglyceride it will do you no good and instead simply float around in your blood until it is RESTORED in another Fat Cell, and I'm happy to do that...I could explain that your body, if not given adequate water to turn your fat into usable energy will instead conserve the water for the vital body functions like maintaining blood volume and hydrating your cells, and that if you don't drink enough water (90 ounces should do it) your body will instead set off a hormonal cascade to make you HUNGRY, TIRED, and SLOW your metabolism...I could explain all of those things to you from a biochemical standpoint, and I'm happy to do it, but the bottom line physiologically is DRINK YOUR 90 ounces of water and you don't have to WORRY about all these other things.

*Are you spacing your 6 meals out every 2.5-3 hours?

If not, START. This program honors the science of fat burning/weight loss, and stable blood sugars are an integral part of that process. If you go more than 3 hours without "throwing a log on the fire" you are signaling to your body that you are in conservation mode, and it will respond accordingly. If you throw a log on the fire of your metabolism every 3 hours, that fire will continue to burn hot and bright, and will happily utilize your long-term energy storage (fat) on a day-to-day basis. If you convince your body you are in a famine situation by NOT eating every 3 hours, you are sending it the instruction to CONSERVE AND STORE, and it will batten down the hatches and do exactly what you have told it to do.

*Are you tracking your condiments and not exceeding 3 maximum?

If not, START. Condiments add up, and they do add calories in the form of carbohydrates.

*Are you having an optional snack every day?

If so, STOP. It may be those extra calories/carbs are throwing you just over the threshold of you body really being convinced it needs to utilize your fat reserves.

Start by doing all of the above. If you are still in a plateau after this, and you AREN'T exercising, or you have a very sedentary job, START MOVING a little more every day.

I recommend getting a FITBIT and setting a goal for 5,000 steps per day, then upping that to 10,000 steps per day.

There you have it! That is my "breaking a plateau guide".

Here is what I would love you to do. REST in the simplicity of the plan. UNDERSTAND that the science of weight loss has to do mostly with your nutrition, what you are putting in your body and when. If you want to encourage your body to utilize the energy it has stored up for a rainy day, let’s give it that rainy day in a controlled situation, which is what this plan DOES. It WILL use the energy, and you will HAVE lots of energy while utilizing this plan. Your body is not your enemy, it is your friend, and its primary concern is your survival. It will follow the instructions YOU give it, so if you haven’t been giving it the instructions it needs to utilize your long-term energy capacity, then start. Today.

*Note to readers who may not yet be on the Optimal Health Program I am describing, please e-mail me at mycoachstacy@gmail.com and I will send the guide out to you for free!

It's Time For an Intervention...On Myself

I have decided to stage an intervention with/on myself.

Why do I need this?
What is it?
How is it accomplished?
When do I plan it?
What's next after that?

Why do I need this:

I have noticed, with glaring clarity, that I have let my healthy habits slip over the last 2 years. It was gradual at first, so much so that I allowed it to slip seemingly "unnoticed" under the radar. Then it picked up steam, and unhealthy habits crept in, ON MY WATCH!

How does this happen?

It happens gradually at first. Perhaps I let a few days go by without getting my water in. I let a few weeks go by without taking the time to exercise. I don't adjust my intake. Ergo, my body begins to respond to the new instructions I am giving it, namely, it starts storing energy again. We all know how the body stores long-term energy for a rainy day.

Then the jeans get a little tighter, but no worries, I've got a few sizes in my closet (up to a 6, and one or two 8's) so I simply graduate to the more comfortable jeans. All the while there is a voice in my head saying "well, you know exactly what to do, you can always hop on the program and drop those few pounds..."

Except, the "always" is never TODAY. THIS MOMENT. NOW.

Eventually, I can't wear many things in my closet anymore. Despair begins to creep in. Can I really do this? I keep saying I should, I keep saying I will, but another day goes by.

That ended yesterday, I went 100% back on my program not because I DON'T want to be overweight, but because I DO want to be my best, my healthiest that I can be. I KNOW what that feels like now, and I WANT IT BACK.

I am fully committed to utilizing all the tools in my toolbox to attain and maintain optimal health. What are those tools?  Well it is our program. Our WHOLE program. And our WHOLE program is not a "diet" it is not "just the food" it is not simply what I put in my mouth and when. The "Healthy Body" aspect of our program has three components:

WHAT I EAT: The Weight-loss portion (however long it takes based on my goals), then Transition (6 weeks), then Maintenance (the rest of my life). All very structured, but NOT all product dependent. The weight-loss portion and Transition IS product-dependent, because our program has dialed in on and fully harnessed the science of fat burning, so it is very effective at accomplishing this through five portion-controlled meal replacements and one healthy meal of protein and veggies that I can either cook myself or purchase fully-prepared. Transition is also product-dependent, but gradually decreases the portion-controlled meal replacements I need every day by replacing them with other food while simultaneously increasing my calories from the weight loss portion GRADUALLY in a very structured manner to reach my Maintenance calorie target-range. All of this I work closely with my health coach, who supports me, to accomplish.

WHAT I LEARN: The educational component of our plan allows me to actively learn healthy habits and learn the skills to support my new healthy lifestyle. Otherwise, this becomes just another "diet" and DIETS FAIL. I engage my mind, set goals, and establish my identity as a healthy person.

WHAT I LIVE-COMMUNITY and SUPPORT: I plug in to a like-minded community of people who are pursuing health, and seek to inspire them and be inspired by them. My health coach is always my health coach, whether I am in weight-loss mode, transition or maintenance, and the greater community supports and encourages also.

So what is all this "intervention" business? What is it?

I am not covering old ground here, I have never staged an "intervention" on myself before so I'm kind of new at this, but this is what it looks like for ME.I have decided to take a "Health Retreat" to focus on the above aspects of our program, and focus on my personal development and spiritual development. I am kidnapping myself and will begin the reprogramming and build around myself an environment of health, both outwardly and inwardly.

I am taking 11 days for this intervention. With the support of my family, who have always encouraged me to be my best, and the very real support of my health coach, I am doing this for ME. I am putting my oxygen mask on.

My days will consist of staying 100% on plan, walking, reading my Bible, reading Dr. A's Habits of Health (part of our educational/skills component), working on "Living a Longer, Healthier Life" workbook, journalling, dreaming, goal setting, and remembering who I am. I am a person who has made a fundamental decision to BE optimally healthy. For awhile there I practiced short-term amnesia and lived as if I weren't a healthy person. I am deciding. I am making my mark, drawing my line in the sand, taking responsibility, WITHOUT JUDGMENT OR CONDEMNATION of myself, and moving forward.

The first part of my retreat, 5 days, will be spent in Sedona Arizona. The second part of my retreat, 7 days, will be spent outdoors in a tent in Oceanside California. Yes, it is extreme. Yes it is exciting. Yes, it is an adventure. I may not put to rest 100% the team of rivals in my head which fight to pull me back into NOT living the life I want to live, but I will definitely be finding ways to reframe the negative chatter and lies they incessantly speak into TRUTH. This will take their power and influence over my actions AWAY. I will learn how to relegate their suggestions to white noise status, and turn down the volume on that white noise.

Of all this I am confident. I am hopeful, yes, but I am turning hope into a strategy, and turning the strategy into action.

I will be blogging DAILY during this 12-day "Health Retreat" so stay tuned for updates! My retreat begins on July 5th. In the meantime, I am DOING THE DO of the weight-loss portion of our plan, so I can enter my retreat with 2 weeks of action under my belt (or GONE from under my belt more like it!).

What is Next After That?

Life. My life. The life I have chosen, being the person I feel I am called to be. And to quote one of my inspirations, a "Daily Commitment to be Consistent."

Rinse and Repeat!

One Day

Then, one day, she began.

To be continued...