You have been working with a client for more than a year when he arrives for his after-work session with some exciting news: That morning, he stepped on his bathroom scale and learned that he had achieved his long-term goal of losing 60 pounds. He is understandably thrilled, and the achievement is certainly cause for celebration. But it should also be a moment of caution and education, as there is a tremendous risk of letdown. While the client may think the hard part is behind him, this is the time to remind him that the lifestyle changes he has made must be maintained if he is going to successfully keep the weight off.
While most people can lose weight via short-term caloric restriction, the vast majority regain that weight (and sometimes more) over time. With so much focus on “weight loss” in popular media, too few people recognize the long-term challenges associated with “weight-loss maintenance.” There is a great opportunity for fitness professionals to educate the public and expand their businesses by broadening their focus to include weight-loss maintenance.
One Point on a Continuum
According to Barbara Brehm, Ed.D., professor of exercise and sport science at Smith College, where she teaches nutrition and health behavior courses, the moment of goal attainment should be a time of reflection and appreciation of the lifestyle changes your client has adopted to reach this milestone. Clients should be reminded to “hold onto the habits” that resulted in their success.
The most important thing to realize, says Dr. Brehm, is that finally meeting one’s goals is just another point on the continuum of long-term health. “You, as the fitness professional, should be preparing your clients for the shift from weight loss to weight-loss maintenance almost from the beginning of the program, or as soon as the client demonstrates that he or she is committed.” Goal achievement can be a catalyst for motivation loss, and it is up to the fitness professional to keep clients on track. “There can be a sense of euphoria with weight loss, which disappears for some when the goal shifts to maintenance,” says Dr. Brehm, “so staying motivated can be a major challenge.”
Gina Crome, M.S., M.P.H, R.D., an ACE-certified Personal Trainer and owner of Lifestyle Management Consultants, concurs, stating that what clients learn while losing weight should be used to maintain that weight loss. “The weight-loss program should be front-loaded with learning, and the longer it takes to lose weight, the more opportunity clients have to learn what it takes to keep the weight off.” This latter point is yet another reason why quick-fix weight-loss techniques are usually platforms for failure.
Tips for Fitness Professionals
Given all of the potential motivational pitfalls, what can you do to facilitate long-term weight-loss maintenance for your clients? Crome and Dr. Brehm share the following tips.
Track things besides weight. Tracking only the number on the scale is problematic, even during the weight-loss phase. Crome, who herself lost 172 pounds and has maintained that weight loss for years, recommends using other tools to shift the focus off the scale, and says this should be done early in the weight-loss program. “If you educate the client that there are many reasons to eat right and exercise, then the motivation to continue isn’t so at risk once the weight-loss goal is achieved.” Crome suggests fitness professionals monitor body-fat percentages and other anthropometrics when appropriate (remembering that this can be demotivating for some obese clients in the early stages of a program), in addition to mental health status, physical-activity levels and even hydration levels. Having multiple measures of success enables clients to recognize achievements even during periods of struggle.
Build an ongoing support system. Almost every client who achieves weight-loss success has both social and professional support along the way, but many will lose sight of the importance of this aspect during the maintenance phase. Take time to develop a network that includes a psychologist, health coach, registered dietitian, nutrition counselor and others who can be called upon to help your clients keep the weight off. Both Crome and Dr. Brehm recommend introducing group sessions for clients in this phase to foster healthy relationships and promote continued success.
Focus on exercise. While nutritional change is the key aspect of weight loss, exercise should be the cornerstone of weight-loss maintenance. In addition to the calorie burning, there are important psychological benefits to exercise, including stress reduction, prevention of cognitive decline, mood enhancement, and alleviation of depression and anxiety. According to Dr. Brehm, educating clients on these additional benefits feeds into the idea of shifting the focus from weight loss to overall health improvement.
Educate. Ongoing education about health should be a key element of any long-term program. The more clients understand the many reasons that weight-loss maintenance is so important the better. Teach your clients about the dangers of yo-yo dieting, or major fluctuations in weight, which can be unhealthier than being overweight in the first place, as well as about hormones, metabolism, thyroid function and the many other less-understood elements of good health.
Top Tips From the National
Weight Control Registry
Registry members have lost an average of 66 pounds and kept it off for five-and-a-half years. There is variety in how NWCR members keep the weight off, but most report continuing to maintain a low-calorie, low-fat diet and doing high levels of activity.
- 78 percent eat breakfast every day.
- 75 percent weigh themselves at least once a week.
- 62 percent watch fewer than 10 hours of TV per week.
- 90 percent exercise, on average, about one hour per day.
The Mystery of the Missing
Many clients use technology such as smartphone apps to track caloric intake and expenditure. Assuming a target weight-loss rate of 2 pounds per week, a 220-pound man with a goal of reaching the 200-pound mark may be consuming between 1,600 and 1,700 calories per day. A 7,000-calorie weekly deficit would cause a 2-pound weight loss, so once that goal is reached, the app tells him that he can increase his intake by 1,000 calories per day and maintain his new weight.
“Not so fast,” laughs Crome. This idea of “getting calories back” reflects that the individual is in “diet mode,” which Crome calls a mentality of failure. These calories need to be slowly added back in, and in a mindful, healthy way. “Remember,” says Crome, “the body has changed as a result of weight loss. Metabolism has shifted, some muscle mass may have been lost—the math isn’t nearly so simple.”
This is another reason why it’s so important to continue to monitor weight and other factors in the immediate aftermath of goal attainment. If clients have a simplistic understanding of calorie balance, they may overdo it and quickly sabotage what they worked so hard to achieve.
Share the findings of the National Weight Control Registry (www.nwcr.ws). The NWCR was developed to identify and investigate the characteristics of individuals who have succeeded at long-term weight loss. Sharing this type of research-based advice adds to your credibility and arms clients with actionable tips. See the sidebar, Top Tips From the National Weight Control Registry, for findings from the NWCR.
Use visualization. As clients approach their goals, Dr. Brehm recommends they incorporate visualization techniques that allow them to see themselves carrying through with the habits that allowed them to lose weight in the first place. It is essential that clients change their habits in ways that they can live with long-term (see sidebar, The Mystery of the Missing 1,000 Calories). Using dramatic caloric restriction or other drastic means of cutting weight is a sure recipe for weight regain.
Have a plan to manage changes in lifestyle. Many clients will feel that they have earned their way out of some of the restrictions they endured while losing weight. For example, a client may have been avoiding a particular restaurant for the past year, knowing that she has a hard time making wise choices when confronted with her favorite foods. Perhaps she even wants to go there to celebrate her hard-earned success. It’s probably not a good idea to tell her that she can never go to her favorite restaurant again; instead, review the menu with her and have a plan going in. Preparing for obstacles is a must if a client is going to maintain lifelong lifestyle change.
Avoid reincorporating bad habits. Many clients may be tempted by old habits now that they’ve achieved their goals—favorite desserts, for example. This is a good time for you to revisit your initial sessions with a client to remind him or her of what caused the obesity in the first place, and of how hard they worked to eradicate those habits.
Self-efficacy and Maintaining Motivation
When clients achieve a lofty goal—particularly if it’s as impressive as losing a large amount of weight by sticking with a long-term program—they are likely at the peak of their self-efficacy. They just conquered the world!
It is essential that you seize that attitude and keep clients motivated, as nothing can deflate a person’s confidence like regaining weight they worked so hard to shed. Use this moment of maximal self-efficacy to set new goals—maintain this weight for three months, try new exercise classes or modalities, or take an activity-focused trip—that will keep the client on the path to lifelong health, fitness and wellness.