Although ACE Certified Health Coaches and Exercise Professionals know that helping clients maximize their fitness and minimize their health risks is an ongoing process, many less ethical companies and individuals are rewarded financially by promising “quick fixes.” These products and services often lead to unrealistic expectations and negative customer experiences. Dropout from programs that seek to promote changes in exercise and dietary behaviors for weight loss is highest in participants who have goals that are the most extreme and unrealistic. Those individuals become disappointed, lose motivation and commitment, and quit when their aspirations are not rapidly met.
While some providers are happy to take their payments up front (and are unconcerned with the long-term ramifications), more ethical professionals understand that progress will need to be both measured and ongoing. Couple that with ubiquitous advertisements promising unrealistic results and it becomes easy to understand that simply educating people on the reality of the situation might not be sufficient. How, then, can we work with clients with long-term goals and still maintain a realistic approach that will serve their health interests?
Based on an extensive body of research around goal setting, I incorporated an effective approach in all five of my National Institutes of Health–certified programs. These programs address sustaining exercise, dietary change, mood change, emotional eating, body-image issues and overweight/obesity across age ranges. The premise is straightforward. Participants are encouraged to set their own long-term goals with little interference from the professional. This is because the coaching will come during the short-term goal setting. This is where the most immediate progress can be realized if we do our job well.
While a long-term outcome goal might be to lose 50 pounds, and a short-term goal might be to lose 6 pounds in the next month, “process goals” are often even more productive. Process goals for the following month might be to try one new exercise modality each week, reduce fast-food consumption from five times/week to one time/week, and increase time in cardiovascular exercise from 20 minutes/week to 45 minutes/week. Such short-term goals should be manageable, measurable and provide a sense of accomplishment (self-efficacy) to the client when completed. Short-term goal specificity and documentation is important. The same goal-setting review I mentioned above suggests that a vague goal to “do your best” is the least productive. My research suggests that charting goal progress over months enhances self-efficacy and persistence. When a short-term goal is attained, it can be revised upward using a similar coaching process.
To keep short-term goal progress on track, a distinct plan of action is also needed. For example, what behaviors will be necessary to increase time in cardiovascular exercise to 45 minutes/week? This might involve planning the week around work and childcare and/or determining if the exercise time will incorporate gym visits, time in the park and/or exercise on home exercise equipment. If different exercise types are to be attempted, arrangements to attend a group fitness class or join an exercise club might be required. What will be needed to reduce fast-food consumption? It is likely that food-preparation changes will be required at home. You can help the client manage these variables and overcome any obstacles before they arise.
Finally, measurement of short-term goal progress is needed. This “progress feedback” will determine how short-term goals can be re-set to accelerate progress toward the long-term goal. Done correctly, these measurements will be obvious. For example, minutes of exercise per week can be totaled from inputs on a calendar right after each session. For a weight-loss goal, logging daily caloric consumption and fruit/vegetable intake may be productive for those who respond well to tracking.
The progression of long-term goal, to short-term goal, to plan of action, to progress feedback that you implement with clients should be supported by the recruitment of social supports beyond what you personally provide (e.g., group exercise classes of an appropriate level) and education on an array of self-regulatory/self-management skills (e.g., countering unproductive self-talk, stress management, prompting positive behaviors or advance planning for an inevitable disruption in the routine). These skills will help counter the numerous lifestyle barriers that also lead to attrition.
I believe this thoughtful approach will ethically and productively circumvent unrealistic client expectations by using focused, evidence-based methods that foster persistence and long-term progress with promoting health.
To learn more from Dr. James Annesi about how to support clients as they pursue sustained weight loss, reserve your spot to attend his free webinar on October 18, 2023: A Self-regulation Approach to Weight Management. During this two-hour event, Dr. Annesi will explore psychosocial changes associated with adhering to a program of moderate exercise and how they can transfer to changes associated with controlled eating and long-term weight maintenance.?