We all know the drill: As each New Year approaches, patients tend to tell us about those unrealized goals they had pledged to meet the year before. Common goals include losing weight, controlling their diabetes, taking more time for themselves, going to the gym regularly, and looking for a new job. Of course, weight loss tops the list as one of the most commonly stated goals.
So why, oh why, do our patients reset the same healthful goals year after year without success? In most cases, they’re setting unrealistic goals based on their current lifestyle and/or have no action plan in place. While solutions to these problems aren’t easy to implement, we as RDs are in the unique position to help our patients refine their goals and develop workable plans to achieve them. This process can be broken down into three steps.
Creating Goals and Action Plans
• First, ask your patients to identify two or three health goals for the New Year. If they have more, have them focus on two or three; this is far more doable.
• Second, determine whether their goals are achievable by looking at their lifestyle. Their goals may need to be revised.
For example, a client says she wants to go to the gym five days per week. She works two jobs and cooks for a family of five. She’s told you that sometimes her days are so busy that she doesn’t even have time to get enough sleep. Do you think this patient will be able to leave her house five days per week to go to the gym?
Meeting this goal would require difficult or impossible changes such as the client working less, not cooking for her family, or getting up one hour or two earlier every day. You need to develop an easier way to fit exercise into her life. A more realistic goal would be to have her stretch for five minutes every morning, take a 20- to 30-minute walk once or twice each day, and do a five-minute relaxation exercise daily. This could lead to her including a visit to the gym once or twice per week in addition, if she’s interested.
Note that this may be a little too much for the client to expect to happen all at once. The client should probably try to stick to the new routine for a few weeks and then stop when time doesn’t allow. If she stops exercising, she also may cancel her follow-up visits with you, feeling bad because she can’t meet the goals you set together.
• Finally, make a realistic action plan to implement change. Note you may need to break down the plan into several steps.
With your guidance, the client will revise her goal from going to the gym five times per week to exercising regularly in a way that fits easily into her preexisting routine. Now it’s time to plan to make this happen. For most clients, an actionable plan requires making lifestyle changes in small steps to meet their goals. In this client’s case, you could suggest the following.
Start the first month with a five-minute stretch or relaxation exercise daily. In addition, include some kind of body movement, such as dancing, walking, steps, or exercise videos that are at least five minutes long one to two times per day. Whatever movement the client chooses, it should be something that doesn’t require extra planning or time spent traveling.
If the first month is successful, increase the five minutes of stretching or relaxation to 10; if the client is still having trouble meeting the five minutes, address barriers and redefine. The most important goal is to make exercise a regular part of her life. Continue in this manner, addressing obstacles and problems with simple solutions.
Always encourage and point out the positive work done. Take care never to criticize or compare your habits to your clients’—it should only be about them. You may need to revise goals throughout the process. Let clients know you are there to support them and will work with them every step of the way. Let them know that any change in the right direction is a success. This approach works with weight loss, better disease management, and more.
May your clients have a happy, healthy New Year!
— Marlisa Brown, MS, RD, CDE, CDN, is an award-winning dietitian, chef, and public speaker. She’s president of Total Wellness, a private nutrition consulting company specializing in diabetes, cardiovascular disease, gastrointestinal disorders, gluten-free diets, culinary programs, corporate wellness, and medical nutrition therapies, in Bayshore, New York, and is author of Gluten-Free Hassle-Free and Easy Gluten-Free. Marlisa blogs at http://marlisaspeaks.com/marlisas-blog/ and www.GlutenFreeEZ.com.