Overweight and Obesity Epidemic in America – Part IX: Preparing To Achieve Victory At Long-Term Weight Loss By The Setting Goals and Objectives

Overweight and Obesity Epidemic in America – Part IX: Preparing To Achieve Victory At Long-Term Weight Loss By The Setting Goals and Objectives

 

Michael Garko, Ph.D.

Host – Let’s Talk Nutrition

 

Introduction

Victory Loves Preparation/Amat Victoria Curam (anonymous). This ancient Latin saying is especially apt when it comes to losing weight and keeping it off. Weight loss and maintenance are among the most difficult and failed health challenges people undertake. Too often when those who are overweight or obese set about to lose weight they undermine their effort and decrease their chances of success because of improper or insufficient preparation. Being victorious or otherwise winning at weight loss, requires thoughtful planning.

To that end, creating goals and objectives are a vital part of the necessary preparation to achieve successful long-term weight loss and maintenance. The June, 2011, issue of Health and Wellbeing Monthly addresses some of these more important goals and objectives so as to help overweight or obese individuals be victorious at long-term weight loss and maintenance. There will also be a discussion on the basics of goals and objectives in terms of defining and setting them.

The Basics of Goals and Objectives

If setting weight-loss goals and objectives is a necessary condition to achieving long-term weight loss, then it would serve overweight and obese individuals to have a basic understanding of goals and objectives in terms of what they are, how they relate to one another and how to frame them so as to make them meaningful and effective and not just words on a page.

Defining Goals and Objectives

Specifically, goals are broadly stated end-states or outcomes which are desired or sought after. Objectives are more specifically stated ways in which goals are to be achieved. Put another way, goals represent desired achievements. Objectives represent the specific strategies and tactics by which those achievements would be accomplished. Stated in yet another way, goals represent aspirations of something to be achieved, while objectives represent the planned actions to make those aspirations a reality.

Setting Weight Loss Goals  

In order to make them useful and effective and to increase the likelihood of achieving them, there are well established guidelines to follow in setting goals (or any other type of goal for that matter). There is a greater likelihood of achieving them, if goals are stated in terms that make them sensible (i.e., practical), understandable (i.e., specific), conceivable (i.e., possible), achievable (i.e., realistic/viable) and measurable (i.e., quantifiable). Further, it is a good practice to write goals in the infinitive form, which means to state objectives beginning with the word “to.” For example, “To lose 50 lb. over the next six months at a rate of two pounds per week using proven principles of diet and exercise.”

Unfortunately, goals are often written in somewhat vague and overbroad terms. For example, a person interested in losing weight might state his/her weight-loss goal just as, “To lose weight.” Stated in this way, there is no specificity as to how much weight the person wants to lose, at what rate and in what amount of time. “To lose 24 pounds this year” is a bit better but still too vague. “To lose a total of 24 pounds in six months at a rate of one pound per week using proven principles of diet and exercise” is practical, specific, possible, and realistic. Further, it can be measured.

Setting Weight-Loss Objectives

Even when they are sensible, understandable, conceivable, achievable and measurable goals, weight-loss goals also require objectives to indicate how they will be accomplished. For example, the goal of “To lose a total of 24 pounds in six months at a rate of one pound per week using proven principles of diet and exercise” can be specified in exact operational terms how the weight-loss goal will be achieved with the use of objectives stated as planned actions of achievement. Examples of weight-loss objectives are provided in the next major section on Recommended Weight Loss and Maintenance Goals and Objectives.

In setting weight-loss objectives, the same criteria identified for creating goals should be applied. That is they should be written in the infinitive form and be sensible (i.e., practical), understandable (i.e., specific), conceivable (i.e., possible), achievable (i.e., realistic/viable) and measurable (i.e., quantifiable).

Recommended Weight Loss and Maintenance Goal and Objectives

The National Heart, Lung and Blood Institute (NHLB) (2000) of the National Institutes of Health proposed three general goals for weight loss and maintenance. They are as follows: 1. To reduce body weight, 2. To maintain a lower body weight over the long term and 3. To prevent further weight gain, a minimum goal. The first goal is about losing a certain amount of weight at a specific rate over a particular amount of time, while the second goal is about managing weight once the first goal is accomplished. As they are stated, these goals are broad in nature and serve only as a general intention or aspiration of what an overweight or obese individual might want to accomplish.

If the initial weight-loss goal is to lose or reduce body weight, then the NHLB (2000) recommends a reduction of approximately 10% of baseline weight over a six month period. The recommendation is for the weight to be reduced at a rate of 1-2 lb/week. This rate of weight loss can be achieved by creating an energy/calorie deficit between 500 to 1,000 calories a day. After six months, this amount of calorie deficit should result in a loss of weight between 20-25 lb.

The NHLB (2000) points out that this degree of moderate weight loss is realistic, can be maintained on a long term basis and that a greater rate of weight loss will not necessarily provide a better result at the end of one year. Maintaining moderate weight loss over a longer period of time is a better approach than to lose a large amount of weight in shorter period of time but then only to regain the weight, potentially resulting in weight cycling (i.e., repeated losing and regaining of weight). Research reveals that rapid weight loss nearly always is followed by the regaining of lost weight and an increased risk for developing gallstones and causing electrolyte abnormalities (NHLB, 2000).

Weight cycling puts the health of a person in jeopardy in other ways. For example, scientific studies have identified a statistically significant association between weight cycling and an increased risk for 1. all-cause mortality, 2. death from cardiovascular disease, 3. heart attack, 4. stroke, 5. type 2 diabetes, 6. elevated levels of low density lipoprotein (LDL – unhealthy cholesterol), 7. hypertension and 8. suppression of the immune system, all of which increases a person’s mortality risk (see Garko, 2011; Mann et al., 2007).

Relying and building upon the NHLB’s (2000) suggested goal of reducing body weight and its recommendations regarding the amount and rate of weight loss for a six month period, one possible weight-loss goal would be, “To reduce body weight by 10% of baseline weight at a rate of 1-2 lb/week over a six month period using proven principles of diet and exercise.”

Suggested weight-loss and maintenance objectives. Below are listed some possible objectives to help accomplish and maintain the weight-loss goal of losing 10% of baseline weight at a rate of 1-2 lb/week over a six month period using proven principles of diet and exercise. They are intended to illustrate how to write objectives and serve as real dietary and lifestyle objectives to employ when attempting to lose weight and keep it off. 

Typically, achieving goals require creating and putting into practice more than one objective. This is especially the case when it comes to losing weight-loss and keeping it off. Most likely it would take a combination of most, if not all, of the recommended objectives to reduce body weight by 10% of baseline weight at a rate of 1-2 lb/week over a six month period using proven principles of diet and exercise. The following list does not purport to be exhaustive, since there any number of other objectives which can help with weight-loss and maintenance:

  • To practice portion control by limiting the amount of food consumed at each meal by at least 10% to start and working up to 20%-25%
  • To decrease daily total caloric intake by 500 calories working up to     1000 calories a day, especially for extreme cases of obesity
  • To increase fiber intake to at least 35 grams a day eating primarily a plant based diet of vegetables and fruit and supplementing with a dietary fiber product consisting of soluble and insoluble fiber
  • To drink at least two liters of water a day
  • To limit daily intake of refined, processed carbohydrates by at least     10% to start and working up to 25% by following the principles of the Glycemic Index
  • To limit daily intake of saturated and trans fats by at least 15% a day
  • To limit daily intake of sodium by at least 25%
  • To engage in regular physical activity/exercise for at least 30 minutes a day to start and working up to at least 60 minutes a day
  • To decrease intake of alcohol by at least 25% a week
  • To  take the appropriate dietary supplements (e.g.. multiple vitamin and mineral, fish oil, fiber, probiotics, digestive enzymes, etc.) to help maintain a healthy nutritional status 

Long-term weight loss and maintenance. After achieving a particular overall weight-loss goal (e.g., To reduce body weight by 10% of baseline weight at a rate of 1-2 lb/week over a six month period using proven principles of diet and exercise), then the challenges becomes to sustain the loss in weight, maintain a lower body weight and not get caught up in weight cycling, something occurs all too frequently especially with fad diets. The NHLB (2000) defines “successful weight maintenance … as a regain of weight that is less than 6.6 pounds (3 kg) in 2 years and a sustained reduction in waist circumference of at least 1.6 inches(4 cm)” (p. 24).

After six months of losing weight, the rate at which weight is lost typically declines and then plateaus. This makes it is difficult for most people to continue to lose weight beyond six months because of changes in resting metabolic rates and the challenge of adhering to a weight-loss protocol on a continued basis (NHLB, 2000). Thus, adjustments and revisions in goals need to be made, especially with respect to diet and physical activity. The NHLB (2000) describes it this way:

Because energy requirements decease as weight is decreased, diet and physical activity goals need to be revised so that an energy deficit is created at the lower weight, allowing the [person] to continue to lose weight. To achieve additional weight loss, the [person] must further decrease calories and/or increase physical activity (p. 24).

Conclusion

Anyone who has been overweight or obese and tried to lose weight knows that it is relatively easy to pack on the pounds but it is another matter to shed the weight and keep it off. Being successful at weight lost requires a considerable effort. Increasing the odds of success can be enhanced with thoughtful preparation involving the setting of weight-loss goals and objectives that are sensible, understandable, conceivable, achievable and measurable.

Generally speaking, goals and objectives are intended to take individuals from where they are to where they want to be. Goals (especially weight-loss goals) need to be reinforced and carried out with objectives, which represent planned actions. When it comes to weight loss and maintenance, goals and objectives provide an overview or roadmap of what the overweight or obese individual hopes to achieve and how he/she intends to achieve it. As such, goals and objectives are important because they serve as a framework for achievement. Thus, at the end of the weight-loss day, Victory Loves Preparation. Victory at weight loss can be achieved by knowing what goals and objectives are how to set and enact them and by knowing which weight loss goals and objectives need to created and carried out. In that regard, it is hoped that this issue of Health and Wellbeing Monthly sheds some light on exactly how preparation in losing weight and keeping off contributes to weight-loss victory for those who are overweight or obese.

References

Garko, M.G. (2011, March). Overweight and obesity epidemic in America – Part VIII: Dieting is not an effective and healthy treatment for overweight and obesity. Health and Wellbeing Monthly.

Mann T, Tomiyama A.J., Westling E., Lew A.M., Samuels B. & Chatman J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220-33.

National Heart, Lung, and Blood Institute (2000). A practical guide: Identification, evaluation, and treatment of overweight and obesity in adults. Retrieved April, 22, 2011, from http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.