Professionals: How to make self-weighing helpful to your clients

Professionals: How to make self-weighing helpful to your clients

I love reading academic research on eating and appetite that is readily applicable to the real-life situations I encounter every day at work with people who are unhappy with what they weigh, how they look, how they eat, or all three.

An example of super-useful research was published recently by Dr Kerstin Frie and colleagues and is something that many of us can use immediately with our clients.

The research study

100 people (all with a BMI of 30 or more) took part and were all asked to weigh themselves daily for eight weeks. Half of them – the experimental group – were encouraged to use a weight tracking app and complete regular questionnaires to prompt them to plan, reflect on and evaluate their actions. The other half – the control group – just weighed every day. Participants tracked their daily weight using the “Weight Loss Tracker BMI” app, which meant they could see their progress in a graph.

The people in the experimental group were given a menu of 53 behaviours that could help with weight loss. These behaviours were grouped under 7 different headings and people were asked to choose one heading for the week and to choose and use at least one specific behaviour each day. The 7 headings are:

  • Eating in a structured way
  • Avoiding or swapping specific foods
  • Changing what you drink
  • Creating a healthier diet
  • Meal-time tactics
  • Burn more calories
  • Be more active as part of your daily life

You can read the full list of 53 weight loss actions here.

People experimented with different behaviours to see what worked for them

The brilliant thing about this is that it means that people were encouraged to experiment with different weight loss approaches and identify their personal set of effective strategies.

They were encouraged to link their actions with weight loss results by completing a weekly questionnaire to reflect on and evaluate the category of actions they had tried out that week. In doing the questionnaire, people were encouraged to identify which actions they found particularly useful and wanted to continue with.

What the researchers found was that taking this approach led to significantly greater weight loss than daily weighing alone – on average people lost half a stone (3.2kg) more in the experimental group than they did in the control group!

Participants felt really positive about the approach

The feedback the researchers received from participants following the programme was overwhelmingly positive, with many saying that the programme let them take control of their weight loss and flexibly manage their weight alongside their busy lives.

The weight loss strategies were simple and straightforward

The researchers said that they were quite surprised by the amount of weight people lost because none of the 53 weight loss strategies they had come up with were revolutionary.

“Each strategy would probably have had only a modest effect. By combining these actions and putting them into context with weight data, people were able to gain insights into how their diet and physical activity affected their weight. The process of self-regulation and experimentation allowed them to develop their own highly personalised weight loss plan.”

The authors summarised their research in this really helpful article. As they say…

“People who weigh themselves regularly are more successful at losing weight and keeping it off. But standing on a scale, in itself, doesn’t help people to magically lose weight. Rather, standing on a bathroom scale every day may encourage some people to think about their eating and exercise habits, plan ways to lose weight, and help them resist temptation. In other words, the bathroom scale might help people self-regulate”

How can you use these findings in your own work with clients?

  1. Explain that self-monitoring is a valuable tool in achieving weight loss, but that weighing on its own isn’t enough for most of us. It’s how you use what the scales tell you that makes the difference.
  2. Have a look at the 7 categories of 53 weight loss actions – you could share the list with your client and explain to them what the research found. Invite them to start a daily practice of choosing which of the 53 actions they’d like to take that day.
  3. When they get on the scales, encourage them to make a specific action plan for using the weight-loss-action they’ve chosen that day (if weighing in the morning) or tomorrow (if weighing in the evening).
  4. Once a week ask them to look over the previous week’s actions and reflect on what went well and what they want to keep doing. That way they will be building up a collection of healthy actions that they can continue regularly and flexibly, according to what’s happening in their life that week.

 

Daily weighing doesn’t work for everyone

Some clients just don’t want to weigh themselves. That’s fine and the point is not to persuade them to do it, but to see whether there are other signs of progress they can use instead. I’ve had clients who used how their clothes felt on them, what notch on their belt fastened up, or what shirt collar size now fits. And I’ve worked with people whose goals were more to do with how they eat than what they weigh, in which case how free they felt around food was the measure that mattered. These outcomes don’t give the same hard numbers that weighing scales do, obviously.

If your client has become fearful of the scales or finds that weighing triggers disordered eating for them, you can ask what will matter to them and monitor that together week by week.

Reference

Frie K., Hartmann-Boyce J., Jebb S., and Aveyard P. (2020) Effectiveness of a self-regulation intervention for weight loss: A randomised controlled trial. British Journal of Health Psychology DOI:10.1111/bjhp.12436

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I run clinical skills workshops for professionals of all disciplines whose work involves helping people change how they eat. Check out upcoming events here.

 

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