April 24, 2009

Sure it's important to have a healthy diet plan to lose weight, but if that isn't enough, then consider this strategic plan used by smart women. Take Jenn for example. The first time Jenn set out to lose those 20 pounds, she gave up sugared sodas. The second time, she ate only protein. She fasted, overdosed on raw carrots and counted fat grams. All of the diet tips and healthy weight loss plans she tried worked, but only for a while. Sheer force of will didn't keep her from chowing down when the impulse struck; nor did it get her into the gym. It was not until Jenn approached her excess weight the same way a new CEO might a faltering business did her 20 extra pounds disappear for good.

Here's the problem-solving approach that Jenn used to successfully supplement her healthy diet plan.

The technique Jenn used is a systematic problem-solving approach developed more than 50 years ago to improve industrial production. Called "quality improvement" or "systems thinking," it means you:

  • look at your problem as part of a larger system
  • find things that contribute to the problem
  • experiment by changing the system in some small way

After you've seen the result of your change, you alter the system again to incorporate the new change, then look for other causes of the problem. Then you experiment with the other solutions until the problem is solved.

If your problem is too much weight, you can use this method to change the behaviors causing it. Farrokh Alemi, Ph.D., associate professor of health-care management at George Mason University School of Nursing in McLean, Va. and his colleagues have tested what they call continuous self-improvement on 400 people seeking personal change, including healthy weight loss and exercising more. Not only has it been successful in changing daily habits, the changes have been long lasting. Here's how it could work for you.

Step 1: Look at the big picture

Shift from seeing your weight problem in personal terms and instead see it as part of a larger system that includes your family needs, social life, work hours and whatever else affects your exercise and eating habits, ncluding any ethnic-food preferences and peer pressures. Once you discover how many outside factors affect your healthy diet plan and exercise, you'll realize that losing weight with willpower alone is almost impossible. "Using willpower for self-improvement is like applying brute force," Alemi says. "Using a systems approach is applying intelligence."

Step 2: Define the problem

Before coming up with solutions, you need to identify the real problem, says Linda Norman, M.S.N., R.N., associate dean at the School of Nursing at Vanderbilt University in Nashville, Tenn., and one of Alemi's research colleagues. Say your favorite jeans are too tight. Instead of telling yourself you need to lose weight, Norman suggests you ask yourself a series of questions, such as "What's associated with the weight gain that's made my jeans tight?" (maybe the underlying problem is boredom at work or the pain of a bad relationship) and "What's contributing to my weight gain?" (maybe you don't make time for exercise, or you eat in response to stress and need to learn other stress-management techniques so you can successfully follow a healthy diet plan). "The more questions you ask," Norman says, "the closer you'll get to the root of the problem."

"It also helps to 'frame' the problem positively," Alemi adds. "For example, you might look at weight gain as an opportunity to get fit." Finally, it's important to define the problem in a way that lets you monitor your progress and measure the outcome by how well you're dealing with the triggers that cause weight gain.

Step 3: Brainstorm solutions

Clearly defining the problem that is preventing you from achieving healthy weight loss will lead you to the solution. If you've stated the problem vaguely -- "I have to eat less" -- you've biased yourself toward dieting as a solution. But if you're specific -- "I need to change jobs or reduce my stress to protect my health" -- you'll probably think of several good answers to your problem, such as seeing a career counselor or starting a new exercise program. Write down every solution that comes to mind, then arrange the list according to priority, starting with the ones that contribute most to the problem or will have the greatest impact on the outcome.

Step 4: Monitor your progress

Make the first item on your list your first experiment. "Say the problem is that you're sedentary, and your first solution is to work out with a friend after work," says Duncan Neuhauser, Ph.D., a professor of health management at Case Western Reserve University School of Medicine in Cleveland and another of Alemi's research colleagues. "You might experiment with using your noon hour to make exercise 'dates.' "

After a few weeks, add up the number of times you exercised. If your first solution didn't work, try an evening exercise class or find a park where people walk or run after work. Win or lose, keep notes. "Measure your progress every day," Neuhauser says, "and put the results in chart or graph form. Visual aids are helpful." The data you gather will also make you aware of your normal variations. You may be more active on certain days of your period, for example, or you may always gain 2 pounds when you spend weekends with certain friends. "The data gathering is not just about keeping track of your weight," Norman says. "It's about tracking the process that affects your weight."

Step 5: Identify barriers

"There are going to be crises, external influences, times you have to eat Grandma's cookies," Neuhauser says. You'll have days when you can't exercise and days when you'll be tempted by holiday meals, and because you're tracking your progress, you'll be able to detect which events actually cause weight gain.

"Overwhelming evidence from many areas, including substance-abuse research, shows that situations trigger relapses," Alemi says. "You need to find out which situations make you return to old habits." Once you're aware that working late makes you too tired to exercise, for example, you can test strategies for leaving work on time. If you blow your balanced healthy diet because you dine out with friends who always order too much, try hosting takeout at your house and make sure you order healthy foods.

Step 6: Build a support team

Some people lose weight with the help of a diet buddy, but for the best chance of success, you need the support of people whose decisions will affect your efforts.

"When you make systemwide changes, your actions affect many people," Alemi says. "If you plan to lose weight by changing your food-shopping, cooking habits and strategy for a balanced healthy diet, then everyone at home will be affected. You're better off to engage them from the start." Start by educating these friends and family members about weight loss in general (including what lifestyle changes are necessary) and your goals in particular with regard to a healthy weight loss, then involve them in your daily experiments. "The whole group needs to agree to rely on the data," Alemie says. As results of your changes come in, including new, healthier habits, share them with the group. After all, when you finally do solve your weight problem, these people are the ones who will help you celebrate your success. They may even thank you for helping them, too.


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