We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).
Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.
People I counsel are usually seeing me because they haven’t been able to achieve their goals for weight and health. Many of them are successful in other areas of their lives. At work, they create objectives, manage budgets, and delegate work to get results. Goal setting is easy for them in their roles as teachers, accountants, and sales associates. Even those who aren’t paid for their work, such as the stay-at-home moms and dads, are often amazingly good at organizing their lives when it comes to grocery shopping, getting the kids to and from various events, paying bills, cleaning house, preparing meals, and volunteering for community organizations. I’ve worked with physicians, nurses, and veterinarians who preserve life when they accomplish their goals, and business owners and executives whose work supports thousands of people.
Many of these folks are efficient, well-oiled machines when it comes to getting things done. They’ve learned to set realistic short-term and long-term goals and the results are impressive. But when health goals are at stake, it’s often a totally different story. The machine becomes clunky in one area of their lives and out of sync in another.
Where do they go wrong? Their intentions are nonspecific, unrealistic, poorly thought out, or rehashed from past unmet goals.
Many of my patients refuse to continue setting nutrition or fitness-related goals. Their attitude is, “Why would I set a goal I know I won’t achieve? Then I’ll feel even worse!” They exist between a rock and a hard place, knowing goals are important, but also knowing the pain of failure.
I often ask clients what they’d tell their children, grandkids or other young people about goals. “Would you tell them to forget about goals because you’ll only disappoint yourself when you don’t achieve them?”
That question usually evokes a blank stare followed by a nervous smile. “No, I guess not.”
“So what would you say?” The responses to this question have several themes:
- Goals are important.
- They help us clarify where we want to go and how we can get there.
- Achieving goals is rewarding in and of itself.
- Not achieving goals can provide lessons on how to set better goals.
- Setting goals can motivate us into action.
- Goals can help us separate essential things from all the rest.
In the early 1980s, George T. Doran, a corporate consultant, coined the acronym S.M.A.R.T. for effective goal setting. Since then, educators have adapted the term to meet their needs for different disciplines. I borrowed George’s ideas to help clients remember the importance of weight-related goals.
This acronym is easy to remember and the letters stand for the following:
B=Behavior (make sure your goals are about behavior, not just outcomes such as weight)
S=Specific (what, when, and where)
M=Measurable (calories, servings of vegetables, miles walked, steps, minutes of exercise, etc.)
A=Achievable (goals are realistic even when unexpected events occur)
R=Reason (why is this important?)
T=Time Frame (what is the length of the goal—one day, a week, a month?)
And The Reason Is?
When we set weight-related goals, they should have meaning and a clear reason for existing. I end most of my sessions with a goal setting exercise by asking the patient to tell me what he or she wants to achieve before our next meeting together. Sometimes people tell me what I want to hear, just to end our session. An attitude of “Let me set these goals so I can get out of here,” isn’t helpful to either of us. The goal is selected, but it doesn’t have meaning.
Neither is it helpful when someone chooses a goal that’s important to someone else or because of feeling obligated. You probably won’t be successful if you set a goal because a psychologist, doctor, minister, or family member twisted your arm.
Before you set a goal, ask, “Why is this goal important to me?” Write the answer in specific terms. By specific, I mean avoid grand, general statements such as, “I want to be healthy,” or “I want to improve my quality of life.” Those are not specific reasons to eat better or lose weight, and they don’t spur you to action. I once heard a speaker discuss this topic and his technique was so effective that I’ve been using it for twenty years. Here’s an example:
When my patient, Barbara, announced she wanted to set the goal of tracking food in a food journal, I asked, “Why is this important to you?”
“Because tracking my food helps me pay attention to what I’m eating.”
“Why is it important for you to pay attention to your eating?”
“Because it helps me lose weight.”
“So you can what?”
“So I can be healthier.”
“So you can what?”
“So I can live longer and have a better quality of life.”
“Live longer for what?”
“To see my grandkids graduate from high school.”
“I have a lot of things I still want to do.”
“I want to travel to Europe with my husband after I retire and I want to hike the Grand Canyon someday. I want to ride bikes with my youngest grandkids and my future grandkids.
“I just want to feel better.”
“Why does that matter to you?”
“Well, I won’t have to take as much medicine and I’ll have energy to do more things.”
“Can you give me more examples?”
“When I feel better, I like to read and learn about new things. I enjoy work more, I laugh more, and my life is extra meaningful. When I feel bad it’s all about me. I want to rest; I just barely get through the day. It’s easier to enjoy almost everything when I have more energy and less pain.”
The point of this exercise is to distill the reasons for our goals into smaller and more specific ideas. These new, small- scale goals are meaningful, and even joyful. In the above example, Barbara’s food journal is tied to quality time with her grandkids, enjoying her job, laughing, and hiking the Grand Canyon. When the rubber hits the road, these factors offer greater motivation than simply telling herself that keeping a food journal will help her lose weight and get healthier. Visualizing all the things she wants to do drives her to accomplish her goal.
In the next article, we’ll review each of these B SMART points individually.
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