Healthy Weight, Healthy Mind: Use B-SMART Goals for Weight Loss Success

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.

The B Is for Behavior

Outcome goals are king in weight management, but they shouldn’t be.

I will lose 30 pounds and keep it off

I’m going to get off my blood pressure medication.

This year I will run a 10k race.

There’s nothing wrong with these goals. Losing weight, getting off medication, and fitness events are all good things. But if this is the extent of goal setting you may fall short. Each outcome goal we set should be coupled with specific actions to support the goal. These actions are called behavioral goals. Although a baseball coach may have a goal to win the championship, nothing is going to happen without specific behavioral goals for the team. Likewise, if your desire to lose 30 pounds isn’t coupled with clear-cut behavioral goals, it probably won’t happen. Action-oriented goals for weight management can include anything that directly or indirectly impacts weight:

Self-weighing Food journaling Weighing/measuring food
Shopping from a grocery list Meal planning Tracking steps
Going to the gym Walking the dog Rating/hunger
Sleep Time spent watching TV Alcohol intake
Dining out Playing in a sports league Eating less at night
Eating at the table Walking on lunch hour Prayer habits
Meditation Journaling thoughts Batch cooking
Seeing a therapist Taking an exercise class Attending a support group

Specific (S) and Measurable (M)

Setting criteria you can measure is an excellent way to find and define specific goals. People frequently tell me their weight-related goals are to exercise more this month, eat better, or get back on track. What do these mean? One more step, one more bite of broccoli? Is getting back on track just a frame of mind or an actual set of behaviors?

Suppose you want to focus on increasing vegetables, eating breakfast, and reducing your calorie intake late at night. Specific and measurable goals could be:

If your goal involves physical activity, take a few minutes to think about what you’ll do, how often you’ll do it, and the amount of time you’ll spend. Also consider factors that affect your activities, such as thunderstorms (if it’s raining I will walk on the treadmill instead of riding my bike outside). For example:

Generally speaking, the more specific and detailed the plan, the better. On one occasion, however, I got more information than I bargained for. Marie told me her plan was to continue doing resistance training three times per week with rubber tubing. I asked her what days and times she would work out and which exercises she would do. Marie told me she waited until the evening to do her exercises because that’s when her husband was home and he liked to watch her workout. Straight faced she added, “He likes it because I work out in the buff.” Since the success rates for maintaining marriages and fitness programs aren’t so great, I supported this plan. I decided to forego my usual questions about exercise form and technique and assumed she was working all her major muscle groups. Since that day, I always feel the need to wipe down rubber tubing before I use it at the gym!

A = Attainable

This step of goal setting is where things often fall apart. In our minds we know what’s recommended, ideal, or possible — and so we set goals accordingly. We ignore that the planets would have to align in perfect order to create the circumstances for us to achieve these goals. If you typically eat three vegetables per month, immediately transitioning to five servings per day is highly improbable. Even though 10,000 steps is recommended, increasing from 4,000 to 6,000 may be more realistic in the beginning. This approach worked well for Janet.

When Janet told me she was wearing her pedometer faithfully, I didn’t really believe this was true. I couldn’t imagine she was truly walking only 900 to 1,200 steps each day. She must be only wearing it a few hours during the day; maybe the pedometer is a lemon or the batteries are bad. The average American, who is notoriously sedentary, accumulates five times as many steps. Although she was overweight, Janet wasn’t disabled in any way. Her knees seemed to be in shape to handle walking and she didn’t complain of any other limitations. Janet would have to increase her walking by a factor of 10 to reach the recommended 10,000 steps per day.

When she described her lifestyle things began to make sense. She was a busy account manager at her firm but worked from home. She parked at her desk all day, only getting up to go to the bathroom or kitchen, both near her office. When she finished working, she would sometimes run an errand or do some light house cleaning, but that was about it for physical activity. In the evening Janet often returned to her computer to finish work, fall into the abyss of social media, or play solitaire. She and her husband would also watch an hour or two of TV. She’d never been an exerciser but was open to the idea of becoming more physically active. She had recently lost weight without exercise but knew her chances of keeping it off were not good unless she moved more. Janet also wanted to feel better. She felt sluggish. Like a toddler who can’t sit still, her body yearned for movement.

She started with a goal of 3,000 steps each day, which she achieved easily just by getting out of her chair more during her work day and doing a daily errand that required some walking. After several weeks of this, we set a goal of 5,000 steps per day at least five days per week. She was able to accomplish this on the weekend by doing yard work and more housecleaning. On work days she decided to walk for 20 minutes when she took a break for lunch. Janet enjoyed the concrete aspect of tracking her steps and the challenge of reaching her goals. She was also motivated by the fact that she felt more energetic, could concentrate better throughout the day, and slept soundly at night.

Sometimes our goals yield observable positive results and
sometimes they simply keep us from sliding backward.

The next goal was to reach 8,000 steps at least three days per week. Again, the weekends were easier. Janet added a 40-minute walk to her already established weekend routine. She also began taking a 40-minute walk with her husband on Wednesday or Thursday evenings. Janet and I continued to set progressive goals and after six months she took 7,000 to 11,000 steps at least five days per week. We didn’t quite reach 10,000 steps every day, but we were close. Janet was now walking in place during long conference calls and enthusiastically signed up for her first 5K. She was always excited to tell me about her new step record, which finally hit 15,000 per day, thanks to a 40-minute Saturday walk plus a trip to the flea market.

Setting attainable goals requires setting aside our should thoughts and all or nothing thinking and focusing on progress, not perfection. Goals need not be like a light switch we flip on and off, going full force and then regressing back to nothing. Instead our goals can be more like a dimmer switch that’s always turned on, sometimes shining brightly and at other times softly illuminating. No matter the intensity of our goals, the act of setting them helps keep us mindful of long-term objectives. Each month, week, or day, consider what you can realistically accomplish. During a busy week of travel, you may focus on maintaining your weight by getting to the hotel gym three times and avoiding dessert and alcohol when dining out in the evening. When you’re at home with better control of the environment, you can turn the dimmer switch up to more frequent exercise, lower-calorie food preparation, and a greater variety of vegetables than were available while traveling. The famed Scottish novelist Robert Louis Stevenson put it this way: “Don’t judge each day by the harvest you reap but by the seeds that you plant.”

“T” Is for Time Frame

Short-term and long-term goals are both important, especially when we focus on losing a substantial amount of weight. Losing 30 pounds means you have to create a 105,000 calorie deficit over an extended period of time. Unfortunately, once you lose weight, the hardest part of weight management awaits you — maintenance. To keep the weight off you’ll need to sustain most of the behavior that helped you lose weight in the first place. A 30-pound weight loss from conventional treatments may take six months to a year as you consistently burn more calories than you consume. Therefore, you’ll need to set many short-term goals along the way. You will have to manage your weight, just as supervisors manage a business, frequently evaluating success and failure while readjusting your goals and objectives.

A common error in goal setting is to have long-term goals without setting enough goals for the short run. In some circumstances I discourage long-term goals, such as overall weight loss, until a client has a chance to set short- term behavioral goals and see how much work weight loss requires. A healthy weight is the weight you reach when you do healthy things over an extended period of time. This can’t be determined by a chart, a formula, or even the weight you felt great at 20 years ago. You’re setting yourself up for disappointment if you set a weight goal you can only reach if you behave in a way that isn’t healthy or realistic to sustain.

That’s why specific shorter-term goals with a wait-and-see approach are often more effective. You’ll get immediate returns by feeling better and becoming more fit, instead of holding onto a distant “pie in the sky” goal. The idea of that goal may still exist, but it won’t be your main focus.

Because obesity is a chronic, relapsing condition, I
encourage you to be diligent about frequently evaluating your progress.

Although no secret formula exists for timing your goals and reviewing progress, I encourage at least weekly goal-setting sessions during the early stages of weight loss. Once a week you can either meet with a professional, a peer, or yourself to review how you did with the previous week’s goals. If you achieved them, how did you do it? If you didn’t, why not? Were your goals unrealistic, not specific enough, or maybe not that important to you? Or was it a problem with execution? Do you need a more specific action plan, such as making sure you go to the grocery store over the weekend and stock up on food to cook healthier meals? Perhaps your goal of exercising in the morning will only work if you have a plan that helps you get to bed earlier the night before. Did you put everyone else’s needs in front of your own? You might reevaluate your thinking.

Over time, accomplishing these short-term goals may lead to habits you follow without thinking. When this happens, weight management becomes easier. However, because obesity is a chronic, relapsing condition, I encourage you to be diligent about frequently evaluating your progress. If your behavior starts to drift in the wrong direction, you can quickly identify the problem areas and use goal setting to help you get back on track. This may be as simple as weighing daily and observing your weight graph once a month to spot trends. Some of my long-term clients, even if they’re doing well, return to the office every month or two for exactly this reason.

Healthy Weight, Healthy Mind: How to Create Good Goals

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:

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.”

“Anything else?”

“I have a lot of things I still want to do.”

“Like what?”

“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.

“What else?”

“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.