Working Towards Goals and Not Expecting PerfectionFriday, June 01, 2012
Jill Weisenberger, MS, RD, CDE, has written a new book, Diabetes Weight Loss, Week by Week, which focuses on taking a normalized, flexible diet plan to help PWD focus on developing skills and learning eating strategies within a realistic format.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
One of the things medical providers and dieters are realizing is that dieting is a tricky science. Dieters may lose weight initially, but in many instances gain the weight back months later. Part of the reason for that is setting up unrealistic plans in the beginning and expecting people to stick with a restrictive diet once the weight goal has been reached.
Jill Weisenberger (pictured here) knows through her clinical experience that people trying to lose weight often struggle and have numerous obstacles to overcome in order to first lose the weight, but then keep it off. She knows it is about a process and taking the time to make realistic lifestyle changes, and that there likely will be some setbacks along the way. One of the reasons she wrote this book, Diabetes Weight Loss, Week by Week, was seeing patients struggle through restrictive diets that put the emphasis on the person’s ability to be very disciplined. Therefore, she created a plan where dieters could have some flexibility, but use goals as a top priority to help them stay the course and lose weight.
DiabetesCare.net talked with Weisenberger about her book’s approach to diet, the importance of setting goals during the process, and what her strategies are for long-term success.
DiabetesCare.net: Can you provide an overview of your book?
Weisenberger: The basic weight loss principles for people with diabetes are the same as those without the disease. What I did for the diabetes patient population was address the special nuances that they face. Some examples include having low blood glucose when facing a new diet; the uncertainty of the potential ramifications of diabetes medications on their shifting weight as they begin to shed pounds; and how diabetes complications interfere with physical activity.
Diabetescare.net: Why did you decide to write this book?
Weisenberger: I have been very fortunate to have worked with individual patients over a long-term period, so I have seen patterns develop within people following them over the course of many months or even a year or two. The book is based on my experience with these patients, as well as seeing a lot of diet books out there use the ‘follow this diet, these are the rules,’ format. And as an RD, I see that some of these diets plans are questionable. They are set up within strict parameters without any kind of flexibility for the dieters to have while following such plans.
I wanted to take the emphasis away from these rules and the willpower expected to follow the diets, and put the emphasis on developing skills, practicing the skills, having strategies, and planning.
Willpower doesn’t really work for anybody long-term. I wanted a book that made people good or great, but not perfect. Trying to practice perfection is just setting them up for failure. And I think that’s what a lot of books do.
DiabetesCare.net: Who is your audience for this book?
Weisenberger: The primary audience is anyone with diabetes who wants to lose weight. Again the principles are the same. Whether they are type 1 or type 2, or they are on oral medicines or insulin.
Likely, my biggest audience will be overweight type 2s, because that is the majority of overweight people with diabetes.
However, for overweight type 1s, people with prediabetes, and even people who are none of those things and they are just looking to lose weight, the book is still applicable. This last group of people can skip over the diabetes elements to the book.
Now not every strategy works for every person. The idea is that you learn all these strategies, practice them, and use the ones that work for you. For example, for some people pre-measuring their snacks is a strategy that will work but for others it doesn’t.
Using strategies over willpower and restrictive dieting is applicable to the entire overweight population.
DiabetesCare.net: Can you talk about your term SMART Goals, defining what the acronym means?
Weisenberger: I first came across the SMART acronym with adults who were learning to read. It stands for Specific, Measureable, Action oriented, Realistic, and Timely (SMART). The idea of a SMART goal is to make it so specific that anyone who reads it knows exactly what you are going to do, and how you are going to do it.
When I ask people what they want to do, they will reply, ‘I want to eat better.’ For somebody reading that, they don’t know what that means and how you are going to do it. An example of a more specific goal might be, ‘I am going to eat a fruit or a vegetable at every meal and snack this week.’ It is very specific and measureable.
It is also that it is actionable; it isn’t that I’m losing weight, it is that I’m eating better and it will help me lose weight. We may not be 100 percent in control of what our bodies do, but we are in 100 percent control of what we do to our bodies.
DiabetesCare.net: In part one of the book you titled it the “Basics in 16 weeks” and provide advice for each week during those 16 weeks. Why the decision to identify the first four months in the program?
Weisenberger: I like to pace people who are trying to lose weight, because there are numerous things to learn, and situations to address for people to lose weight successfully—and it takes time to learn these things.
I know people want to jump in and do everything at once, especially in the very beginning when their motivation is very high, but this enthusiasm is not long-lasting and getting everything thrown at you at once can be very overwhelming.
So, I took those first 16 weeks as a good time to develop the foundation and give people enough information up front to be successful, but not too much. After 16 weeks, I switch to the month-to-month plan because people don’t need quite as much information, but they do need new information to help with motivation, address new situations that come up, and reinforce the basics they learned in the first four months.
It was important for me to make the book a full year as people struggle when seasons change, during vacations and holidays, and when school starts and ends. I wanted dieters to go through almost every experience they could have while still being focused on the plan over the course of a year.
I expect people to mess up; it is more likely people will fall off their plans 6 months into their diets, as they may lose their focus. So, if they have a setback several months into the book, they can get back on track, practice skills, fine-tune them, and learn new strategies in the book.
DiabetesCare.net: You have a detailed action plan for every week in the first 16 weeks and then in the subsequent months that follow. Can you talk about the importance of the action plan and meeting goals?
Weisenberger: It is one thing to learn something, but it is something else to put it into action. If all I did was read a chapter, and not work-up a plan on how to use it, then it is likely that I would not use it.
It is a way to get people to change. In a way, it is about giving homework, but it is about them choosing it for themselves. For nearly every single visit, I ask patients what are their goals and what their action plan is. I want them to be able to leave my office, knowing exactly what they are going to do. This sets them up for success. It is along the lines of the SMART goals. Having an action plan is clearly stating what you are going to do. It is a way to take the information and be sure that you use it.
DiabetesCare.net: How is your book different from other diabetes weight loss books?
Weisenberger: There aren’t a lot of weight loss books for people with diabetes. What makes it different is that it doesn’t prescribe a particular diet, so you could use carb counting as a method. You could count calories. I don’t prescribe a particular diet, but show you how to make a good diet work for you in the long term. Most diet books are not about skills but about, ‘follow these rules and have enough willpower to make it work.’
This is about recognizing what a healthy diet is, and learning how to put it into action in your own unique life. Also the week-by-week and month-by-month format is unique as it helps dieters take on certain skills without taking on too much at one time.
I think what makes the book different is that it is not a one-size-fits-all type of plan. You can individualize it according to your own goals, your own food preferences, and your own medical history. By going through each chapter, and practicing skills and reflecting on the efforts, each reader can build his or her own unique way to a healthier, slimmer self.
DiabetesCare.net: What is your overall goal for this book?
Weisenberger: I want people to see that managing diabetes and losing weight can be done at the same time. I often hear from people that they think it is one or the other and that they are competing goals. They are not.
And I want them to see successful weight loss means finding a healthy obtainable eating plan that tastes good and you can follow forever. It is not about being perfect; it is about being better.
To read more about Weisenberger, go to her website. Her book is going to be released in July, but people interested in pre-ordering a copy can do so on Amazon or on ADA`s ShopDiabetes.