The Life You Want
Page 26
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Appendix 1
THE LIFESTYLE LOG
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RECORDING YOUR FOOD INTAKE, exercise, and hours of sleep, as well as your emotions, moods, or situations throughout the day, offers a goldmine of information that you can use to start changing habits. You might discover that you get a lot more exercise after a good night’s sleep, that you tend to chow down on cookies in the evenings after a particularly stressful day, or that your little candy nibbling habit really adds up over the course of the day. In chapters 2, 3, and 4, we ask you to use this food log for just those sorts of discoveries.
Here are a few tips on using the log:
You can download this log for free by going to www.thebestlife.com/ motivation.
Recording food intake. People tend to underreport their intake by about 30 percent. In order to get the most accurate reading, write down what you eat immediately after eating. The longer you wait, the more distorted your memory. Carry blank logs with you, or write down the headings in this log on a small notebook that you carry around or even on your smartphone. Remember to record every morsel and every sip—it all counts. Also useful: snapping before and after photos of your meal, snack, or treat.
Recording hunger. Using the Hunger Scale below, write down your hunger level right before and right after eating any meal, snack, or treat.
Recording exercise. Write down the minutes of aerobic exercise and, using the Perceived Exertion scale on pages 158–160, estimate your level. If you’re weight training, record the number of sets and reps for each exercise as well as the weight. You can look back at old logs and see how you’re progressing. If you use a pedometer, record steps but don’t “double dip” by recording both steps and minutes!
Recording sleep. Make a note of what time you went to bed and what time you got up, so that you can calculate how many hours of sleep you’re getting each night. Write the number of hours in your log.
Recording situations and emotions. Here’s where you jot down “Stressed at work trying to meet a deadline,” or “Angry because _________ criticized me,” or “Tired,” or any other mood state or situation.
The Hunger Scale
Sometimes it’s not easy to determine if your desire to eat is driven by true physical hunger, emotions, or the brain wiring described in chapter 3. But learning to eat only when you’re actually hungry is key to avoiding overeating and to control your weight. The Hunger Scale will help you do just that.
Here’s how it works: Before you start eating a meal or snack, rate your hunger level using the scale on the following page and record it in the Lifestyle Log. Ideally, you should eat when you’re at a level 3 or 4. Try not to let yourself get to a 1 or 2; at these levels, you’re more likely to overdo it. After a meal, jot down your hunger level again; you should aim to stop eating when you reach 5 (the level recommended for weight loss). Later, after you’ve hit your goal weight, you can stop eating at 6 (the level recommended for maintenance).
LIFESTYLE LOG
10 Stuffed. You are so full, you feel nauseated.
9 Very uncomfortably full. You need to loosen your clothes.
8 Uncomfortably full. You feel bloated.
7 Full. You feel a little bit uncomfortable.
6 Perfectly comfortable. You feel satisfied.
5 Comfortable. You’re more or less satisfied but could eat a little more.
4 Slightly uncomfortable. You’re just beginning to feel signs of hunger.
3 Uncomfortable. Your stomach is rumbling.
2 Very uncomfortable. You feel irritable and unable to concentrate.
1 Weak and light-headed. Your stomach acid is churning.
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Appendix 2
BODY MASS INDEX
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WHEN IT COMES TO body weight, what matters more than the number on the scale is how much of that weight is muscle (lean tissue) and how much is fat. Scientists devised a formula, which in many cases correlates pretty closely with body fat in adults: the body mass index (BMI). BMI is basically a ratio of height to weight, and the BMI scale is the basis for terms such as overweight and obesity. These are the widely accepted BMI categories:
Underweight: BMI 18.5 or under
Normal weight: BMI 18.6 to 24.9 (18.6 to 22.9 for Asians *)
Overweight: BMI 25 to 29.5 (23 to 26.9 for Asians)
Obese: 30 or higher (27 or higher for Asians)
The overweight category is associated with an increased risk for heart disease, diabetes, and cancer. In some studies, a BMI in this range correlates to a percent body fat of 32 percent to 36 percent for women and 20 percent to 25 percent for men. Body fat exceeding 30 percent for women and 25 percent for men is considered risky.
The obese category is associated with an even greater risk for the same conditions mentioned above. Some studies indicate that a BMI of 30 correlates to a percent body fat of 39 percent to 42 percent for women and 25 percent to 30 percent for men.
The BMI isn’t a foolproof assessment of body fat and, therefore, of health risk. For instance, because the BMI formula is based on weight and height, heavy but muscular people with low levels of body fat can fall into the overweight or obese categories. Many football players and bodybuilders have BMIs of 25 or more but have a low percentage of body fat. On the flip side, some people, particularly the elderly, who have little muscle mass, may have a BMI in the “normal” range but actually have a high percentage of body fat.
And BMI doesn’t reflect the distribution of your body fat. And that makes a big health difference. If much of your fat is concentrated deep in your belly (visceral fat), you’re at a greater risk for heart disease, cancer, and diabetes. But if it’s mainly sitting on your hips and thighs, it poses little to no risk. A waistline of more than 35 inches for women (31½ for Asian women) and 40 inches for men (35½ for Asian men) is considered risky. (To measure, place the tape around the largest part of your belly.)
Look for your BMI on the following chart or get it automatically calculated by going to www.thebestlife.com/motivation. If you’re curious and want to calculate it yourself, the formula is:
Source: Adapted from Clinical Guidelines on the Identification, Evalution, and Treatment of Overweight and Obesity in Adults: The Evidence Report.
* The BMI cutoffs for Asians are different because, at the same bMI number, Asians typically carry more fat than African Americans, Hispanics, or white Americans.
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Appendix 3
THE GOLDBERG
DEPRESSION SCALE
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Use this questionnaire to help determine whether you should see a mental health professional for diagnosis and treatment of depression, or to monitor your mood.
You might reproduce this scale and use it on a weekly basis to track your moods. It also might be used to show your doctor how your symptoms have changed from one visit to the next. Changes of five or more points are significant. This scale is not designed to make a diagnosis of depression or take the place of a professional diagnosis. If you suspect that you are depressed, please consult with a mental health professional as soon as possible.
The eighteen statements on the following pages refer to how you have felt and behaved during the past week. For each item, indicate the extent to which it is true by circling the appropriate number below the statement.
1. I do things slowly.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
2. My future seems hopeless.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
3. It is hard for me to concentrate on reading.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
; (4) Quite a lot
(5) Very much
4. The pleasure and joy have gone out of my life.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
5. I have difficulty making decisions.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
6. I have lost interest in aspects of my life that used to be important to me.
(0) Not at all
(1) Just a little
(2) somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
7. I feel sad, blue, and unhappy.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
8. I am agitated and keep moving around.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
9. I feel fatigued.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
10. It takes great effort for me to do simple things.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
11. I feel that I am a guilty person who deserves to be punished.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
12. I feel like a failure.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
13. I feel lifeless—more dead than alive.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
14. I’m getting too much, too little, or not enough restful sleep.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
15. I spend time thinking about HOW I might kill myself.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
16. I feel trapped or caught.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
17. I feel depressed even when good things happen to me.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
18. Without trying to diet, I have lost or gained weight.
(0) Not at all
(1) Just a little
(2) Somewhat
(3) Moderately
(4) Quite a lot
(5) Very much
Score Interpretation
Add up your total points. The higher the number, the more severe your depression may be. If you take the quiz again weekly or monthly, changes of 5 or more points between tests may be significant. Use the ranges below as a guide.
Score ranges:
0–9 no depression likely
10–17 possibly mildly depressed
18–21 borderline depression
22–35 mild to moderate depression
36–53 moderate to severe depression
54 and up severely depressed
Copyright © 1993 Ivan Goldberg. All rights reserved. Used with permission.
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Appendix 4
GOAL - SETTING
WORKSHEET
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AS YOU WORK ON changing habits, you need to set goals, such as going out for a walk five days a week, or limiting sweets to 150 calories per day, or setting aside thirty relaxing minutes for yourself each day. The goal-setting worksheet on the next page (first described on page 78) will help ensure that your goals really happen. It helps you set realistic, manageable, and very specific goals. Toward the end of chapters 2, 3, and 4, we’ve filled in examples for you. It might help to refer back to them before you use this blank worksheet to set your own goal. You may use this again and again for all your various goals. You can print out a free copy of this worksheet at www.thebestlife.com/motivation.
Use the worksheet to set a goal that you can and will work on during the next twenty-four hours. The next day, after you’ve tried out your strategy, set a two-week goal, which is short enough not to be overwhelming but long enough to start setting up a good habit. Revisit your plan in two weeks. If it’s still working and it’s the most you can do (let’s say that you are exercising an hour in the morning on Monday and Friday), then stick with it. If the plan isn’t working well or you can do even more (exercise three days a week instead of two), then adjust your plan.
1. What is my goal?
Find a goal that you know you can achieve—nothing overly ambitious.
2. What is the most positive outcome of achieving this goal?
This is crucial: You must be able to name and imagine a benefit. Otherwise, this technique won’t work; the positive outcome is what’s driving motivation and infusing meaning.
3. What is the main obstacle standing in my way?
4. How can I overcome the obstacle?
Be very specific, noting when and where the obstacle occurs.
5. How do I prevent the obstacle from occurring in the first place?
Again, be specific about when and where.
6. How, specifically, should I achieve my goal?
For this answer, focus specifically when and where you can make it happen; for example: “Get to the park by 7 a.m. on Monday, Wednesday, and Friday to power walk for 45 minutes.”
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Appendix 5
THE MOTIVATIONAL INTERVIEW
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HOW MOTIVATED—AND READY—ARE YOU to make healthy lifestyle changes? The motivational interview will help answer those questions. It will also help guide you to the specific changes you’re most ready to make. The motivational interview was first used to help people break their addiction to alcohol or drugs and is now being used successfully to help motivate people to make diet and exercise changes.
You first saw this interview in chapter 2, where it was used to help you overcome emotional eating. In chapters 3 and 4, we suggested that you flip to this appendix and take the motivational interview again, this time directed at either eating a healthier diet or increasing exercise.
Traditionally, a therapist asks the question and the patient responds. In this case, you’re going to be both the therapist and the patient. As therapist, you’ll be compassionate and nonjudgmental—no putting yourself down! The goal isn’t to make yourself feel guilty, it’s to know yourself better. For instance, instead of saying, “Why are you killing yourself with all that junk food?” which is bound to shut you right down, ask yourself how your eating habits are affecting your life. A much more thoughtful, helpful answer will come out of that question. It’s quite possible to have thoughts and feelings that you suppress, and you won’t realize what they are until you let them bubble to the surface. This is your chance to be introspective, prod
ded by the questions that your therapist (aka you) is going to ask.
As the “patient,” you’ll need to look deep within yourself to honestly answer the questions and take responsibility for your responses—even (and especially) if you don’t like what you hear. You may, for instance, not like to admit to yourself that you gave up swimming, the only type of exercise you really like, because you felt embarrassed walking from the locker room to the pool in a bathing suit. Or that you don’t want to give up your junk food habit because, despite the heartache it’s causing, you really enjoy the high you get from food.
In your role as the therapist, you’ll need to draw the truth out of yourself, and note where there’s resistance to change (“I have to be there to wake my kids up in the morning”), and prompt your patient to look for a way to resolve the resistance (“Well, actually, maybe my husband could hold down the fort until I get back from the gym”).
Take your time with the motivational interview. Write down your answers; they’ll serve as a reference point to how you’re progressing, and some of them will offer you a motivating reminder during those times when your enthusiasm wanes. Use this interview for any healthy lifestyle change you want to make. Tailor it to your needs by filling in the blanks. In parentheses, we’ve offered an exercise or diet suggestion. Now pull out a pad of paper and get comfortable.
ARE YOU MOTIVATED? GAUGE HOW MUCH
1. How is my current weight affecting my life right now?
2. How is_____________ (not getting enough exercise or an unhealthy diet) affecting my life right now?