at
a
Glanc
e
Group Session 14
Key Behavioral
Strategies
Relapse prevention
Problem solving
Participant
Behavioral
Strategies
Before the next group session, the participants will:
Practice self-management techniques in preparation for maintenance
Post their personal rules/behaviors on the refrigerator or another visible
place
Observe lifestyle for behaviors that may be hard to maintain and create
rules and a plan to prevent relapse
Process Objectives
& Session Content
Participate in an exercise activity
Discuss characteristics of people who successfully lost weight
Review their own self management technique
Determine their calorie needs for maintenance
Identify high-risk situations that could lead to return of old habits and
create a plan for preventing relapse
Create personal rules or boundaries for eating while maintaining weight
Handouts What’s Your Secret
Breaking Bad Habits
My Five Rules
My Action Plan for the Week
Food and Fitness Diary (FFD)
New Leaf Module Handout “Success Stories”
Resources
http://www.nwcr.ws/
Topics/Agenda
(2 hours)
CHECK-IN ~20 MINUTES
DO IT! ~40 MINUTES
TRY IT! DISCUSSION/ACTIVITIES ~40 MINUTES
Negative thoughts
Negative emotional states
NEXT STEPS ~20 MINUTES
Agenda for Session #14 Page 1 of 5
I. Check-In
Negative thoughts and
feelings
Use of positive
affirmations
~ 20 minutes
Check- In
Sample discussion approach:
Last week you made a plan to start using positive affirmations and to
stop the negative thoughts and feelings. Would someone share her
positive reaffirmation with us? Did it work? Were you able to more
often identify negative thoughts after last week? Did noticing the
negative behavior change your actions? Were you less likely to act out
or take these feelings out on others? How many people were
surprised at how often you had negative thoughts? How do they
make you feel?
Your Notes:
II. Try It
Maintaining a healthy
weight (“Be a
Successful Loser”)
Identifying high-risk
situations and
preventing relapses
Plan for weight
management
(“Identifying High
Risk Behaviors”; “ My
Five Rules”)
1. Maintaining a healthy weight
Discuss what works in mainta• ining a healthy weight
• Introduce concepts from the National Weight Control Registry
• http://www.nwcr.ws/
Sample discussion approach:
We’ve talked a lot about what contributes to successful weight loss
and many of you have shared your techniques with us. Let’s think
about these things again. What has helped you lose weight and keep
it off? What has been most helpful for you? Most effective? What do
you think will help you continue to manage your weight? You might
also think about people you know who have been successful at
managing their weight. What do they do? What helps them find
success?
Scientists have looked at some of the techniques used by individuals
most successful at losing and keeping weight off. Let’s review some of
these characteristics. (Distribute What’s Your Secret? handout)
Your Notes
Refer participants to New
Leaf handout “Success
Stories” for additional
information. The handout
can serve as a resource for
more information but will
not be covered in class.
Agenda for Session #14 Page 2 of 5
~40 minutes
How many of these things do you do? How many can you do? Do
you believe that these are successful characteristics?
The people most likely to make successful long-term lifestyle changes
are those that have the skills and confidence to do so. Maintenance is
staying with all the factors that brought you success – like keeping
food records, continuing to exercise, managing challenges in new
ways, etc.
2. Identifying high-risk situations and preventing relapses
• Discuss potential situations for relapses
• Talk about how to prevent these relapses
Sample discussion approach:
It is very common for us to experience relapses or weight re-gain as
old habits are hard to break. Weight re-gain occurs when people
slowly go back to the old habits that brought about an unhealthy
weight in the first place. Unless we anticipate our high-risk areas and
create some strategies for dealing with them, it is likely that we could
slip back into old patterns. Slips are normal and anticipating them can
help you handle high-risk situations when they arrive.
Let’s walk through a few examples. You’ve given up fast food while
on your eating plan for weight loss. It has been months since you
have stopped at a McDonald’s or Burger King but you are on a road
trip with your family and you decide that fast food is the easiest place
for dinner. Before you know it, fast food is being consumed more
regularly than before. How many people can see this happening?
What can you do to prevent this from re-occurring? What if you have
no control over where your family stops for dinner? What can you do
in this situation? (i.e., order healthier meals) What if you just have to
have a burger and fries – what should you order? (i.e., small
hamburger with no cheese or special sauce and a small fry – think kid
size).
Agenda for Session #14 Page 3 of 5
Relapses generally do not occur overnight. There are various stages
of relapse. The first is a lapse which is a small or insignificant slip
(think eating a half a bag of cookies one time). The second stage is
the relapse where a series of old habits begin to appear (think eating a
half a bag of cookies every week). The third stage is the collapse
(think eating a half a bag of cookies everyday and then disregarding
the rest of your healthy eating and exercise habits). What do you
think are the major causes of a lapse? (i.e., life stressors,
environmental influences etc.) How many people have experienced
some sort of relapse? Can someone share their experience with the
group? What can you do to prevent a relapse?
3. Planning for weight management
• Identify high risk situations
• Develop rules or boundaries for these situations
Sample discussion approach:
We have already talked about some of the successful characteristics of
a ‘loser.’ But, these all may not work for you. It is important to have
your own plan to help you manage your weight. The first step is
identifying your high risk situations. (Distribute Breaking Bad
Habits) Once you are finished filling this out, circle 2 habits or
behaviors you are most concerned about resurfacing in the future.
Break into groups and brainstorm on strategies to prevent this relapse.
Sometimes it is helpful to have certain personal rules that help you
manage your health. As we talked about earlier, there are basic
concepts that will help you with your weight-loss or weight-
maintenance efforts. They are centered on five basic concepts. The
first is ensuring that you are active. The second is recording or
monitoring what you are eating and even how much exercise you are
getting, think Food and Fitness Diary. The third concept is keeping
Agenda for Session #14 Page 4 of 5
track of your weight. Weighing yourself helps keep you on track and
hopefully keeps you motivated. The fourth and fifth concepts deal
with diet. Eating a well balanced diet consisting of a variety of fresh
foods, minimizing fast food, fatty meats and heavily processed foods,
will help you keep the weight off and lose more weight. The last
concept deals with how much you are eating. Even if you are eating
all the right foods, if you eat too much, you will not reach your goals.
Keeping these things in mind, let’s take a few minutes to write down
some personal rules to live by. (Distribute My Five Rules)
Your Notes
III. DO IT !!!
Objectives
1. Increase heart rate
2. Extend the activity session
Sample discussion
We have used walking a lot in our Do It sessions because it is
something that almost everyone can do. How many of you are
regularly walking? Sometimes it makes it easier to walk in a group.
Remember the first session where we walked in pairs and then
switched? We will do this again today, but this time we are going to
walk for 5 minutes before splitting. Also, today we are going to walk
for a little longer. Hopefully, you are all in better shape since
beginning the program and can increase the duration. During your
walk, share with your partner your experience in the program. Share
frustrations and successes.
Group Walk
~ 40 MINUTES
Before we begin, let’s warm up. Can someone lead us in some warm-
up exercises? (Have participants walk and signal when the 5 minutes
is up and switch partners. At the end of the 35 minutes, have
someone lead the group in cool down exercises).
Agenda for Session #14 Page 5 of 5
IV. Next Steps
This is our second-to-last group activity. What would you like to do
for the last activity? Any ideas? (Take a vote and arrange activity for
Session 16).
1. Plan for the Week
Participants write a weekly action plan on the inside cover of the diary
in at least the following areas:
--Relapse prevention
--Physical activity links
--Participant choice
2. Tracking (Self-Monitoring):
Plan for the Week
The recommended tracking for the week is:
Tracking (Self-
Monitoring)
a. Write down all the food you eat and drink every day.
b. Calculate the calories from the foods you eat and drink, total,
and summarize for at least 3 days.
What to Expect Next
Week
c. Keep track of servings of fruits and vegetables each day.
d. Write down the minutes of exercise above your normal
routine.
~20 minutes
3. What to expect next week
• Staying Motivated!
What’s Your Secret?
Do you know people that have been able to lose weight and keep it off
and thought ‘how do they do it?’ We asked and this is what they said.
“I use both diet and exercise to lose and maintain my weight.”
“It is harder for me to just eat a small portion of my favorite foods,
so I just try not to eat them at all or only on special occasions.”
“I watch the portion size of foods I eat.”
“I still eat some of my favorite foods, but I make sure I stay within a
certain calorie range everyday.”
“To maintain weight, I exercise for at least 210 minutes every week.
For me that means walking for 30 minutes everyday.”
“I don’t let a bad day discourage me and just take it one day at a
time.”
“I weigh myself once every week and if I have put on a pound I
am extra careful that week.”
“I try to make healthy choices no matter where I am either at
home, at a friends or eating out.”
“It is hard sometimes, but it is more important for me to be healthy
than it is to eat a piece of cake.”
“I constantly set small goals and each time I reach those goals, I
plan a special celebration like going to get a manicure.”
“When I am feeling discouraged or tempted to eat something
unhealthy, I call my sister who helps me remember why it is so
important to be healthy.”
“I keep a list of my goals and when I feel hopeless I look back at
the list and realize how far I have come and then I know I can
keep going.”
Version 1.2 6/30/2005 Session 14
Breaking Bad Habits
Example
Habit 1 Habit 2 Habit 3
Bad habits that
could creep
back into my
lifestyle
Eating ice cream
everyday
Triggers for these
bad habits
Reward for a hard
day’s work
Strategies I have
used in the past
to deal with this
bad habit
Do not have ice
cream in the house
New strategies for
preventing
recurrence of
these bad habits
Eat low-fat frozen
yogurt
Go to the ice cream
shop and get 1
scoop of ice cream
on occasion
Taking a long hot
bath
Going for a walk
Calling a friend
Version 1.2 6/30/2005 Session 14
My Five Rules
Activity Rule: I will walk for 30 minutes at least 3 times a week
Recording Rule: I will keep a record of what I eat for five days
Weight Rule: I will weigh myself at least once a week
Diet Rule: I will eat at least two vegetables everyday
Diet Rule: I will eat breakfast everyday
Version 1.2 6/30/2005 Session 14
My Action Plan for the Week
GOAL #1: Preventing relapses
3 strategies to help you prevent relapses
1.
2.
3.
GOAL #2: 30 minutes of moderate physical activity on 5 days of the
week
Day Activity Minutes
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
TOTAL
GOAL #3: Keep track of all food/drinks and physical activity in the Food
and Fitness Diary every day
Things that may get in my way How I can make sure they don’t
1.
2.
3.
1.
2.
3.
GOAL #4: My other goal is:
____________________________________________
What I need to do to reach this goal:
Version 1.2 6/30/2005 Session 14
