Living a Healthy Life with Chronic Pain (36 page)

To reach and maintain a healthy weight, you may need to make some changes in your eating habits and lifestyle. This is true whether you want to gain or lose weight. If you decide you need to change your weight, keep this very important advice in mind: you must decide to do this for yourself—not for friends or family. Make changes that you believe you can stick with for a long time. If you decide to make changes for someone other than yourself or plan for only short-term changes, you probably won’t succeed.

To get started, review the information about action planning in
Chapters 2
. Consider asking your doctor to refer you to a registered dietitian for help. This is not something you need to do alone.

When making the decision to change your weight, you must ask yourself two primary questions:

• Why do I want to change my weight?
  The reasons for losing or gaining weight are personal. They differ for each of us. The most important reason for some may be physical health. For others it may be personal or emotional reasons. Think about the reasons why you want to gain or lose weight. Here are some examples:
  

Table 14.1
Body Mass Index (
continued
)

Jot your important reasons here:

• Am I ready to make lifelong changes?
  The next step is to determine whether this is a good time to start making changes in your eating and exercise. If you are not ready, you may be setting yourself up for failure. But the truth is that there will likely never be a “perfect” time. Consider the following:
  

Table 14.2
Weight Classifcations Based on Body Mass Index

Table 14.3
on
page 241
can help you identify some of these factors. To overcome barriers, use some of the problem-solving tools found in
Chapters 2
.

After you have thought about these issues, you may find that now is not the right time to start. If it is not, set a future date to revisit things. Accept that this is the right decision for you at this time, and focus your attention on other goals.

If you do decide that now is the right time, start by changing the things that are simplest, easiest, and most comfortable for you. This means working on only one or two things at a time. Do not try to do too much too quickly. Remember, slow and steady wins the race.

Two important ingredients for successfully changing your weight are to start small by taking “baby steps” and make changes that you know will work. There is no getting around it. Whether you want to lose or gain weight, you will need to change the amount and perhaps the way you eat. Making changes to something as fundamental as the way you eat can be a challenge. This may seem scary, but by starting with things that are doable, you can be successful.

Start by changing only one or two things at a time. Yes, we said this before but it is really important. For instance, instead of eating 1/2 cup of rice, eat a few tablespoons less or a few tablespoons more. To eat less, try slowing down how fast you eat. To increase calories, spread out your eating over several small meals a day. Allow yourself time to get used to these changes and then slowly change other things you are doing.

Table 14.3
Factors Affecting the Decision to Gain or Lose Weight Now

Don’t attempt drastic changes. If you tell yourself you are going to walk five miles (eight km) a day every day of the week and never eat potatoes or bread again, you won’t be able to stick with that for very long. You probably won’t lose weight, and you will feel frustrated and discouraged. But when you make a plan to have only one piece of toast at breakfast every morning instead of two and take two 10-minute walks four times a week and stick to it, you are making good, long-term changes that will translate to success.

When you change your weight slowly over time, you have a better chance of maintaining that change. This is partly because your brain begins to recognize the changes you are slowly making as part of your regular routine or habit rather than just a passing fad. The goal-setting and action-planning skills discussed in
Chapters 2
will help with this. Remember, the best weight management plan combines healthy eating and exercise and is a slow, steady path that feels right to you.

A good starting point is to keep a diary of what you eat now and how much you exercise. Do this for a week. It will help you learn where you need to make changes. Write down:

• What and where you eat
  

• Why you are eating (hungry, bored, habit)
  

• How you feel when eating (your mood or emotions)
  

• Your exercise (what you are doing or not doing now)
  

Your diary could include a section for ideas about what you would like to do differently. Don’t worry; if all your ideas don’t work out right away, you can always go back to them. Our sample lifestyle tracking diary may be a useful self-management tool (see
Table 14.4
on
page 243
).

A simple and practical plan to get you started is the 200 Plan. It involves making small daily changes in what you eat and the amount of physical activity you do. The 200 Plan is straightforward: to lose weight, eat 100 fewer calories a day than you do now, and burn off an extra 100 calories a day with additional exercise. Eating 100 fewer calories and burning off another 100 calories each day can add up to a 20-pound weight change over the course of a year. If you would like to gain weight, add 100 calories to your diet while keeping your exercise level at the recommended 20 to 40 minutes most days of the week. The 200 Plan is a good way to balance eating and exercise and can help you make a long-term change in your weight. Sticking to this plan on a daily basis is essential for success.

Start by checking with the food guide,
Table 13.2
on
pages 226
–
233
, which gives estimated serving sizes and calories. For example, a 1-ounce (28 g) slice of bread has close to 100 calories. By not eating one of the slices of bread on your daily lunch sandwich, right there you have cut out close to 100 calories. To consume 100 additional calories, add just two tablespoons (30 mL) of nuts to your food intake over the day.

Add 20 to 30 minutes to your regular aerobic exercise routine, which could be walking, bicycling, dancing, or gardening (See
Chapters 7
through
9
and the following section in this chapter for more information on exercise.) Take the stairs and park farther away from the store or work. If time is an issue, doing your exercise in three 5- to 10-minute chunks throughout the day works just as well as doing it all at once.

Table 14.4
Lifestyle Tracking Diary