1. Opportunity to intervene?
Firstly, the appropriate timing to carry out the intervention is important – the physical setting and emotional setting needs to be right e.g. approach the subject with sensitivity in a quiet, confidential area of the workplace.
Furthermore, significant events or transition points in people’s lives present an important opportunity for intervening at some or all of the levels, because it is then that people often review their own behaviour and contact services. Typical transition points include: leaving school, entering the workforce, becoming a parent, becoming unemployed, retirement and bereavement. (top)
2. Raising the issue
As weight is such a sensitive issue, you may want to use indirect questions to start with. Raise the issue in a friendly, non-threatening manner.
Q: We are offering people the opportunity to check if their weight is within the healthy range, would you like -
just some information?
OR
personal advice with this?
Q: Did you know that being within your healthy weight range has many health benefits?
Doing brief interventions requires good communication skills. It is important to:
- listen to what people say
- notice what they do not say
- watch what they do
- think about their situation
- think about what you know about them
- talk with them in a way which is not threatening
- avoid giving a lecture about health behaviour
A warm, reflective, and understanding style of delivering brief intervention is more effective than an aggressive, confrontational, or coercive style. (top)
3. How to work out the BMI
A BMI (body mass index) is used to decide whether weight could be affecting your health, as it assesses whether people are the right weight for their height.
1.Using the individuals current weight and height measurements, plot their BMI with them (on the chart, p34) and use this to show them what category of weight range they fall into (e.g. underweight, ok, overweight or very overweight).
2.If they are reluctant to find out their BMI, suggest they could also measure their waist at home, as shown in the leaflet.
3.Alternatively, if the leaflet is unavailable, you can calculate their BMI number to see what range they fall into
(instructions also shown on p35 of the leaflet)
To calculate the BMI:
1. Find out their height in metres and multiply the number by itself. That gives you their height squared.
2. Find out their weight in kilograms and divide that number by their height squared.
3. The final number is your BMI:
BMI = weight (kg)
[height (metres)] x [height (metres)] |
4. How to classify the BMI
Having calculated the BMI you can then classify it using the following chart (also shown on p35 of the leaflet)
BMI (kg/m2) |
Weight Classification |
<18.5 |
Underweight |
18.5 – 24.9 |
Healthy weight |
≥ 25 – 29.9 |
Overweight |
≥ 30 |
Obese |
|
|
 |
|
5. Discussing the BMI & explaining why excess weight could be a problem
Ask the individual how theyfeel about their BMI score OR begin a discussion using the following;
E.g. using your measurements, we can see that your BMI is in the [overweight or obese] category [show the individual where they lie on the BMI chart]. When weight goes into the [overweight or obese] category, this can seriously affect your health. What do you think?
Explain that further weight gain is undesirable – ‘It would be good for your health if you do not put on any more weight. Gaining more weight will put your health at greater risk’.
Do they have all the information they need to decide what to do for the best? Follow on to talk about recommendations on ‘how to lose weight’ and benefits of modest weight loss. (top)
6. Recommendations - Healthy Eating and Physical Activity – ‘How to lose weight’ section of the leaflet
‘How to lose weight’ section of the leaflet (click here)
7. What are the benefits of modest weight loss?
Highlight information on leaflet (page 6); ‘Losing 5-10% of weight at a rate of around 1-2lb per week should improve your health. This could be your initial goal’. (click here)
8. Stages of change model – are they ready to change?
Brief interventions can help instigate a natural process, from pre-contemplation, to contemplation to action. The Stages of change model is a useful tool to describe the process that people will go through en route to health behaviour change.
Follow the link to the stages of change model in relation to carrying out and a brief intervention around weight loss. (click here)
However, are they ready to commit to change?
As well as exploring readiness, it’s useful to explore the importance of changing by using a question such as:
How important is it for you to lose weight? If 0 was ‘not important’ and 10 was ‘very important’, what number would you give yourself?
Also, explore the individual’s confidence in changing to a healthier lifestyle by using a question such as:
If you decided right now to lose a little weight, how confident do you feel about succeeding with this? If 0 was ‘not confident’ and 10 was ‘very confident’, what number would you give yourself?
The response to the above questions will help you understand exactly what someone feels about change. Follow the link to some useful questions (click here) which can help you further Explore Importance and Build Confidence. (top)
9. Top tips for Weight Loss
- Aim to cut down on activities that involve little movement, such as watching television and using the computer.
- Add a little activity as part of your daily routine – use the stairs rather than the lift, get off the bus one stop early, walk up escalators.
- Find times in the day when you can take a brisk walk – several 10 minute walks are as beneficial as one longer walk.
- Identify ways of becoming more active as a family – try walking, swimming, cycling, dancing or playing together in the park.
- Make activities part of your social life – meet up with a friend or neighbour for a daily walk.
- Think of ways of becoming more active that you will enjoy, like dancing, bowling or gardening.
- Eat three meals each day and reduce the size of the portions.
- Start the day with cereal and a piece of fruit or a glass of fruit juice.
- Have at least five portions of fruit or vegetables every day.
- Take a packed lunch if this helps you to have a healthier meal.
- Plan ahead for your family food shopping and meals.
- Avoid extra snacks and drinks containing fat and sugar.
- Have plenty to drink, including water.
- Try to avoid using food as a reward or for comfort.
- Ask for encouragement and help from the people close to you, like your partner, friends and children.
- Only eat at planned times and stick to similar times each day.
- Plan meals ahead for yourself and the whole family.
- Check if you’re really hungry before you eat. It may be thirst or a craving.
- Sit down at the table to eat and do nothing else while eating.
- Set aside regular times for activities or classes. Make it a habit by planning to attend come rain or shine.
- Plan to be more active with a friend or relative and make it a social occasion (eg gardening together, walking to work with a colleague).
- Chew slowly and take your time over food.
- Plan to say no to second helpings or cook only the amount of food you will eat.
- Don’t shop for food when you’re hungry.
- Keep to your shopping list.
- Put healthy snacks like fruit, chopped vegetables and yoghurt at the front of the fridge where they’re readily available.
- Write a list of activities you can do instead of being tempted to eat (eg cleaning out a cupboard, going for a walk, sorting out your papers, going swimming). (top)
10. Making a SMART Plan
If the individual appears ready to change use the ‘My ‘small steps’ goals’ tool in the leaflet (p23) to assist the individual in deciding upon some goals which will work for them, allow the individual to take the lead.
Remember to assist the individual in making the goals SMART –
Specific - vague terms are not useful and can easily be confusing.
Measurable - how will you know if the goal has been achieved?
Achievable - don't set impossibly high targets for yourself.
Realistic - you know yourself, what can you actually do?
Time-limited - set a period in which this will be achieved.
SMART goal examples;
To walk to the paper shop at least five times a week, for the next month, instead of driving
Use the stairs at work at least 3 times a day instead of the lift
If the individual doesn't succeed at their goal, they need to examine why not, re-frame the goal and then try again. If they do succeed, it is important to acknowledge it. Rewarding themselves with an appropriate treat, such as going to see a favourite film, buying a new CD, perhaps, or going for a swim is important, they deserve it! (top)
11. Links to local and national support services
Local
- Weight Matters (Health Promotion Service) – for information on professional training on weight management.
Contact Sally Hayes on 01209 313419 or 01209 310063
- Shape-up (Health Promotion Service) – weight management groups and men’s 1 to 1 support.
Contact Mary Williamson on 01209 313419 or 07917 266316
- Why Weight (Family Learning) – A programme aimed at families, in the early years settings, to encourage them to live their lives, in a way that will enable them to maintain a healthy weight in the years to come.
The sessions are progressive, building on the knowledge, understanding, confidence and skills that parents need, to make changes to what they eat and to their activity levels.
Contact Family Learning on 01726 891993, for details of a Why Weight family course near you.
- Cooking for a Healthy Weight (Eatsome Project)
Contact Amy Bromfield on 07899 983174
- Over 50’s Physical Activity to manage your weight (LEAPActive)
Contact Tracey Barter on 01209 313419
- Quitting Smoking and Managing Weight
Contact Carl Duffin on 01209 313419
- For information, link to the obesity/healthy weight on the Health Promotion Service Cornwall site (in the professional zone) (click here)
National
12. Leaflet available for ordering or downloading
To order your leaflets through the Health Promotion Library (click here)
Download the leaflet here - Your Weight, Your Health - How to take control of your weight
Link to the HPS library to order the leaflet (click here)
|
