Tag Archives: behavior change

“Secrets” to Behavior Change

Posted on by
Reply
Share

If I’ve learned anything while working at the Clergy Health Initiative, it’s that changing health behaviors is HARD! Whether you’re attempting to lose weight, increase physical activity, Walking Shoesor manage a chronic disease, there truly is no silver bullet or magic wand. The ticket to your success will not only look different from that of every other person, but it may even feel like your own personal science experiment. Sometimes it takes trying this or that strategy before landing on the right one or the right combination of strategies that leads to progress.

So, while we can’t recommend the golden set of health rules, there do seem to be some universal concepts that work, which you can personalize for your own situation and goals. The 9 tips below are summarized from this article in The Washington Post:

  1. Readiness  Not your spouse, doctor, or friend, but YOU, have to be the one to recognize a behavior that needs improvement, and then you have to be ready to get to work.
  2. Assess  Whether it’s through technology or old-fashioned pen and paper, keep track of your habits for a few days. Write down descriptions of your meals, exercising, or sleep patterns to see the reality of your situation.
  3. Be selective  Choose behaviors that will impact your life in a meaningful way so that you are motivated to follow through with the required changes.
  4. Use SMART goals  Create specific, measurable, attainable, realistic, and time-specific goals.
  5. Track your progress  This will help you recognize progress, trends, and can serve as accountability.
  6. Evaluate  Think of this change process as an experiment and be willing to look for other strategies if you’re not seeing success within a desired time period.
  7. Success  Break up your goals into small, actionable behaviors. For example, rather than just saying you want to lose weight, break that up into small steps. One step might be taking fruit to work every day as a snack. You will feel good when you are successful in meeting this smaller goal, and that will likely lead to future changes.
  8. Practice  Stick with what works and slowly add in other small changes. For example, once you’ve gotten into the habit of having fruit for a snack every day, keep doing that and add another small change. Maybe you could replace your sweet tea at lunch with water.
  9. Support  Find someone in your life who can applaud you in your successes and who can help you stay on track when the going gets tough.  Or, seek out professional support, such as a dietician or fitness trainer.

Remember, health changes are not easy, nor are they one-size-fits-all. Do what works for you!

-Katie Huffman

The Science of Self-Talk

Posted on by
Reply
Share

Young Girl Playing By HerselfBack several months ago, we did a blog post on the power of self-talk and shared some tips for how to do it “well.”  Why does self-talk work?  Is it just that having your own internal cheerleader boosts your confidence and improves your mood?  Well, preliminary research into the brain science suggests that self-talk actually affects how you view yourself and therefore can impact your feelings AND behaviors.

In October, NPR’s Morning Edition aired a story on the science of self-talk.  They described a 2013 study where women who had been diagnosed with anorexia were asked to walk through a doorway; to do so, the women turned sideways and squeezed through even when there was physically plenty of space.  These women’s brains portrayed an unrealistic representation of their actual bodies.

So, in therapy, the approach for treating these women might be to get at their internal dialogue- to remove ‘negative or pejorative terms’ from their self-talk.  According to the NPR report, “The underlying notion is that it’s not enough for a patient to lose physical weight — or gain it, as some women need to — if she doesn’t also change the way her body looks in her mind’s eye.”

Dr. Branch Coslett, a cognitive neuroscientist at the University of Pennsylvania, plans to study how people with poor body image get such an unrealistic impression of their physical bodies.  Preliminarily, Dr. Coslett thinks that “self-talk probably does shape the physiology of perception, given that other sensory perceptions — the intensity of pain, for example, or whether a certain taste is pleasing or foul, or even what we see — can be strongly influenced by opinions, assumptions, cultural biases and blind spots.”  So, self-talk is kind of like brain “remodeling.”

The most effective self-talk?  The kind where you think and talk about yourself in third person.  Use your own name to offer advice and to give a pep talk.  It’s all because of that phenomenon where we tend to be kinder to other people than we are to ourselves.  Click here for more tips on effective self-talk.

Click to hear or read the NPR story “Why Saying is Believing- The Science of Self-Talk.”

-Katie Huffman

To Not Feel Deprived

Posted on by
2
Share

Gretchen Rubin, a happiness author and blogger whom we’ve featured on the blog before, has taken on a new challenge: figuring out what’s behind a habit and “how to make good habits and break bad ones (really).”  Ms. Rubin will reveal her findings in a book due out in 2015.  In the meantime, she has been blogging about her research into questions such as

  • Sometimes, people acquire habits overnight, and sometimes, they drop longtime habits just as abruptly.  Why?
  • Do the same habit-formation strategies apply equally well to everyone?
  • What are the overarching strategies that allow us to change our habits?

Ms. Rubin suggests that when in pursuit of a good habit, one of the most important things to do is to avoid deprivation.  When we feel that we have been deprived of something, we often compensate by giving ourselves permission to break the desired habit, even if by just a little.  For example, I’ve been known to say, “I was really good with my calorie counting this week, so I’m going to indulge in this brownie tonight.”

Ms. Rubin points to a recent study published in the NY Times.  In the study, participants were split into 2 groups before going on a 1-mile walk and then eating lunch: 1 group was told that the walk was for exercise and that they should focus on their exertion; the other group was told the walk was for pleasure and that they should enjoy themselves.  Afterwards, the “exercise” group reported feeling more tired and grumpy, and they ate more sweets at lunch.  The study results suggest that if you view a habit or activity positively, you’ll be more likely to stick to it and less likely to feel deprived.

In several posts, Ms. Rubin refers to “the strategy of treats.”  This is not about a reward system where you get a treat if you maintain a habit or reach a goal but is instead about giving yourself small, healthy treats on a regular basis:

“Treats help us to feel energized, restored, and light-hearted. Without them, we can start to feel resentful, depleted, and irritable. When we give ourselves plenty of healthy treats, we don’t feel deprived. And when we don’t feel deprived, we don’t feel entitled to break our good habits. It’s a Secret of Adulthood for Habits: When we give more to ourselves, we can expect more from ourselves.”

Some examples of treats that don’t cost much in the way of calories, money, or time are:

  • Rather than saving them for fresh flowersvacation, reading “fun” books regularly
  • Using spa-like hand soap in your own bathroom (not just for your guests!)
  • Lighting candles during a regular-old weeknight dinner
  • Twinkle lights every day of the year
  • Flipping through vacation photo albums
  • Keeping fresh flowers on your desk

What are your favorite treats?

-Katie Huffman

Thoughts inspired by Gretchen Rubin’s June 9, 2014 post, “A Key to Good Habits? Don’t Allow Ourselves to Feel Deprived,” Image by Flickr user Morgan

The Power of Self-Talk

Posted on by
Reply
Share

Have you ever realized you were talking to yourself and then abruptly put a stop to it so the people around you didn’t think you were losing your mind?  Apparently, most people engage in this kind of self-talk.  Some people talk to themselves out loud, causing others to raise an eyebrow and cross to the other side of the street; some people talk to themselves silently and no one else is the wiser.

Whether it’s under your breath or aloud, you can positively affect your mood and behavior with self-talk, but HOW you do it is key.  Elizabeth Bernstein of the Wall Street Journal says there are two types of helpful self-talk:

  • Motivational– pumping yourself up before a stressful task or encouraging yourself to complete a task, such as saying, “Come on!  You can do this.”
  • Instructional– talking yourself through a task, step-by-step so that it becomes ingrained, such as a golfer talking through each component of their swing (“eye on the ball, head down, etc”).

Some tips for constructive self-talk:

  • Keep it short and precise.
  • Be consistent- do it regularly so it becomes automatic.
  • Use third person language instead of first person- addressing yourself by your name or “you” instead of “I” helps you be more kind to yourself, kind of like taking on the perspective of a good friend.
  • Don’t be too confident- Being too confident may cause you to under-prepare or not take something seriously enough.  Instead, say something like, “You worked really hard to get ready for this sermon.  You can do this!”
  • Don’t be too critical- Being too critical may cause a cycle of shame and perceived failure.  Instead, focus on maybe what didn’t go so well and how you might fix it in the future.

To read the whole article and see some illustrated examples of constructive self-talk, click here.

Click here to read The Science of Self-Talk

-Katie Huffman

To do, or not to do….a To-Do List

Posted on by
2
Share

to do list--redSo here we are a couple of months into 2014, and my wife and I are still discussing our goals, our vision and our plans for the year. We have talked about finding more ways to keep ourselves and each other on track.

As parents who both work full time, the To-Do-List is an important tool for getting things done in our home. If you ask my wife, she might say that the Honey-Do-List is the only way things get done in our home. Sometimes “The List” is an actual list written on a notepad or on the dry erase board, or even a post it note. Other times, it involves her leaving me a voicemail message, sending a text or an email, or just telling me.

Without task or to-do lists, it is easy to become overwhelmed by the amount of things you have to do, and it is also far more likely that you will forget things. Many of us are familiar with the phrase, “There’s an app for that.”  Recently Forbes magazine released its list of The 9 Best To-Do List Apps For 2014. When it comes to managing, scheduling, prioritizing, sharing, and completing tasks on a To-Do-List, taking advantage of these digital apps can help you organize and juggle multiple to-do-lists, meet tight deadlines, and make better use of your valuable time. By being creative with your To-Do-List, you can provide yourself a healthy framework for accountability, affirmation, improved focus, motivation, organization, prioritizing, time keeping, and increased productivity or efficiency.

One example, Wunderlist, is a free app that I have really grown to like. Wunderlist syncs across iPhone, iPad, Mac, Android, Windows and the Web to keep you on top of your to-do’s from just about any device. It has several options and features that allow users to customize their experience, maximizing the app’s usefulness:

  • Share your list with a colleague, a friend, your spouse
  • Include a note, a photo, or web content
  • Add recurrences to capture your daily, weekly and monthly tasks
  • Break big tasks into smaller achievable goals through sub-tasks
  • Print your list with just one click
  • Assign To-Do’s, start conversations, or attach spreadsheets, PDFs, videos and sound files to a task (requires an upgrade to Wunderlist Pro, $4.99/month)

Developing a daily routine is one of the most powerful ways to become better at keeping and completing To-Do-Lists. You might find some inspiration from these seven famous entrepreneurs and their routines. When you flip your perspective by reflecting on what you actually got done at the end of the day, you’re looking at real, concrete evidence of productivity rather than thinking about all the should’ve, could’ve, would’ves. At that point, the To-Do-List, becomes the Done List.

What is your relationship with To-Do-Lists? Share what works for you in the comments below.

-Dwight Tucker

Image courtesy of Straighten Your Paths.com via Creative Commons

February Wellness Calendar

Posted on by
Reply
Share

Back at the beginning of January, I came across a new kind of calendar where you focus on a different wellness goal every day of the month.  For each day, a healthy activity is suggested and you customize it by setting a goal that makes sense for you.  The daily goals can be very simple and include things like hydration, having fun, eating healthy, staying active, and self-care… good habits that many of us in Spirited Life are striving for.

The blogger who creates these calendars says, “A healthy lifestyle is made up of a whole collection of small daily decisions… and when spread out over a week, month or year, it adds up to a healthy, happy you.”  I found that even though I might only focus on hydration for one day, those actions I set up carry over into the following days and without meaning to, I’ve started a habit of drinking more water every day.

I enjoyed this exercise and plan on trying it again in February.  Click here or on the image below to download a copy for yourself.  And the good news is that this is for YOU, so if you don’t like one of the recommended activities, replace it with something of your choosing!

feb2014-Katie Huffman

(Find more calendars and healthy recipes at back to her roots)

Re-framing “self-care”

Posted on by
Reply
Share

The following thoughts have been excerpted from a blog post entitled, “Self-regulation over Pastor Hesterself-care,” by Dan Hester, on his personal blog, ParsonDan.  Pastor Hester is a Group 3 Spirited Life participant and currently serves at St. Andrew’s UMC in Charlotte.  

“Much has been published about clergy self-care. Most of what I have come across makes the simple point that if I am in better shape, then I can be more effective as a pastor. A smaller portion of the material reminds me that God doesn’t need me to die for anyone; that’s already been handled. The burgeoning and much needed movement of positive psychology adds that God really doesn’t want anyone to be miserable, and self-care can help us enjoy this good life. I cannot find much fault with any of these points of view. Oddly enough, however, neither have I found much motivation to actually make needed changes in my life from these insights. Where I have found some recent motivation is with a systems thinking based view of the problem.

Systems thinking would rather talk about self-regulation than self-care. Self regulation is the basic functioning that makes self-differentiation possible. It’s what gives me responsibility for what’s mine, and leaves to you what is yours. Self-regulation is the capacity to choose wisely, based on solid-self principles and not on the anxious needs of the moment…

The language of self-care hasn’t always been effective for me. I think that ineffectiveness is because the phrase never conjured up any consequences apart from my own body and mind. But, when I think systems about the consequences of my choices, somehow the language of self-regulation connects with me. Through systemic thinking, I know that these decisions are not just about my own body, they reverberate across all my relationships. My excuses for not exercising usually have to do with lack of time. I can replace the important work of exercise with other important work. But if I see exercise as a building block of personal integrity, if I see it as a gateway decision to other important decisions, if I see it as a self-regulating act that has implications into my family and congregation, then that decision becomes irreplaceable and thus I have a little more success with it. I emphasize a little.

…I want to positively affect the lives of my family, my congregation, and myself. The best way I can do that is through doing my part in the emotional systems that connect us all, and practice self-regulation. Self-regulation is taking responsibility for my own condition, focusing more on my own resiliency rather than the environment, trying my best to act on my best thinking rather than my anxiety, ridding myself of the notion that the rules of biology don’t apply to me, and creating a repertoire of responses rather than banging away with one tool only. In the long run (no pun intended) this kind of practice will help me stand up for my convictions. It means I’ve upped my exercise regimen from zero to two or three times a week. Big whoop, right? But at least I’m moving.”

-Dan Hester

To read Pastor Hester’s blog post in its entirety, click here.  

The Reflection in the Mirror: A Personal Story of Weight Loss

Posted on by
1
Share

When I joined the Clergy Health Initiative in early 2012, I was charged with coordinating the bi-annual health screenings that, in part, help pastors in Spirited Life track their personal progress in the program.  Over time, I’ve come to see my role as helping to provide a “mirror” for Spirited Life pastors.  Some of our pastors love the reflection they see when they come to a health screening… 20 pounds lost, blood pressure that’s come under control, a waist circumference that means it’s time to go shopping for smaller clothes.  Other pastors, I’m certain, dread what they expect to see in the health screening mirror. Despite great intentions, too many desserts were consumed last month.  Mornings once spent on the treadmill have fallen victim to busy schedules, and the numbers will be evidence of that. It’d be easier to skip the health screening this next round, to not have to look in that “mirror” and see the reflection that proves the digression.  After all, ignorance is bliss, right?

Not quite.  You see, I know first-hand that ignorance of our health is anything but bliss.  And I know this because I was once obese.  Not heavy or just a tad overweight, but legitimately and clinically obese.  I started early, initially gaining weight in high school, and despite running the gauntlet of several fad diets, continued to pile on weight in college.

Upon graduation, I loaded up my car, left North Carolina and headed west to San Diego.  As a young adult in an expensive city, I quickly took two jobs – one working in an HIV research center, and the other, serving specialty coffee drinks in a local café.  My first year in San Diego often included 70-hour work weeks, often not having a day off for 30 days in a row.  My schedule, and limited budget, made it difficult (in my mind) to eat healthy meals or make time for exercise, and so I piled on even more pounds.  I told myself it was okay if I was overweight, because I was doing important work for society in my HIV research job.  And I was kind, charitable, intelligent.  That should be enough, right?  It shouldn’t matter what I looked like on the outside, because I was a good person on the inside.  And sure, there’s truth to that.  But in focusing on superficial appearance with that approach, I was ignoring the part of my inside that was my health. And health does matter.

Back then, my dad tried to be my first “mirror.”  He’s a family physician, a two-time marathon finisher, a fit and healthy guy.  When he looked at me, I knew he saw a good person, but he also saw my future reflected in many of his patients – a future that was likely to include heart disease or diabetes.  But I ignored that part of my reflection in his eyes – the one of sadness over my poor health.  I was even ignoring real mirrors in my apartment… no full-length mirrors hung on my walls back then.  And what about pictures?  Well, thanks to technology, I could quickly crop those to “shave” off my arm fat or eliminate my hips from view altogether. I spent extra time on my hair and makeup and focused on that part of my physical appearance, easily ignoring the rest.

But then, there was the picture I couldn’t fix. My brother had come to visit and one particular photo featured us standing on a vista overlooking the ocean. There was no way to crop the picture without getting rid of all that beautiful background.  That’s the day I finally, truly saw the reflection I’d been so actively avoiding.  I was double the size of my brother. My posture was slumped, my eyes sad. I looked unhealthy.  And when I plugged the numbers from my last doctor’s visit into a BMI calculator, the big block letters that popped up agreed.  I was OBESE and officially at risk for all the things my dad so feared for me.

This time, I didn’t jump on a fad diet.  Little by little, I started changing my unhealthy ways and working to build healthier habits.  Sugary lattes were traded for plain coffee with a bit of skim milk. Lunches eaten out were replaced with portion-controlled meals and an apple. And a few months later when my dad was diagnosed with early-stage prostate cancer, I decided to deal with my emotions on the pavement, and in his honor, became a runner.

Nearly 8 years later, I’m 50 pounds lighter than I was back then. My blood pressure is low, my cholesterol levels are in check, and most days, I feel pretty darn good. But that victory has taken years to achieve, and more importantly, maintain. I’ve certainly struggled through my fair share of battles along the way. A knee injury sidelined my running career 6 months after it began. More recently, after having started running again, I temporarily lost my go-to running buddy when my dog was injured in an accident. And then there’s the demanding seasonal work schedule that comes with coordinating dozens of health screenings twice a year. It’s easy to get off track. But I’ve also learned, that it can be just as easy to get back on track if I keep mirrors around me.  Sure, there’s the full-length one in my bedroom now hung in a place that can’t be avoided.  But there are other “mirrors” I choose to see too.  There’s the bathroom scale I step on each week.  The self-awareness that I feel better when eating mostly fresh fruits and vegetables over processed foods.  The joy that comes from seeing my recovered pup’s tongue dangling out of his mouth in exhaustion after a run.  There’s a new picture I make sure to look at too and this one’s not cropped! It was taken while on vacation with friends in Europe a couple years ago. My face reflects pure happiness – and I’m literally jumping for joy in my new, lighter, healthier body.

For those readers who are participating in Spirited Life, there’s a good chance that you’ve seen me at a screening, heard my voice on the phone, or received an email from me about attending your next screening.  I wanted to share the story of my own weight loss and health maintenance journey so that you’d also know how much I really do celebrate your victories with you.  And that I understand the hard work, time, and setbacks that are part of the journey toward better health.  I used to look at thin people and think that being skinny and healthy was natural for them. I know now that, more than likely, they reflect upon and work on their health in their own ways each day, and they surely have their own challenges to contend with on their journey.

I hope you’ll let us, the health screenings team, continue to be a mirror in your lives.  And I hope that by sharing my story, you’ll take some time to find the metaphorical mirrors that might help you along your own path towards wellness.

Pray Without Ceasing

Posted on by
2
Share

The following is a guest post from John Bryant, a participant in Group 2 of Spirited Life. He is the pastor at Wesley Chapel United Methodist Church in Misenheimer, NC.  His blog can be found here: http://johntbryant.wordpress.com/

* * * * * * * * * * * * * * *

“Pray without ceasing.” — 1 Thessalonians 5:17

John on Galilee

I’ve never considered myself a very accomplished pray-er.  I have difficulty finding the words I want to say, especially when I’m praying extemporaneously.  It’s one reason I found such peace in services of Morning Prayer while at Duke; I never needed my own words but could lean on the words of others.

Needless to say, Paul’s admonition has always filled me with dread.  Without ceasing? Really? It’s hard enough already!  That verse creates such a high standard that I can never live up to. I can’t constantly be in a state of prayer can I? What does it mean when I fail? The pressure mounted to the point that I figured it was better not to even try.  Pray at meal times, in church, upon request, and call that good enough.

Galilee Stone

So imagine my surprise when a trinket ended up providing me with an answer.  I bought this stone on my recent trip to the Holy Land. We were sailing on the Sea of Galilee (See above: John and his wife Kathy on the Sea of Galilee), which was one of my favorite moments of the whole trip. We visited a number of churches where tradition states some event happened (and maybe it did), but the Sea is the Sea. On this body of water, the disciples fished and Jesus traveled and taught. There’s no changing that. So I bought this stone, over-priced as it certainly was, as a reminder of the trip and how meaningful that moment was to me.

I thought about simply carrying the stone in my pocket, but I was afraid of losing it if it caught on something while I was retrieving my keys or phone. Instead, since it came with a cord, I decided to wear it around my neck. I leave it under my shirt because I don’t like to be flashy about these sorts of things and it had a tendency to knock into things whenever I leaned over.

I’m still not used to wearing it, so I find myself adjusting or at least noticing it several times during the day. It finally occurred to me that this was a great reminder to pray.

In the mornings, when I put it around my neck, I pause to say the Wesleyan Covenant Prayer. In the evenings, when I take it off, I pray over my day using a practice called the Daily Examen. And during the day, whenever I adjust or notice it, I pray a simple breath prayer.  Breath prayers are simple, one sentence prayers that can be said in the time it takes to breath in and out. I typically pray something like “Jesus Christ, have mercy on me, a sinner.”

This pattern is by no means perfect and I still have a lot of growth before me in my personal prayer life. Yet having something as simple as a small stone has given me cues that remind me of how important prayer is.

What helps you to pray without ceasing?

Click for Rev. Bryant’s post, The Practice of Paying Attention.

Food Journaling 101

Posted on by
2
Share

Recently, I’ve been hearing a lot about food journaling, and I’ve even written a few blog posts about web and smart phone applications that support this habit.  But I never gave it much thought beyond that it’s a helpful weight loss tool, so I wanted to dig a little deeper into the supporting research and rationale.Food_Journal

What is food journaling?  While it sounds pretty straightforward, there are any number of combinations of details you can record in a food journal.  The general idea is to write down everything you eat and drink at meals and in between on a daily basis.  Details to include might be portion size as well as calorie and other nutritional content.  You can also record when, where, and how you were feeling at the time of eating.  Some food journals include space for noting how much physical activity you get each day, too.

Increasing numbers of studies are focusing in on the value of keeping a food journal in conjunction with losing weight.  In a 2012 Northwestern study, which we’ve mentioned on the blog before, people who used a mobile food and activity tracking app alongside of another weight loss program lost an average of 15 pounds (and kept the weight off for a year).  Another 2012 study, associated with Fred Hutchinson Cancer Research Center in Seattle, found that women who kept food records lost six more pounds on average than women who did not.  This study also found that food journaling helped people take weight off more quickly initially and maintain this weight loss for a longer period of time.  In a 2008 study, participants who kept a food journal for at least 6 days a week lost twice as much weight as those who did not.

The main rationales behind food journaling are awareness and accountability.  Knowledge about your habits is the first step in helping you decide what changes you may need to strive for.  You can use food journals to see the nutritional breakdown of your diet… are you getting enough protein?  Fruits and vegetables?  Too much salt?   You can look for patterns… do you get most of your daily calories at a certain meal?  Do you go for something sweet at the same time every day?  Do certain emotions trigger your appetite?  Then, once you set a goal for yourself, you can use the journal to help you stay within these bounds.  Showing your record to someone else, whether it’s a friend, family member, or counselor, only increases the level of accountability the journal provides.

FoodViewThere are many styles of food journals to pick from.  Some people prefer to use pen and paper, while others like to use a web or mobile phone application.  However, studies show that modern technology, which is available to you anytime and anywhere, can contribute to greater adherence and accuracy than paper journals.  Paper templates for food journals can be found through Real Simple, NIH, WebMD, and American Heart Association.  Web and mobile phone apps include: SparkPeople; Lose It!; MyFitness Pal; MyNetDiary; My Plate Calorie Tracker from LiveStrong.

Some final tips for food journaling:

  • Write down your food and beverage intake as you go rather than waiting until the end of the day.
  • Be honest; don’t skip a day or meal that was particularly indulgent.
  • Pick a style of journal (paper vs. digital) that will work for you.
  • Start with fewer details and only be as detailed as will allow you to continue the practice.

With some dedication and consistency, keeping a food journal is one of the most effective ways to make changes in your diet, and it’s certainly one of the cheapest!

–Katie Huffman

(Image by Kirstin Carey of Nourish 123 blog, courtesy of Creative Commons)

Sources: WebMD- Keeping Food Diary; WebMD- Food Journal; Fred Hutchinson Cancer Research Center; Proceedings of UCLA Healthcare, Volume 15 (2011) Clinical Vignette; American Heart Association- How to Keep Track of What You Eat; Real Simple- How to Keep a Food Journal; NIH’s Weight Control Information Center; Humana                         Hollis, et al.  Weight Loss During the Intensive Intervention Phase of the Weight-Loss Maintenance Trial.  American Journal of Preventive Medicine 2008; 35(2):118–126.
Kong, et al.  Self-Monitoring and Eating-Related Behaviors Are Associated with 12-Month Weight Loss in Postmenopausal Overweight-to-Obese Women.  Journal of the Academy of Nutrition and Dietetics 2012; 112(9): 1428-1435.