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Medical Wellness Archives

Developing a Weight Loss Program

2004: Volume 1, Number 2


Lauve Metcalfe, MS, FAWHP

Lauve Metcalfe is Director of Program Development and Community Outreach for the University of Arizona’s Center for Physical Activity and Nutrition.


Throughout the last decade, obesity has risen to epidemic levels in the U.S. Obesity reduces life expectancy, leads to devastating and costly health problems, and is associated with stigma and discrimination. According to the National Institutes of Health, more than 65 percent of U.S. adults are considered overweight or obese. Nearly 31 percent of adults—more than 61 million people—meet the criteria for obesity. If the current trend continues, the escalating rates of obesity in the U.S. population will place an ever growing economic burden on the nation’s health, our healthcare system, and on small and large employers.

A realistic solution to this growing health problem will require more than simply asking people to eat less and exercise more. Obesity is a social, environmental, emotional, and physical issue that requires a broadbased plan of attack (multidisciplinary approach) to establish lifestyles and workstyles that support healthier behaviors, which will help reduce our nation’s waistline.

The first step in creating a weight-loss strategy is to identify available resources in the community, national and local organizations, and Web-based information sources. A multidimensional model can be created to fit any budget. The key is offering core components that have been successful in weight-loss and maintenance programs.

A core educational program emphasizing the following four primary components is recommended:

1. Increasing physical and lifestyle activity

2. Establishing healthful eating patterns

3. Creating positive social support systems

4. Understanding the mind/body connection

Physical and Lifestyle Activity
Lifestyle activity focuses on multiple possibilities available to increase energy expenditure through simple lifestyle behavior changes. Research shows we expend fewer calories in physical activity than we did in the past because of technologies that have made our lives so comfortable. These include computer games, elevators, remote controls, and drive-through windows. Participants are encouraged to burn approximately 1,500-2,000 calories per week through an exercise routine.

Walking is the recommended activity, primarily because nearly everyone can walk and it can be done throughout the year.  Pedometers can be used to monitor daily steps with the goal of working up to 10,000 steps per day.


Participants should experiment with ways to increase lifestyle activity, such as walking the dog, taking the stairs, parking further away from the destination, washing the car, moving furniture, carrying groceries, and walking to a coworker’s office instead of sending an e-mail.

Healthful Eating
This component emphasizes a non-dieting approach to weight loss.  The foundation of this segment includes choosing appropriate foods, drinking enough water, becoming an educated consumer, limiting or cutting out junk food, planning meals using a variety of foods, developing dining-out strategies, and reducing both fat calories and portion sizes. Participants should be encouraged to eat 200-300 fewer calories per day than they have been eating, emphasize fruits and vegetables, consume less than 30 percent of calories from fat, and minimize fast food, sugar, and salt in their food plans.

Social Support
Social interaction helps develop positive interpersonal relationships and skills for dealing with psychological and emotional barriers to weight loss. Support groups can be organized to meet weekly for exercising, sharing recipes, and reviewing daily challenges with the program. There are also various online support resources. Coaching and training skills should be provided to maintain support and develop active listening and group dynamic skills. Support groups provide a safe environment for participants to discuss their feelings including their barriers to losing weight.

Mind-Body Connection
This program segment highlights the interconnection of the mind and body, in particular that thoughts can influence eating behavior. Participants are also provided with insights on food issues, body issues, eating behavior, making appropriate food choices, emotional issues about food and daily challenges, and developing skills to live a wellness lifestyle.

There are a variety of social and cultural issues that sabotage weight loss and maintenance. Five potential barriers include:

1. Hesitation to put self first (caregiver mentality). Many women and men feel guilty about putting their health priorities above their work, family, and community commitments. Early in weight loss programs, it’s key to encourage participants to fuel up their own tanks first and then take care of everyone and everything else.

2. Unrealistic expectations. The quick fix— taking the easy way—to weight management is seductive. Advertisements give misleading information and provide unrealistic outcomes creating nationwide confusion about the difference between a good and bad carbohydrates, good and bad cholesterol, and good and bad fats. Participants should be educated that healthy weight loss constitutes one to two pounds per week.

3. Unreasonable social norms. Our social perception of an ideal body type is extremely unrealistic, especially for girls and women in today’s culture. Body image pressures that keep men and women from liking or accepting their bodies include demands for being youthful, thin, fit, and sexy. A healthy weight program emphasizes beauty in all body types and supports each individual to reach the best fitness level they can.

4. Family dynamics. Experiences and skills acquired in youth have a great influence on adult lifestyle habits and behavior. Identifying a person’s family-accepted norms about food, physical activity, and emotional nurturing patterns can provide valuable insight into reinforcing positive behavior and altering negative adult habits.

5. Lack of skill development. Many adults do not have the knowledge or skills they need to modify their eating and physical activity habits. Seeking a professional for education, guidance, and coaching while learning new behavior skills is essential. There are many community health professionals available to help, including exercise trainers, registered dietitians, physicians, health counselors, and chefs and local restaurants catering to wellness.


These providers can share a wealth of information about preparing healthful foods, establishing new eating behaviors, creating a physical activity plan, finding the time to exercise, and developing the skills to maintain emotional balance. These skills are essential for ongoing success. Women and men of all ages need encouragement, education, and mentoring to develop the necessary skills and behaviors to tackle this growing obesity epidemic. Providing opportunities for weight loss at home and at the worksite leads to a healthier community.


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