Coaching Clients Through the Pain of Regain

 The holidays are here!  This is the time we reconnect with family and friends and celebrate.  It’s a busy time that can prevent us from staying focused on our healthy lifestyle and fitness routine.  We eat foods generally reserved for these special occasions and have a few (extra) wonderful holiday drinks.  This time with others nourishes our souls which is so important! Unfortunately, it is also responsible for an average weight gain of between 5-8 pounds.  Once the holidays are over, it’s time to get back to our regular diet and fitness routines. This is when we will see the client’s that need a kick start or just validation that they are back on track with their fitness routines and healthy eating.

Generally, these clients can take the weight off within 4-6 weeks without feeling the agony of deprivation.  New Year’s resolutions have been honored! My concern is with the client’s that have returned as a result of a considerable amount of weight regain.   First item on the agenda for this client is to let them know they will not be judged for this relapse. You can be certain they are beating themselves up emotionally over the regain.  Now comes the dialogue; what happened to cause this substantial weight gain?  Did they fall back into old habits?  Are they dealing with stress or physical illness?  Listen very closely to what your client is saying, how they are saying it and what their body language is communicating to you.  Depending on the amount of regain and the physical and/or emotional state of the client, it might be in the best interest of this client to recommend that they see their primary care physician or possibly see a mental health provider if they have stressors that they are unable to cope with and are using food to self-medicate.

When this client is ready to get back to their healthy diet and exercise plan, we will be starting out with the basics just to have a quick refresher.  A food and exercise journal is a necessity. Hydration is reinforced. Water, water and more water! Recommendations are given and strongly encouraged to have variety of protein packed meals prepared and available ahead of time.  Prepare several days meals at once and you never have to make the choice what to eat when you feel like your starving! This also prevents the temptation to go through the local drive thru and order a meal that will make you feel poorly physically and emotionally.  Snacks must be preplanned and controlled. I recommend 1 midmorning and 1 midafternoon snack (approximately 2-3 hours after breakfast and lunch). Have a piece of fresh fruit and low fat cheese or a low carb protein bar available. So we have established how to hit the ground running with their diet.  I ask what will keep them motivated to eat healthy and I do provide them with motivational quotes which I feel remind us what we are trying to achieve when we begin to lose focus.  I will also let them know we will review together, the food and exercise journal weekly. We will review what is working and what is not. Again, I am reinforcing previously taught skills and behaviors that did not become permanent. I am also internally evaluating this client for a true commitment!  This is a good time to discuss with the client if they would like to be responsible for recording their weight which should be done daily or would they prefer to have it recorded during the coaching session. Again no judging, either choice is fine but a daily weigh in is a must! With dietary guidelines established now let’s talk fitness.  I reiterate to the client you must exercise so a fitness plan that is manageable and enjoyable is really the only way to ensure long term weight goals.  I let the client lead on this. What do they enjoy the most and what is their least favorite exercise.

We work the exercise schedule so that they know what day will be cardio, weights etc.  I also let them know this isn’t set in stone.  The schedule can be flexible but the agreed upon weekly fitness goals need to be met and it is the responsibility of the client.  Once the client gets past the initial fear of being judged and feeling the shame of regaining weight, they will generally get on board with the lifestyle commitment. Regain clients I generally monitor a bit closer as they are more likely to lapse in the first 30 days. Positive reinforcement and client responsibility are the 2 approaches that I find to be most effective.   Should they have a lapse (and confess to it) I help them get back on track immediately so the lapse does not become another relapse. No shame, own it and move on but understand the trigger that caused the lapse and how to better deal with it in the future.

For the bariatric patients, they need to be reminded that their weight loss surgery was not a “Magic Bullet” and regain has occurred as a result of reverting to old habits! So many bariatric clients are shocked they regained weight and they suggest their surgery must not have worked! This is when they are reeducated; your surgery worked because you did commit to the lifestyle change early on and lost the excess weight. You regained because you fell into old habits.  Relapse is very possible even after bariatric surgery. The bariatric clients should be kept to the same plan of action as any other regain client providing they are physically healthy.  Whether you have had weight loss surgery or you lost weight by other means diet, hydration, exercise and a strong resolve is the key to maintaining a healthy weight and avoiding the pain of regain.  Without these 4 components, the client will most assuredly remain at