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Weight Loss is Not a Goal



One of the basic tenants of behaviour change is goal setting. A popular framework for this is S.M.A.R.T., which stands for Specific, Measureable, Attainable, Realistic and Timely.

But does goal setting in behaviour change actually work?

This question was addressed by CON-Bootcamper Erin Pearson from the University of Western Ontario (London, ON), in a paper just published in Patient Education and Counselling, in which she reports her findings from a systematic review of the literature.

Specifically, this paper describes goal setting components used for behavior change specific to diet and physical activity in community-based interventions targeting overweight and obese adults.

Eighteen studies were evaluated using the S.T.A.R.T. (Specificity, Timing, Acquisition, Rewards and feedback, and Tools) criteria which were developed for the purposes of this paper in order to elucidate which intervention features elicit optimal health behavior outcomes.

The analyses, however, ran into problems as, despite suggestions that developing specific goals that are in close proximity, involve the participant in acquisition, and incorporate regular feedback, are common features in these program, it was not possible to ascertain whether this goal setting element in itself was useful or not, as it was generally confounded by other intervention components such as education sessions or self-monitoring records.

Thus, Pearson concluded that while goal setting shows promise as a tool that can be incorporated into weight reduction programs by health care professionals and researchers, further studies are warranted to identify the specific mechanisms through which individuals with overweight or obesity can apply the S.T.A.R.T. criteria with respect to goal setting for the purposes of weight loss.

One aspect that is clear to me at least is that weight-loss itself should not be a goal as weight loss is not a behaviour. If the goal of the intervention is to change behaviour then the goals should probably be behavioural goals that meet the S.M.A.R.T. (or S.T.A.R.T.) criteria.

Whether or not these behaviour changes actually result in sustainable weight loss is likely irrelevant as long as they improve health.

Thus the goal to eat a proper breakfast on at least five mornings a week or to not eat out more than two times a week or to walk at least 5,000 steps on four days a week are specific, measurable, attainable, realistic and timely behavioural goals, whereas losing 10 lbs by the end of the month is not – why? Because “weight loss” is NOT a behaviour!

Indeed, I have warned before that there is an inherent danger of aiming for weight-loss goals:

1) patients tend to focus more on the numbers on the scale than on the actual health behaviours

2) if the weight goal is not achieved patients are generally disappointed, disheartened and likely to abandon the program altogether (along with the healthy behaviours)

3) Even if patients do achieve their first weight-goal, they tend to set new (even lower) weight-goals, which lead to the same problems described in 1 and 2 – ultimately they end up setting a weight goal that is either unachievable or unsustainable and the chances are that the lower the goal, the unhealthier the strategies used to achieve and/or sustain it.

Thus, while I fully support the notion of SMART (or START), the goal should be a behavioural goal and not weight loss.

Just remember that weight-loss is NOT a behaviour.

AMS
Edmonton, Alberta

Pearson ES (2011). Goal setting as a health behavior change strategy in overweight and obese adults: A systematic literature review examining intervention components. Patient education and counseling PMID: 21852063

13 Comments

  1. Well this is definitely food for thought. I think that changing behaviors and habits have been my biggest challenge. I will give you a specific example of a goal I had while working towards becoming healthier and how this affected me. My goal was to weigh myself every day, the same way and as close to the same time as possible. While you may think this makes me focus on the numbers and weight loss rather than my lifestyle it actually has a different result. It has provided me the following positives:
    – it helped me better understand the daily ups and downs of my body. Daily fluctuations could top 7.5 pounds in one day.
    – it held me accountable to the food intake from the day before
    – it helped me understand what foods, activities and even sleep patterns affected my weight
    – it reduced my mental focus from the numbers on the scale to focusing on learning, understanding how my body and mind work and working towards improving those issues.
    All the above positives have one huge outcome- more mental peace.
    Believe me when I say that the scales can be an anxiety filled activity one goes through. In the past the almighty number ruled my mental well-being. I know in my previous attempts at becoming healthier I didn’t go to get weighed because I was so stressed out to see the number on the scale. I also know the mental games one plays with the scales:
    – don’t weigh yourself the day after overeating (pretending like it didn’t happen)
    – reduced eating/skipping meals prior to weigh-ins
    – over exercising then weighing to reduce the scale number
    – even going so far as taking a break of a week/month to try to get that number back down.
    I could go on. The mental stress of this is unbearable at times. There is a large spectrum of negative emotions associated with this activity.
    By accomplishing this one daily routine it has improved the following:
    – I feel more in control of my body, not it controlling me
    – I feel less anxiety by understanding and accepting the ebb and flow of a simple number
    – I feel more educated about how exercise, weather, illness, medications and foods etc.. affect my body
    – I helps me to stay focused on living a healthy life.
    Many goals I have set for myself were monumental, most were small, tiny in fact. But any goal I chose to make had an asterisk with the following question: *Can I do this goal the rest of my life? If the answer was no, then I set a different one. If you can’t achieve a goal because it is so lofty then I would recommend learning how to set achievable lasting goals.
    So I am a proponent of goal setting because I see its benefits.

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  2. I used START when I seriously revved up my weight loss/fitness journey. I used MEASURABLE: exercise at least X times per week, eat no more than Y calories a day (which is food that is portioned, measured) by tracking on Sparkpeople and stopping when limit is reached, drink Z glasses of water daily by habituating drinking THIS number of glasses with each meal, eat B number of fruits/vegetables by having at least 2 veggie and 1 fruit servings with each meal, and shop twice a week for fresh produce so they are readily available, say an affirmation once a day, read an inspiring weight loss article/blog daily (from a blog, a book, a magazine, news story,etc), and weigh-in ONCE A WEEK on my blog for accountability. Sparkpeople makes it easy to track goal-oriented behavior (affirmations, water, calories, exercise minutes, articles read…). Helped me.

    I do have a weight target, but I had to choose measurable steps to get there. But it’s the behavior/habits I needed to change, from couch potato 100% to active. From “eat what I want” to measure/portion/choose fresher. It was hard. But I had the “things I need to do to get to my target weight” to help.

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  3. Sometimes a history of being obsessed with that number is problematic, and is more harmful than helpful.

    When I feel too obsessed with the number on the scale but still want to make sure I’m staying around the same weight, I take out an old scale, get on it, and have someone set it to zero or 10 or 100 or some random number that has nothing to do with my weight. Then I can weigh myself every day without having to care what the number is; I only know that as long as it stays within a few lbs of zero (or whatever random number I’ve chosen), then I’m on the right track.

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  4. Thank for the additional link. I believe that I am addicted to this practice in a healthy though.

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  5. Wow. I’ve got to say that I agree with this post pretty much 100%.

    The discussion of daily weighing is interesting. I have to say that I don’t do it. It’s one of the habits I was raised with that I gave up as an adult because I found it crazy-making. On the other hand, I’ve never found it necessary to micromanage my weight. It fluctuates, but stays in the same range. If I was gaining or losing a lot of weight, I’d notice because of the fit of my clothes.

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  6. For weight loss, the ideal “starting” goal should be no sugar, no grains, and no omega 6 oils. After you beat the addiction, and learn how damaging to the body there three are, and learn to eat real food, most will lose weight without hunger.

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  7. I totally agree with you Jodi … I weight myself every day …. actually twice a day (mornings & evenings) and it eased my stress on weight loss as I do understand fluctuations better and I got to know my body better … I can pretty much predict what my weight is if I analyze my food intake/exercise/sleep from the day/night before. It gives me peace to go on the scale to confirm I am staying on track.
    And as Dr. Sharma says, this is a behaviour so we are all good πŸ™‚
    Ultimately, one has to find what works best to achieve a healthy sustainable lifestyle and this little task of weighing myself seems to work as I lost 260lbs (yes, I had surgery and some skin removed which I consider a tool in my healthier life journey).

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  8. During my weight loss journey, I set new SMART goals every week. And, so far, I’ve lost 161 pounds and kept it off for over a year WITHOUT SURGERY. While the SMART goals are all definitely “behaviors” or “behavior related,” I view the corresponding weight loss as an inevitable outcome of these positive, realistic, attainable goals and behavior changes.

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  9. Thought one: The title of this post alone stands as a radical challenge to conventional wisdom. More power to you.

    Thought two: Eight years into maintenance, even behavioral goals get challenging. A body’s unique medical limitations and one’s life circumstances and obligations put boundaries on the type and amount of exercise one can do, for example. Things that were easy to do, and presumably had become lifetime habits (at year four, five or six, etc.), become tedious. It is important to insert joy into one’s life, sometimes forcibly, and accept that the behaviors that maintain radical loss may not be the source of that joy. They are simply requirements of a life that, overall, works for you.

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  10. Great post, and I totally agree. Especially the title point – that weight loss is not a goal. I have thought about this a lot lately and I think that “weight loss goals” are really self-criticisms, not a goals. And self-criticism is rarely the path to success. What are we trying to achieve with weight loss? Having enough energy to do X activity? Looking good in a pair of jeans? More energy? These are goals. What will a weight loss target of whatever # of pounds even feel like? Will it take us to our actual goal, or when we get there, will we look at ourselves with that self-criticism and immediately thrust another arbitrary number of pounds on ourselves without even congratulating ourselves for what we have accomplished?

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