The Process of Change - Making Lasting Nutrition Habits

Working as a nutrition coach can be so rewarding. You get to help people set and meet goals while seeing real, physical results. You help them lose weight, gain confidence, get fitter, and most crucially be healthier.

The work you do, though, is much more complicated than simply planning meals and helping a client learn how to balance macronutrients and calories. There is a psychology to this, and it's all about the process of change.

In order to best help your clients make positive, healthy changes, you need to understand how change occurs, what the phases are, and how to manage it for the best outcomes. By getting to know your clients, assessing their needs, developing plans, setting goals, removing barriers, and celebrating wins, all while communicating with them, you can make a real impact.

A Behavioral Model of Change

In the 1980s, psychologists developed a useful model for how people change their behaviors.1 While the model is based on smoking and addiction, it applies to all kinds of changes that we strive for, including health and nutrition.

Any time we make changes to our behaviors, from taking steps to lose weight to meeting fitness goals or even reducing screen time, we go through these steps. Everyone is an individual, of course, and some people will spend more or less time in each phase. Often we even go backwards and repeat steps. But the goal is to get to the end and maintain new, more positive behavioral changes.

As a nutrition coach, it will help you better understand your client and his or her readiness to make real changes if you are familiar with this model.

Pre-contemplation - Not Ready for Change

Someone in this very early stage may have an occasional idea to make changes, but they aren't seriously thinking about it yet. A potential client at this point may have thoughts like these:

"Maybe I eat too much junk food, but it's because I don't have time to eat well. Plus it's really expensive."

"My weight has gone up a little bit over the last few years, but it's just because my metabolism has slowed down, not because of my diet."

What you should notice about these statements is that each includes an excuse. In the pre-contemplation stage a person may be aware of the issues but is also ready with an excuse that, for the moment, prevents them from changing.

Contemplation - Open to Changing Habits

In this stage a person is starting to think more seriously about the changes they may need to make. That individual whose weight keeps going up is finally starting to realize that changing his eating habits could reverse the trend. He's more aware of the consequences of his food choices. He's in the middle of weighing pros and cons and trying to determine what to do next.

It is during contemplation that people are open to learning more, to gathering information. This is a great time to convince people to become clients. These are the individuals who will listen to what you have to say at a networking event, at the gym, or at a health fair.

Preparation - Ready for Real Support

Once someone has reached the preparation phase, she is determined to take action and make a change. It may take just a few weeks from this point to take the first step. This is when you will get a call or an email from a new client wanting to make some nutritional changes.

For the next stage to really be effective, this person needs to do some research and take the time to fully accept the change that is coming. Now is a great time to have an initial consultation with no strings attached. You can help your potential client understand what to expect and feel better about going forward with coaching.

Action - Working with a Coach

Once you have a client working with you to make nutritional changes, he is in the action phase. He's actually doing it because he knows it is important to change and he has adequate confidence in the ability to do so. Now is the time to keep your client hooked, to encourage him, to reward the small wins, to show him the positive consequences of his changes, and to help him plan for avoiding relapses.

Maintenance - Lasting Lifestyle Changes

Now is when your client is making real habits out of nutritional changes. Your job is to keep the momentum going and to help her avoid slipping back into an earlier stage. At this point your client has more self-confidence and fully understands that the pros well outweigh the cons of nutritious eating and making positive changes.

Regressions can happen, even at this late stage in the process of change. Make sure you are supportive when a client slips up. Assure them that this is normal, but that they need to regroup and get right back into their new healthy habits.

To learn more about how small habits lead to big change, check out this short ISSA course, Tiny Habits - The Method of Success.

Managing the Process of Change as a Nutrition Coach

Change management process is a term often used in organizations, like businesses, but we can apply it here too. A coach is a leader, even when you're only leading one individual. Leaders manage the process of change and make it easier and more effective. As a nutrition coach you can learn how to guide clients through major lifestyle changes by going through these important stages of process change management:

1. Assess and Prioritize - Beginning the Process of Change

Assessment should always be the first step in making changes. Good coaches assess their clients constantly in order to update goals and approaches. The initial assessment should determine a client's current diet and nutrition knowledge, expectations, willingness to make changes, social support, lifestyle, and overall health.

Because making changes isn't easy, it's important to prioritize and triage. With help from your client, determine what is most important to tackle first. Trying to make all the changes or meet all goals at once is a way to set someone up for failure.

2. Get to Know Your Clients

You may be tempted to jump right to goal setting once you have triaged priorities, but this is a mistake. First get to know your clients better. To be the best coach, you need to understand their values, priorities, limitations, motivations, self-confidence level, and personal goals and desires related to nutrition.

To do this you can use questionnaires and personal inventories, but follow these up with real and meaningful conversations. Ask questions that go beyond yes or no answers to find out clearly what they want to change and why.

3. Set Realistic Goals - Develop a Vision

Now it's time to set goals and to develop an overall vision. Start with a clear, overarching idea of what your client wants to achieve: lose weight, be healthier, eat a more balanced diet, eat for optimal athletic performance. Then you can break that down into smaller, bite-sized goals.

For goals to be achievable they need to be small and stepwise, one leading to the next. But more than anything they need to be realistic. If goals are too big or nearly impossible, your client will give up hope. Realistic goals are specific. For instance, "lose enough weight to look like I did when I was 18," is neither realistic nor specific. "Lose ten pounds" is much better and something you and your client can achieve together.

This is also a good time to talk about trade-offs, what your client is and is not willing to do. Will your client really give up her weekly girls' night out with wine and high-calorie snacks in order to meet her weight goal? Find out what she wants, what she's willing to do to get there, and what she won't do so that you both have realistic expectations and goals.

4. Implement a Plan - And Enlist Your Client

Keep in mind that your plan will change, and make sure your client knows that. The plan is the heart of the action portion of meeting client nutrition goals, but it's almost impossible to get right on the first try. To create and implement a plan, make your client an active part of it. You are the guide, but this is his set of goals to meet and his changes to make, so ask for and use his input.

5. Celebrate the Little Things

Change is always more fun with rewards. It's how we're wired. When we get a positive response, we're more likely to do it again. Celebrate meeting even small goals. Make a big deal out of it. Not only does this reward and encourage constructive behaviors, it helps your clients focus on the positive. It's important to assess and evaluate failures, but too much focus on the negatives can derail the process of making lasting changes.

6. Identify and Remove Barriers

Barriers to change affect everyone. It's your job as a coach to help clients identify them and make plans to overcome them. Ask your clients to come up with a list of the factors limiting them from making changes. For instance, your mom client might say that time is a big limiting factor. She is so busy caring for everyone else that her own nutrition falls by the wayside. The only way to move past or minimize these barriers is to recognize them.

For inspiration and to motivate your clients to make real changes check out this ISSA post on the real key to success.

7. Face Ambivalence Head-on

Ambivalence is tough. It's when your client says she wants to lose weight but keeps going to the fast food drive through for lunch. Contradictory feelings and actions prevent real change from occurring, and you have to help clients work through them. Assure your clients that this is a normal part of the process of change but that they need to identify the forces working against it. This will help them find the motivation to really do it.

8. Provide Feedback

Communication is so important in the coaching process. Always be communicative, telling clients what you expect from them. Be direct, clear, and consistent with your message. And most important, provide feedback often. Feedback is necessary for change, so provide it as soon as you see a need and do it in a way that is constructive and supportive.

The process of change isn't easy for anyone. But the more you understand it, the better nutrition coach you will be.

To learn more about becoming a successful nutrition coach, check out the ISSA's Nutrition Specialist Course.

Click HERE to download this handout and share with your clients!

References

1. Prochaska, J.O., DiClemente, C. C. (1983) Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change. Journal of Consulting and Clinical Psychology. 51 (3) 390-395