Key intervention concepts | Small changes | Large changes |
---|---|---|
Dietary changes recommended for maintaining weight (green zone) | Instructed to make one small change in diet every day (roughly equivalent to 100 calories) | Start with 1200–1800 kcal/day diet to create weight loss buffer in first 8 weeks. After buffer created, gradually increase caloric intake until maintaining weight loss, but continue to consume low calorie, low fat healthy diet |
Physical activity changes recommended for maintaining weight (green zone) | Given pedometers and instructed to increase steps by 2000 steps per day over baseline levels and maintain this level | Instructed to exercise to 250Â min/week (50Â min/day on 5Â days/week) throughout the entire program. |
Self-monitoring of behavior changes | During first 16Â weeks and during refresher courses, record number of steps per day and check off whether or not a small change in diet was made every day. Self-monitor weight daily throughout the entire program. | Self-monitor food intake (calories and fat grams) for first 16Â weeks of the program, throughout the refresher course, and if they experience weight regain. Self-monitor weight daily throughout the entire program. |
What to do if regain 1 pound or more above the weight they achieve at the end of the initial 8Â week program and enter yellow zone, but remain at or below baseline | Taught to resume self-monitoring of steps and small changes to diet. Use problem-solving skills, with an emphasis on changing surrounding environment to support small changes. | Taught to resume self-monitoring of food intake for several days to help identify problem areas and get back on track. Use problem-solving skills, with an emphasis on changing surrounding environment to support large changes. |
What to do if exceed baseline or starting weight (red zone) | Instructed to implement additional small change(s) in both eating and exercise (e.g. make at least 1 small change at each meal, each day and increase steps by 3000 over baseline level). | Instructed to reinitiate large changes – return to 1200–1800 kcal/day diet, continue 250 min/week of activity, and self-monitor intake and activity until they are back in the green zone. |