Have you ever wondered why you can’t make the dietary changes that you set yourself stick? Are you not able to create new habits that are long lasting? Do you find it difficult to make a long lasting change to your diet?

If you answered YES to all these questions and are thinking “this is me, why?”, I’m here to help explain why sometimes making changes to our diet can prove easier said than done.

Change comes about because we have chosen to make a change and are motivated to make it happen. More often that not, we believe we SHOULD make changes rather than WANTING too. This can lead to changes that are short lived or fail after a few weeks.

With regards to our diets, we are all aware of habits and food choices that are beneficial to health. Somehow though, implementing these habits and food choices into our diets can be difficult. One reason for this can be put down to behaviour change and where we are in the cycle of change.

What is behaviour change?

Behaviour change can be simply described as a 5 step cycle:

We can simply define each stage as the following:

Pre-contemplation: at the this stage there is no intention to change behaviour in the foreseeable future

Contemplation: aware that a problem exists but have not committed to taking action yet

Preparation: information gathering and planning stage

Action: modification of behaviour to overcome problems

Maintenance: prevention of relapse

Depending where you are on this cycle will determine the action you will or will not take to make change.

The action stage will arise when you are ready to commit to active modification of behaviour to achieve the desired change. In a weight loss example, the action stage may arise as a result of active engagement with a dietitian and setting clear, defined and agreed goals to deliver the change. The difference here to making changes when you are in the pre-contemplation stage are that you are MOTIVATED to make the change and are driving the change rather than being instructed by someone else.

Relapse can occur during any stage of the behaviour change cycle and it is important that the cause of the relapse is identified so that the commitment to change can be re-established.

Motivation to change arises when you know what problems are caused by a particular behaviour and you are concerned about these problems. In addition to this, self esteem and competence are also important to allow change to happen.

How do dietitians use behaviour change techniques in their practice?

The role of the dietitian is to translate scientific and medical knowledge relating to food and health into everyday language by educating and giving practical, personalised advice to clients, patients, carers and colleagues. Nutrition education does not focus purely on what change to make but how to help people make behavioural changes.

Dietitians use behaviour change techniques in their practice to support individuals under their care to make the necessary and desired changes beneficial to health. As healthcare professionals understanding the importance of behaviour change and being able to identify where a person is in the cycle of change is so beneficial to providing patient centred care and supporting dietary change. Success of dietary changes is the result of the dietitian and patient working together to identify the reason for change, the motivation for change and to agree realistic goals that can result in behaviour change. However, the behaviour change journey does not end here. Following the action stage it is important that the maintenance stage is not overlooked. The maintenance stage is taking into account how the behaviour change will be sustained.

Setting behavioural goals is key to achieving a successful outcome. This is where the dietitian and client will work in collaboration to set SMART goals. The acronym SMART is defined as:

Specific e.g. I will reduce the amount of sugar I take in my hot drinks

Measurable e.g. I will reduced the number of sugars in my hot drinks from 1 to none

Achievable. Setting realistic and achievable goals is key to success and this may mean a gradual approach e.g. reduce the number of sugars in hot drinks gradually to allow for the adjustment to taste

Relevant to the goal of treatment i.e. I want to reduce my sugar intake as I’m pre-diabetic

Time specific i.e. defining and agreeing a time frame for the goal

Several behaviour change goals may be set depending on the overall goal of nutritional treatment. These smaller, specific goals can help with motivation and personal sense of achievement.

What next?

If you have decided you want to make some dietary changes and want the support of a dietitian, I offer 1-1 online video consultations. Please contact me here to arrange a free 15 minute call to discuss how I could help you.