Behaviour change

Citation

(2012), "Behaviour change", Nutrition & Food Science, Vol. 42 No. 6. https://doi.org/10.1108/nfs.2012.01742faa.019

Behaviour change

Article Type: Food facts From: Nutrition & Food Science, Volume 42, Issue 6

An audience of health professionals gathered in London for the BNF’s behaviour change conference on 26 June and learned that the issues affecting behaviour change, in relation to weight loss and maintenance, are complex and interconnected. Acclaimed academics presented scientific evidence and case studies on different aspects of overweight and obesity management at the conference, and confirmed that knowledge and scare tactics alone are not effective in changing eating and physical activity behaviour.

Bridget Benelam, Senior Nutrition Scientist at the BNF said: “We know that simply giving people information or telling them what they should, or should not do is not effective in changing behaviour. What does work is more complicated and speakers at the conference advocated that interventions including an individual approach, elements of self-regulation, group support and empathy can be effective in encouraging successful, sustained behaviour change”.

Delivering the first of the conference presentations, Professor Susan Michie, University College London, discussed the thinking behind the COM-B System, which addresses behaviour (B) as an interaction between three necessary conditions: capability, opportunity and motivation (COM). Professor Michie explained that COM-B is at the centre of a new framework (Michie et al., 2011) for intervention which combines nine interactive functions, based on elements of capability, motivation and opportunity and seven policy categories including regulation, environmental planning and service provision. She concluded that to address issues of overweight and obesity, health professional teams must start by understanding the problem, the target behaviour and the context in which it exists. Only then can interventions be successfully implemented.

Dr Melvyn Hillsdon, University of Exeter, introduced the concept of “unresolved ambivalence” to conference delegates, explaining that conflicting positive and negative internal motivational thinking about making lifestyle changes could leave subjects “locked in the same behaviour”. Dr Hillsdon used footage of health professionals using motivational interviewing techniques in real-life scenarios to illustrate his points and said that:

[…] the more a client talks about personally beneficial reasons for them to change, the more they are likely to actually make the change and this “change talk” is in part determined by the skilfulness of health professionals.

Dr Hillsdon concluded by urging delegates to reference the Department of Health’s (2012) Let’s Get Moving patient support pack which uses motivational interviewing techniques and is available via the internet.

Dr James Stubbs, from Slimming World, presented a compelling account of his own and others’ research findings, which show that both physiology and emotions change when we lose weight and this creates a challenge for those trying to maintain weight loss in the long term. According to Dr Stubbs, research shows that a society where obesity is stigmatised leads to self-criticism, which often results in people rebelling, becoming defensive and seeking comfort, frequently in food. He stressed that the maintenance of weight loss is a difficult and complex area, as “the loss of weight creates physiological changes which pull you back to where you have come from”. This means that a different set of behaviours needs to be established to avoid relapsing and weight regain. People who keep the weight off control their appetite, exercise more and remain vigilant to catching small slips in behaviour that can lead to weight regain. He argues that: “It takes time to adjust our thinking and behaviour. People who successfully keep weight off make intrinsic changes and form new habits”. Weight loss and long-term weight management success is best achieved by combining low-energy density eating with gradual incremental increases in physical activity in a supportive group environment that overcomes weight loss challenges and helps people turn behaviour changes into life-long healthy habits.

Dr Paul Chadwick, University College London, delivered a lively examination of the opportunities for behaviour change throughout life and in different environments, and explained that adults make over 200 decisions regarding food each day, the majority of which are subconscious. Dr Chadwick believes that childhood presents an important window for behaviour change as this is where children can develop “flavour bridges” from the sweet, energy dense foods that they are hardwired to prefer, to a broader range of more nutrient rich, less energy dense foods. The key could lie with parents, families and adults who come into contact with children in a social setting, to encourage good choices and broad experiences with foods.

During the afternoon of the BNF’s behaviour change conference, six case studies were presented. Professor Ken Fox, University of Bristol, presented his work on developing a physical activity programme in partnership with a commercial slimming company; Professor Paul Gately, of MoreLife and Leeds Metropolitan University, presented alarming figures for overweight and obese children – there are 4.3 million in the UK. Professor Gatley stressed the need for interventions that focus on the needs of individuals – “one size doesn’t fit all”. He also called for “someone or some organisation to lead and be responsible for the issue. Without this leadership and clear direction we won’t address the issue”.

The day concluded with a panel discussion including all the speakers from the day. A number of issues raised by the audience were debated including the use of role models or heroes to make healthy eating and physical activity “cool”. Dr Chadwick highlighted that, for most children, their heroes were their parents and their brothers and sisters, and that much progress could be made by helping parents and carers to champion healthy behaviours.