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Archive for September 4th, 2009

Experts share tips about choosing a fitness professional who can put you on the road to better health.
By Annabelle Robertson
WebMD Feature
Reviewed by Louise Chang, MD

Laurie Heit couldn’t imagine working with a wellness coach. In fact, she didn’t even know what a wellness coach was — until one transformed her life.

A compulsive overeater, Heit had struggled with her weight since childhood. She went on diet after diet, and was finally ready to join Overeaters Anonymous when a friend told her about wellness coaching. She suggested Chere Bork, a registered dietitian and coach. Heit jumped at the chance.

After her first appointment, Heit was so impressed that she decided to do more. She has now had 12 telephone coaching sessions with Bork at a cost of $75 each. She insists they were worth every penny.

Although Heit has made significant improvements to her diet and lost weight, she says she’s gained something far more important. Through the coaching process, Heit discovered that losing weight wasn’t what she needed most. She longed to be at home with her family. So after debating the options, Heit quit her insurance job and became a full-time homemaker. She’s never been happier.

“My goal didn’t change, but how I got there did,” she explains. “The time and exploration of the right food plan helped me explore myself and my wants in life.”

Fitness Trends

According to a recent survey by the American College of Sports Medicine (ACSM), “educated and experienced fitness professionals” now constitute the most important fitness trend in the world, having jumped from third to first place since last year. “Personal trainers” rose from seventh to third place.

“We want to be well. We yearn to be in control and feel better. We want more energy,” says Margaret Moore, founder of Well Coaches, the only health and wellness coaching certification program endorsed by the ACSM. “But there is an enormous gap between wanting to be well and the everyday reality of living with the mental and physical health penalties of overeating, underexercising, and having too little down time.”

That gap is growing. The CDC reports that more than 66% of adult Americans are overweight or obese.

Doctors’ Views on Wellness Coaching

That’s one of the reasons why Moore and other wellness coaches have been working to increase awareness about the field among medical professionals. Moore readily admits, however, that although the idea is becoming increasingly popular with the public, it’s only beginning to catch on with doctors.

“Physician referral to coaches is still at an early stage,” she says. “We don’t have reimbursement, and it’s going to take years to fall into place. We see grass-roots, small-scale doctors coming to us. But most physicians just aren’t into it yet. It’s still very new.”

One doctor who has embraced the idea is Michael Lano, MD. Director of the Ridgeview Clinics, a group of primary care facilities in suburban Minneapolis, Lano refers several patients a month to Bork.

“I’m a family physician and I always tell my patients that it’s my job to help them live a long, healthy life,” he says. “But 98% is their part, and that’s what the life coach helps with — everything from diet and exercise to emotional well-being. It’s the same thing that we [doctors] deal with, but she deals with it from a lifestyle perspective.”

Lano says he sees significant improvements in patients who work with Bork. Most begin exercising and eating better. Many make other important changes as well, which tend to have a boomerang effect on their overall outlook and lifestyle, as they did with Heit.

Ideal Candidates for Wellness Coaching

However, not everyone is a good candidate for wellness coaching, says Lano. Some may be too old or sick to change. Others may simply be unmotivated. The ideal patient is someone who may not be doing anything bad, but they’re not doing the good things, either, he says. “They’re not eating well. They’re not exercising. They’re stressed. They’re stuck. They’re not making progress.”

Jim Harburger found himself in that situation. The 66-year-old clinical psychiatrist began to gain weight 32 years ago when he abandoned his heavy smoking habit. Gradually, his weight began to creep from 165 pounds to 220 pounds.

Much of the problem, Harburger says, was stress from his high pressure job as the director of a large behavioral health organization. But the trigger was the daily gift of sweets offered by his secretaries, which Harburger found irresistible.

“The metaphor was that I was being eaten alive by my job, but I was actually eating to handle the anxieties from my work,” he says.

Harburger joined a gym. But like so many others, he found it hard to get there and went only sporadically. Desperate, he finally decided to hire a personal trainer. The gym recommended Ellen Albertson, a staff member who was a registered dietitian, a licensed nutritionist, a certified personal trainer, and a licensed corporate wellness coach.

Albertson began each session with 20 minutes of walking, during which time she and Harburger would talk.

“One might think I could walk on my own, but what she was doing was listening to me about my life, learning about how I managed eating, the stressors in my life, and my relationship to my body,” he explains. “She became familiar, almost like a good therapist, with all aspects of my life. And slowly, she built a relationship that I started to value.”

Albertson also helped Harburger manage his cravings. A self-confessed sugar addict, he likened it to withdrawal from cocaine. “I felt my body shaking, I couldn’t think, and I was in total transition for almost a week,” he says. “Now I know that if I have a cookie, I need to separate myself from what I am eating or I will just keep eating.”

The result? Harburger, who visits the gym almost every day now, dropped 40 pounds over a three-year period.

Albertson says she sees it all the time. People come in expecting to be told what to do, but what actually works best for them is to slow down, think about their goals, and then determine the path themselves.

“People are out of touch with their bodies. When you listen to your body, you eat when you’re hungry, you stop when you’re full, and you enjoy food for its rightful place in your life,” she says.

Looking for the Right Wellness Coach

Michael Arloski, PhD, is the author of Wellness Coaching for Lasting Change, a training manual used by several coaching programs, works with dozens of corporate clients, training them on the finer points of coaching for long-term lifestyle changes.

“We need to move from ‘prescribe and treat,’ or what I like to call ‘education and implore’ — where we’re begging someone to change after we give them a lot of information — to a coaching model where we’re advocating for change and becoming an ally with that person,” he says.

To determine whether a coach is reputable, Moore suggests checking references and asking for testimonials. Look for people with degrees or certification from reputable organizations such as WellCoaches and then interview them extensively about their background.

Moore advises choosing a coach who makes you feel the most energized and confident. You should be inspired after a coaching session, with lots of “Aha!” moments, as well as motivated about your ability to make needed changes in your life.

Plan to pay between $50 and $150 a session, and expect to spend at least three months with a coach before seeing meaningful progress, which is typically defined as the creation of two or three healthy new habits. And don’t hesitate to end the relationship if something doesn’t feel right.

In addition to his dramatic weight loss, Harburger says the changes have had a positive effect on his career. Harburger’s wellness coaching has led him to return to private practice and reduce his workweek to 75%.

“I struggled with giving myself permission to do that, but it was miraculous. Before, I would never have initiated that. Now, I feel so unencumbered,” he says. “It’s like I’m on constant vacation.”

Link to article in WebMD .

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In an article from Reader’s Digest, “Change the Way You React to Stress,” Robert Fried, Ph.D., director of the Stress and Biofeedback Clinic at the Albert Ellis Institute and a senior professor of psychology at Hunter College said, “When you’re stressed, you may be sitting on the outside but running on the inside. Deep breathing for stress reduction means you’re sitting on the outside and you’re reposing on the inside.”

Once you’ve learned to do deep breathing, says Dr. Fried, author of Breathe Well, Be Well, it takes less work to breathe, thus reducing the amount of work your body has to do and sending a message to your brain that you’re inactive. After a while your body gets the signal and your heart rate and oxygen consumption slow.

The Deep Breathing Technique

This exercise combines deep breathing with mental imagery to help you feel relaxed yet alert. The results are immediate, so you can pull out the technique any time you need to feel calmer and more in control. Dr. Fried has used it in treating everything from tension and anxiety to burnout syndrome, panic disorder, agoraphobia, depression, tension headache, and high blood pressure.

A few notes of caution (yes, even something as seemingly innocuous as deep breathing isn’t entirely risk-free — a testament to its power to effect change in the body). If you’re not used to deep breathing, your diaphragm muscle will need time to adjust and become toned, so start slowly. If you experience cramps while doing the exercise, stop. Also, deep breathing may cause a significant decrease in blood pressure, so if you suffer from low blood pressure or fainting, be cautious when trying it. Check with your doctor before doing this exercise if you have a condition in which you may need to hyperventilate, such as diabetes or kidney disease. (Under certain circumstances hyperventilation may be the body’s protection against diabetic acidosis.) And diabetics, take note: The sudden reduction in blood levels of certain stress hormones has been demonstrated to reduce the need for insulin and may cause your blood sugar to drop.

Day 1. First, seat yourself comfortably, with your back supported by the back of the chair. Loosen any tight-fitting clothing and place your hands on your knees. Let yourself relax. Now you’re ready to begin.

• Close your mouth and breathe through your nose only.

• Put one hand on your chest and the other on your stomach. As you inhale, hold your chest and don’t let it rise. Let the hand on your abdomen rise as the air fills your lungs.

• Exhale slowly, pulling your abdomen back as far as it will go without letting that raise your chest in the process. Spend a minute or so on this exercise. If you feel dizzy, you are working too hard. Stop and rest a little until the dizziness passes, then make the motions a little more subtle.

Day 2. Follow the same routine you followed yesterday, but practice the exercise for two to three minutes.

Day 3. Breathe for four minutes, and try the exercise without your hands. You should now be noticing that your inhale and exhale are approximately the same duration. There should be no pause before or after inhale or exhale — just one smooth motion. Your breathing rate may range between three and seven breaths per minute.

Day 4. Today you introduce imagery. Sit in your chair as before. Now:

• Close your eyes.

• Picture a very specific scene — the beach in July, a cool pine forest, swimming underwater. Try to put yourself in the scene — hear the sounds, feel the air (or water), smell the scents.

• As you focus on this scene, begin your deep breathing. Each time you inhale, imagine that you are breathing in the air of your scene, saying to yourself, “I feel awake, alert, and refreshed.” And as you breathe out, feel the tensionin your body flow out with your breath as you say to yourself, “I feel relaxed, warm, and comfortable.”

Do this for four breaths, then stop. After a few minutes of rest, repeat the exercise. Try the routine once in the morning and once in the evening. After about three weeks, Dr. Fried recommends that you do the exercise in rounds of three: Four or five breathing cycles and a few moments of rest, followed by a second round of four or five breathing cycles and a few moments of rest, and finally a third round of four or five breathing cycles.

Once you’ve mastered deep breathing, you can pull it out of your relaxation arsenal whenever life gets tense. Not only will it help slow your body down, but it may also, in effect, slow down time, providing those critical moments that are often the difference between exploding and maintaining your cool. As you breathe in and out, release the physical tension and then ask yourself the following questions:

• Is the way I’m reacting to this situation increasing my tension?

• Is this reaction logical and reasonable?

• Is this reaction realistic?

• Is there another way to view the situation?

The answers may enable you to “spin” the stressful situation from the negative to the positive, or at least to the neutral.

Deep Breathing Technique from Reader’s Digest article, “Change The Way You React To Stress:Deep Breathing Exercise”

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Relaxation Exercises to Reduce Stress, Anxiety, and Depression
from Helpguide.org

Deep Breathing

Stress Relief: Yoga, Meditation, and Other Relaxation Techniques

The body’s natural relaxation response is a powerful antidote to stress. Relaxation techniques such as deep breathing, visualization, progressive muscle relaxation, meditation, and yoga can help you activate this relaxation response. When practiced regularly, these activities lead to a reduction in your everyday stress levels and a boost in your feelings of joy and serenity. What’s more, they also serve a protective quality by teaching you how to stay calm and collected in the face of life’s curveballs.

The Relaxation Response

The relaxation response is a mentally active process that leaves the body relaxed. It is best done in an awake state so don’t practice relaxation when you are very sleepy. The Relaxation Response IS trainable and becomes more profound with practice.

The stress response floods your body with chemicals that prepare you for “fight or flight.” But while the stress response is helpful in true emergency situations where you must be alert, it wears your body down when constantly activated. You can’t avoid all stress, but you can counteract its negative effects by learning how to evoke the relaxation response.

The relaxation response brings your system back into balance: deepening your breathing, reducing stress hormones, slowing down your heart rate and blood pressure, and relaxing your muscles. In addition to its calming physical effects, research shows that the relaxation response also increases energy and focus, combats illness, relieves aches and pains, heightens problem-solving abilities, and boosts motivation and productivity.

Starting a Relaxation Response Practice

A variety of relaxation techniques help you achieve the relaxation response. Those whose stress-busting benefits have been widely studied include deep breathing, progressive muscle relaxation, meditation, visualization, yoga, and tai chi.

Learning the basics of these relaxation techniques isn’t difficult. But it takes daily practice to get full benefit of their stress-relieving power. Most stress experts recommend setting aside at least 10 to 20 minutes a day for your relaxation practice. If you’d like to get even more stress relief, aim for 30 minutes to an hour.

More Relaxation Techniques from www.helpguide.org

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