But what does that really mean?
I know from personal experience that external forces didn’t have an impact. Embarassing moments in department store dressing rooms, not going out to dinner parties because I had nothing to wear except extra-large scrubs, or seeing my BMI hit 29.
It wasn’t until I cleared my internal obstacles that I was able to change my relationship with food, which went from succour to simple physical sustinance.
As I look back on my weight loss journey (43 lbs!), I wonder if this time it worked because I was ready as in stages of change ready. You know the stages of change model: precontemplation, contemplation, preparation, action, and maintenance. This model has proven effective with alcohol addiction and so it makes sense that it might also work with weight loss. Because for many of us (and I do not use us lightly or loosely), over eating is an addiction.
I don’t think you can possibly lose weight if you haven’t accepted that your weight is an issue (contemplation phase) and given thought to what you are going to do about it (preparation phase); however, it is that action phase that is THE killer.
If you are like me you have fallen of the action wagon more times that you care to count. You know what I mean, you start the day with the best of intentions and then something happens 1 or 2 days (sometimes 1-2 hours) into the “plan” and you fuck up your calorie intake and then, well, in for a penny in for a pound. Since the day is a write off, you indulge in an evening of that self-loathing slow dance, changing partners from pantry to fridge and back again, and then promise tomorrow you will get back on the plan. Sometimes it takes a few days to reacquaint yourself with action. Sometimes a few months, because you feel really bad. You know you let yourself down. And facing yourself is hard.
I don’t have all the answers, but I think this Cochrane review shouldn’t discourage people from assessing their readiness for weight loss. If you don’t think your weight is a problem or you are not ready to do something about it, no plan will work for you. I don’t think we need to study that, it’s common sense.
But the lack of success with stages of change in this Cochrane review tells me that the studies are looking at the stages of change model in not quite the right way. If you look at stages of change and just apply it to your weight, you will not be successful. Because the problem you need to address is not being over weight, but rather why you over eat (and here I mean me, but maybe it applies to you as well).
Once I was ready to accept and change why I was over eating, I changed my relationship with food and the action part of the plan was actually easy.
So given my experience (yes, the dreaded n =1) the way to apply the stages of change, is not, “Are you ready to make the changes needed to lose weight?”, but rather, “Are you ready to address why you are over eating?”
It’s a subtle difference, but an important one.