Page 151 - Nutrition Counseling and Education Skills: A Guide for Professionals

SELF-ASSESSMENT 1

Describe examples of modeling you may have experienced.

Changing Eating Behaviors

As the principles that govern behavior and behavior change became more clearly defined, it became
increasingly apparent that nutritionists and behavioral scientists should work together to provide methods of
using these principles in applied settings where changes in dietary habits are the primary goal. The American
Heart Association has been one of the leaders in encouraging this type of collaboration and has developed a
clinical practice guideline on lifestyle interventions.10 The most common application has been the behavioral
management of obesity, but cooperative programs have led to application in such diverse areas of concern as
CVDs, eating disorders, and diabetes mellitus.

Dietary behaviors should be studied in terms of the client’s total environment, which includes the physical,
social, cultural, psychological, physiologic, and environmental factors compounded by all conditions and
events that precede and follow eating. Behavioral scientists have referred to this as the “ABC” framework,
derived from an analysis of the Antecedents stimuli or cues, the Behavior response itself or eating, and the
Consequences reinforcement or reward of the behavior.11

For an example of the ABC framework, consider the following scenario: a man at home alone notices a
package of cookies left on the kitchen counter; this may be considered the antecedent or cue. Next, the man
eats some or all cookies in the kitchen; this is considered the behavior. After eating the cookies, the man may
experience the consequence, that of satisfaction from the taste of the cookies, with reduced feelings of hunger
or frustration to reinforce the behavior. The nutrition counselor and the client must find ways to decrease
unhealthy eating behaviors and increase new desirable ones.

Antecedents

Behavior modification techniques work by regulating the antecedents, the behavior of eating itself, and the
consequences or rewards. Analysis of antecedents of behavior seeks to control or limit the stimuli or cues to
eating. For example, a cue may be seeing or smelling food, watching television, arriving home from work or
school, attending a social event, or noticing the presence of extra food on the table at mealtime. Behavior may
be influenced by both internal and external factors. There may be internal cues, such as physiologic feelings of
hunger or psychological feelings of loneliness or boredom. Other external variables may cue eating, such as
noting the time of day or passing an ice cream shop in the street. Both internal and external factors may be
mediated by cognitive factors, such as not caring about current weight levels or not wishing to dull one’s
appetite for the next meal.12

Once the antecedents are identified, the mediating variable theory calls for identifying the variable most
strongly associated with the behavior.13 The premise is that if one alters the mediating variable, one would
expect to influence the behavior associated with that variable. Conversely, if the behavior is only weakly
associated with a variable, changes to the mediating variable are not expected to manifest in successful
behavior change.

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