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Weight & Healthy Lifestyle Counseling

This article first appeared in
The Times Record, August 18, 2010
Reproduced by permission

Changing weight ... changing lifestyle
Program in Brunswick helps keep off unwanted pounds

By Patrick Gabrion, Times Record Business Editor

Losing weight.

When put together, you'd be hard pressed–as witnessed by countless generations of human beings–to find two tougher words to achieve and sustain.
While several programs are available to help people drop those unwanted pounds, there is a new service being offered at Mid Coast Hospital in Brunswick that is worth checking out.

It’s called the Mid Coast Center for Weight & Lifestyle Change and, as its information literature indicates, it is a solution-oriented program that takes a multidisciplinary approach to delve into the emotional, physical, and nutritional issues that contribute to obesity.

“Most people who have has a history of being overweight will tell you that they know how to lose weight. What they have trouble with is sustaining the weight loss,” said a program staffer. “We have developed a program that helps people understand why they have trouble sustaining weight loss. We do this by offering classes and individual psychotherapy that focus on people’s relationship with food.

“The program also encourages emotional exploration into areas of body image, self-image, self-esteem, and how they are all related to and affected by each other,” the staffer continued.
The Times Record recently talked with members of the program’s staff to learn more about the new service, the success of a pilot program, the obesity problem in America, and how interested people can enroll in upcoming sessions.

Q. The name of your program is Mid Coast Center for Weight & Lifestyle Change, a new service at Mid Coast Hospital in Brunswick. Please describe what the program is and its objectives.

A. The center is an outpatient multidisciplinary weight loss program that meets once a week at Mid Coast Hospital. The program staff is made up of a dietician, a wellness nurse, a psychotherapist, and a medical director.
The emphasis is to help participants not only lose weight, but more importantly, make long-term lifestyle changes for sustained weight loss and improved health and well-being.

Q. Talk about who originated the idea for the program and why.

A. The idea originated from a wellness program for Mid Coast Hospital employees and an Obesity Task Force that was started a few years ago at Mid Coast Hospital. We started by looking at what types of programs were available around the country, what strategies had been found to be successful in the clinical literature, and what we felt was needed locally, and we built this program around that information.

Q. In order to get a better understanding of how the program would work, you began with 48 employees of Mid Coast Hospital. How did that work out and did you achieve what you set out to do? Were there any surprises during the first program that you didn’t anticipate?

A. We ran three sessions with groups of 16 employees, then followed not only their weight loss, but other objective evidence of quality of life and healthy habits for one year. We found that the average person lost 10 percent of their body weight, usually within six months of starting the program. The majority had kept off most of that weight for that one year.

We are happy to see that people’s quality of life scores were significantly higher at the end of the program and many of their healthier eating habits, like not skipping meals and eating more fruits and vegetables, were maintained quite well over time. Participants also reported that their quality of life remained higher as they practiced new strategies for stress management.

Q. You have now opened the program to the public. Why?

A. Our objective from the start was to make it available to the public, but we wanted data to prove to ourselves that it was an effective program.

Q. How big a problem is obesity in America and, in particular, in Maine? Why should we be concerned with our weight?

A. Obesity rates in the United States have risen nearly 100 percent over the last 20 years. In Maine, about 61 to 65 percent of adults are either overweight (BMI 25-29.9) or obese (BMI 30 and above). We are ranked 35th among other states in obesity rates (meaning there are 34 states that have higher rates than Maine).

Q. Your program takes a multidisciplinary approach, with a strong emphasis on the behavioral aspect. Please explain why this is so important.

A. Most people who have a history of being overweight will tell you that they know how to lose weight. What they have trouble with is sustaining the weight loss. We have developed a program that helps people understand why they have trouble sustaining weight loss. We do this by offering classes and individual psychotherapy that focus on people’s relationship with food; how they use food, identifying the difference between emotional and physical hunger, helping them identify their individual patterns of emotional or stress eating.

The program also encourages emotional exploration into areas of body image, self-image, self-esteem, and how they are all related to and affected by each other. As people learn to understand themselves and their feelings, and develop new skills to change, long-term weight issues are often more successfully resolved.

Q. What separates your program from most of the other programs that re available? Why do you believe your program is better?

A. There are a lot of very helpful programs available, but we feel that our program gives more individual attention, as well as addresses the nutritional, emotional, and physical issues of weight problems.

As we state before, the emphasis and strength of our program is helping people learn new ways to keep weight loss off and increase the quality of their lives. We also offer a monthly support group at Mid Coast Hospital and a six-week psychotherapy/exercise after-care group with Allison Basile and a local personal fitness instructor, Ida Messerman.

Q. Talk about the accountability and empowerment you place on program participants.

A. For many people, there is a lot of shame associated with being heavy. Dieters often talk about themselves as being “good” or “bad,” and with most programs, a participant’s success is based on how much weight they lose in a week or a month.

Our program works with people to help them realize that they always have a choice: a choice about what foods they choose to eat, a choice of what they do with their feelings, a choice of how much they want to change their lives. We work to help people empower themselves and increase their self worth, all within a supportive environment.

Logistically, besides being expected to attend the weekly groups, participants are expected to fill out and submit each week both a food and an exercise log. They are given feed back from both the dietician and the wellness nurse on these logs. They are also asked to set weekly behavioral goals for themselves, as well as behaviors they want to be held accountable for and send those in via the Internet each week.

Q. Briefly, talk about the members of the program staff, i.e. their names, backgrounds, and specialties.

A. Allison Basile, LCPC, has been a psychotherapist in private practice in Maine since 1986. She is also a certified life coach. Allison’s specialty is in eating disorders and eating issues. Allison teaches the groups on emotional eating, body image, and stress management. The majority of the participants also see her for individual counseling while they are in the program.

Kristin Perry, RD, LD, is a nutritionist who also has a background in psychology. She does our individual nutrition counseling, teaches some of the classes, and gives weekly feed back to all participants on their food logs.

Credit should also be given to Alison Fernald, RD, LD, who helped build and develop this program, but who has moved on to new projects.

Celeste Pascarella, RN, MS, has been the health promotion nurse at Mid Coast Hospital and has been a cardiopulmonary rehabilitation nurse for many years. She does our health assessments and exercise coaching and also acts as our program coordinator.

Peg Duhamel, MD, is an internist with a special interest in obesity and acts as our medical director.

Q. Can you please provide two or three testimonials from people who have participated in the pilot project?

A. “This is a program that has made a huge change in my life. I feel better and am doing more than I have in years. What I learned from this program will stay with me the rest of my life.”–J.S.

Kim from Brunswick–“When I joined Mid Coast Center for Weight & Lifestyle Change, I had tried just about every other weight loss diet/exercise/gimmick/trick around with moderate results but always regaining my weight and lapsing into old habits. Mid Coast’s program was the first program I ever participated in that was grounded in ‘real life,’ teaching me ways to eat that fit into my busy lifestyle using foods that I liked.

“I have made many positive changes in my life since participating in the program. I exercise regularly and can honestly say I enjoy it. I make much better food choices and ‘m aware of what my food triggers are. Eating and exercising will always be a lifelong struggle for me, but for the first time, can say I feel equipped to handle challenges and make great choices. I can’t thank the wonderful, understanding, and supportive instructors enough.”

Q. You have another session starting in September. Who is right for this program? What are the benchmarks?

A. Any person, male or female, who has a Body Mass Index of 27.5 or greater, is eligible for our program. The program is designed for people who are motivated to make long-term changes in their lifestyle in order to achieve weight loss and better health.

We work with people to change their weight by changing their relationship with food and changing their lifestyles. Even if they don’t lose much weight, we can keep them from continuing to gain, and we view that as a success as much as someone who loses 50 lbs.

Q. If a person is interested in the program, what steps do they need to take to apply?

A. The easiest way is to call our assistant at 406-7446 [corrected post publication] and she can send you our information sheet and referral form. You will need to ask your doctor to fill out the referral form and fax it to us with some of your medical information.

Q. How much of a time commitment is there for those in the program? How long does the program last?

A. It is quite a significant time commitment, so participants must be sure they know what they are signing up for. The program is 12 weeks long, with a 1½ hour class each week, Thursdays 4:30 to 6 p.m. But there is also an optional exercise group at 4 p.m. just before the class starts.

There are four required individual appointments at the start of the program, several questionnaires, and optional individual behavioral therapy.

Q. What does it cost to participate in the program and it is covered by insurance?

A. Much of the cost is covered by insurance, but it depends on your insurance policy. After receiving a referral from your doctor, we will check your benefits and send you a letter telling you what your out-of-pocket costs will be. Then you can decide if you want to enroll.

Q. You have already touched on the obesity problem in the United States. It seems to be particularly acute among young people. Are there any plans for a program focusing on teens?

A. The rate of obesity in teens has tripled in the last 20 years. This is related to less active lifestyles, worse eating habits, and high calorie foods that are so readily available.

We had planned a six-week program for high school-age students this spring, but we did not get enough interest to hold a class. We were surprised because we have heard about a lot of concern from school nurses and parents about the need for such a program. We hope to hold sessions for teens again in the future.

However, Mid Coast Hospital and the Bath Family YMCA have joined together to create a program called FUEL (Fun Understanding nutrition, Exercise & Learning). The program will be starting Sept. 20 and will be held at the Bath YMCA from 3:15 to 4:30 p.m. on Mondays and 3:15 to 5 p.m. on Wednesdays for six weeks. It is an after-school physical activity and nutrition program. Contact Kevin Shute at 443-4112, Ext. 22.

Q. How supportive has the administration at Mid Coast Hospital been about the program?

The administrators at Mid Coast Hospital have a very strong commitment to prevention and community health, so they have been interested and supportive from the very beginning.

Q. Once again, what is the contact telephone number to get more information on the program and to apply?

A. Call 406-7446 [corrected post publication].

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