How can a health coach help me?

Health and wellness coaching is a transformative process that empowers individuals to achieve sustained change in their lives, leading to a biological transformation of mindset and behaviour. This transformation is facilitated through four key coaching mechanisms: fostering growth-promoting relationships, eliciting self-motivation, building confidence, and guiding the process of change. Let's delve into each of these mechanisms and explore how they contribute to lasting change.

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Mechanism 1: Growth-Promoting Relationships

At the heart of effective coaching lies the establishment of a growth-promoting relationship between the coach and the client. This relationship is grounded in the principles of humanistic psychology, which emphasise the inherent potential of individuals to be creative, resourceful, and resilient. Rather than viewing clients as broken or needing to be fixed, coaches adopt a strengths-based approach, recognizing the client's capacity to optimise health, well-being, and performance in life and work.

In a safe, nonjudgmental, and invigorating space, skilled coaches help clients discover what they truly want and need. They assist clients in carving away the layers of life's clutter to reveal their best selves, much like Michelangelo's famous quote, "I saw the angel in the stone and carved to set it free." This process involves valuing the client's learning journey more than the coach's expert knowledge, fostering a partnership where both coach and client learn and grow together.

A crucial aspect of this relationship is the coach's mindful presence. Coaches support clients in developing new behaviours and mindsets by facilitating client-directed neuroplasticity, which is the brain's ability to grow, adapt, and change. This involves rewiring the brain by forging new neural connections and networks, a process that can take months or even years to solidify.

Through coaching conversations, clients focus their brain's attentional resources on personal ambitions and growth, enhancing their brain's ability to learn and adapt. In today's distraction-filled world, undistracted attention is a rare and valuable state, enabling the brain to enter an integrated, coherent state where creativity and learning thrive.

Coaching is inherently a creative process, helping clients imagine new possibilities and develop new mindsets. This creativity is supported by seven brain activation states identified by Carson (2010), which include absorbing new information, intense reasoning, envisioning outcomes, brainstorming, experiencing a flow state, and evaluating options to implement action plans.

In essence, coaching relationships engage, arouse, energise, and challenge clients to do the work needed to change their brains. Coaches employ both "doing" skills, such as listening and inquiry, and "being" skills, such as mindfulness, empathy, and authenticity, to promote brain learning and growth.

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Mechanism 2: Elicit Self-Motivation

Motivation is a critical driver of change, and coaching helps clients tap into autonomous motivation, which leads to sustainable change. According to Deci and Ryan (2002), motivation can be categorised into two types: external and autonomous. External motivation involves external influences, such as doing something to avoid conflict with others, and is often short-lived.

In contrast, autonomous motivation is future-oriented and aligned with personal values and desired identities. It involves connecting behaviours to meaningful future outcomes or the identity one wishes to project. For example, a client may be motivated to become fit and strong to have the energy to make a difference daily or to prevent future health issues that could burden loved ones.

Autonomous motivation also includes activities that produce flow experiences, where individuals engage in activities they love for their own sake. Although finding such activities can take time, they provide a powerful source of motivation for health behaviours.

Coaches support clients in developing future-oriented, positive identity-based motivation by exploring the "why behind the why." By digging deeper into their motivations, clients can tap into longer-lasting, meaningful reasons for change that sustain them through the challenges of daily life.

Authentic motivation enhances cognitive function, attention, emotion regulation, and creativity, providing a reliable source of energy for the change journey. It taps into intrinsic and biological energy sources, such as the drive to help others, be a role model, and make life meaningful.

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Mechanism 3: Build Confidence

While motivation is essential, it must be accompanied by self-efficacy or confidence in one's ability to overcome obstacles. Confidence is built through diligent efforts over time, and small successes contribute to an upward spiral of motivation and confidence.

Many individuals face challenges that have led to failed change attempts, resulting in low self-efficacy or chronic contemplation. Coaches help clients overcome this by leveraging positive emotions to enhance resilience, creativity, and problem-solving.

Coaches also tap into Deci and Ryan's (2002) self-determination theory, emphasising the importance of competence. People are more successful when they apply their strengths, talents, and values, leading to quicker mental processing and creative solutions.

The Transtheoretical Model of Change (Prochaska, 1995) provides coaches with tools to assess client readiness for change, self-efficacy, and processes of change. This model helps clients identify their stage of change and develop personalised plans to navigate challenges.

Coaches engage clients in creative brainstorming and relational flow, generating new insights and increasing hope and optimism. This process empowers clients to find new paths around obstacles and harvest valuable learning from setbacks.

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Mechanism 4: Process of Change

The final mechanism involves guiding clients through the process of change, similar to structured projects with strategies, goals, and timelines. Coaching often begins with assessments to track progress, followed by envisioning the ideal future and designing experiments and action plans to achieve goals.

Behavioural or SMART (Specific, Measurable, Actionable, Realistic, and Time-bound) goals provide clear targets for clients to work toward. Clients may set skill-building, performance, or habit-based goals, with regular progress reports and milestones to celebrate achievements. Accountability is a crucial aspect of the change process. Clients determine how they want to be accountable, using tools like mobile apps for tracking and reporting progress. Coaches also connect clients with other health experts and resources as needed.

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While coaching sessions may follow a structure, coaching is not formulaic. The heart of coaching lies in relational flow, where both coach and client engage in intuitive, creative exploration. These peak moments lead to shifts in perspective and insights that drive lasting change.

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By Margaux Pelletier, Health Coach at rfynd

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Embarking on a weight loss journey often involves more than just changing what we eat and how much we exercise. It requires a deep understanding of the psychological factors that influence our relationship with food and our eating behaviours, and often involves looking toward our inner thoughts, feelings, and sensations. The good news is, when you are willing to look inward and develop this deeper awareness of what makes you tick, you can take steps to better look after yourself in ways that promote positive health and wellbeing

The Connection Between Emotions and Eating: 

For many of us, food is more than just fuel – it's tied to our emotions, memories, social and cultural traditions and experiences. Emotional eating refers to the tendency to turn to food in response to unpleasant emotional experiences with the function of providing ourselves with comfort, soothing, or stress relief, and as a form of distraction. Whether it's reaching for a bowl of ice cream after a bad day at work or indulging in a bag of chips when feeling lonely or bored, emotional eating can sabotage our weight loss efforts and contribute to negative emotional states such as guilt and shame, which in turn may lead to further emotional eating – it can be a vicious, and subconscious, cycle!

Understanding Food Cravings: 

Food cravings are intense desires for specific foods, often high in sugar, fat, or salt, that can feel irresistible. While cravings are a normal part of being human, they can sometimes be driven by emotional triggers or physiological factors such as hormonal fluctuations or nutrient deficiencies. Cravings can also be reinforced by environmental cues, such as seeing or smelling a favourite food, which can activate reward centres in the brain and lead to compulsive eating behaviours.

Strategies for Overcoming Emotional Eating:

• Understanding your triggers: Identifying the major life events or, more commonly, the daily life stressors that trigger unpleasant or aversive emotional experiences is important in the life cycle of emotional eating. Such triggers could include work stress or conflict, health issues, or financial stressors. It could also be a certain time of day, such as the afternoon slump at work when you feel fatigued, or the period of time after you have navigated the chaos of your kids dinner and bedtime.
• Emotional Awareness: Learning to ‘notice and name’ our emotions and then regulate these without immediately turning to food is a crucial step in overcoming emotional eating. Carrying out a daily emotion ‘check-in’ with yourself using an emotion list or chart is a helpful step in increasing your emotional awareness – research indicates that we sometimes only need to ‘name it to tame it’ to get some relief from the heat of an emotion. Journaling and talking to a trusted friend, coach or therapist are also ways to develop your awareness of the underlying emotions driving our cravings and open the door to developing healthier coping strategies.
• Emotional regulation: Once we are consciously aware of our triggers and the emotions that arise from these, we can move on to regulating, or managing, the unpleasant or aversive emotions in ways that promote positive health and wellbeing. Engaging in relaxation techniques such as deep breathing or muscle relaxation, or using mindful meditation to ‘ride the wave’ of the emotion can be helpful. Having a go-to list of other forms of distraction is useful, such as engaging in hobbies, reading, going for walk, or calling a friend, or just generally keeping your hands busy doing something else (there will always be chores to be done!). Keeping a list of emotion regulation strategies that work for you in a place where you can see them in times of vulnerability, such as on the fridge or pantry wall, is a top trick that many clients use.
• Mindful Eating: Mindfulness involves paying attention to the present moment without judgement, including our thoughts, feelings, and sensations. By practicing mindful eating, we can become more aware of our hunger and fullness cues, as well as the emotional triggers that lead us to overeat. Taking the time to savour each bite, chew slowly, and tune into our body's signals can help us make more conscious choices about what and how much we eat.
• Building Resilience: Building resilience involves cultivating coping skills and resources to deal with life's inevitable challenges and setbacks. Engaging in regular physical activity, getting enough sleep, and prioritising self-care activities that bring us joy and fulfilment can help bolster our resilience and reduce our reliance on food as a source of comfort.

Strategies for Overcoming Food Cravings:

• Balanced Nutrition: Ensuring that our meals and snacks are balanced and nutrient-dense can help stabilise blood sugar levels and reduce cravings for unhealthy foods. Aim to include a variety of whole foods such as fruits, vegetables, lean proteins, and healthy fats in your diet to support overall health and well-being.
• Planning Ahead: Planning meals and snacks in advance can help us make healthier choices and avoid impulsive eating behaviours. Keep nutritious snacks on hand, such as fresh fruit, nuts, or yoghurt, to satisfy hunger between meals and prevent cravings for less healthy options.
• Distraction Techniques: When faced with a craving, distracting ourselves with an engaging activity or taking a short walk can help redirect our attention away from food and reduce the intensity of the craving. Finding alternative ways to cope with stress or boredom, such as listening to music, practising a hobby, or spending time with loved ones, can also help diminish the urge to eat.

Navigating the psychological aspects of weight loss, including emotional eating and food cravings, requires patience, self-awareness, and compassion. By understanding the underlying causes of these behaviours and implementing effective strategies for managing them, we can develop a healthier relationship with food and achieve our weight loss goals more successfully. Remember that progress is not linear, and it's okay to seek support from friends, family, or professionals along the way. 

At rfynd, we believe in the transformative power of psychological change when individuals are provided with the right support and resources. That's why we offer a comprehensive support system that includes dietitians, health coaches and psychologists to guide and empower our clients on their weight care journey. We believe that sustainable change is not only possible but achievable for everyone.

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By Dr Minthali Price, Psychologist at rfynd and Kylie Russell, Dietitian at rfynd.

Advances in ‘anti-obesity medications’ (AOMs) such as GLP-1 receptor agonists (GLP-1s) offer promising results for weight management. These medications are effective when used alongside diet and lifestyle modification. While the GLP-1’s mechanism of action is explained in detail here (link to ‘The truth about weight loss medications’ blog) we know they can significantly reduce appetite and calorie intake. However, with less food going in, ensuring you get the right nutrients becomes even more crucial. With so many people globally using GLP-1s to manage their weight, evidenced based guidelines have been released supporting clinicians on optimising nutrition for patients when taking AOMs¹. Summarised in this blog are the key recommendations from these guidelines including how to avoid nutrient deficiencies, and other factors to consider for successful weight management with GLP-1s.

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Energy intake

Since everyone's body is unique, our energy needs vary. Age, gender, weight, activity level, and even other factors play a role in how much fuel your body needs. For those wanting to lose weight, guidelines typically recommend a minimum daily calorie intake of 1200-1500 for women and 1500-1800 for men during weight loss². However it's important to remember these are just starting points.

Even if you're consuming enough calories overall, poor food choices can lead to nutrient deficiencies. This is especially true with GLP-1s, which can decrease appetite. To optimise health outcomes, a focus on nutrient-dense foods becomes important. These foods are characterised by a high micronutrient (vitamins, minerals) to calorie ratio, with minimal added sugars, saturated fats, and sodium. Examples include vegetables, fruits, whole grains, legumes (beans, peas, lentils), lean protein sources (fish, poultry), and low-fat dairy products³.

Very low-calorie diets (VLCDs) with less than 800 calories per day should only be undertaken under the close supervision of a specially trained professional, such as a registered dietitian, due to the increased risk of nutritional and medical complications⁴. These specialised plans often involve meal replacements and carry a higher risk of complications like dehydration and electrolyte imbalance⁴. They also cannot be used in the long term.

Remember that as you reach your weight loss goals, your calorie needs will likely change. This is where having the right support in place can help you adjust your intake to maintain a healthy weight in the long term. 

Dietary protein

When taking GLP-1s, protein plays a critical role in maintaining good health. Insufficient protein intake can lead to muscle loss, weakness, reduced immunity and various other health problems. The recommended daily protein intake varies depending on factors like weight and overall health. For healthy adults, the minimum recommendation is 0.8 grams of protein per kilogram of body weight⁵. However, for individuals with obesity aiming to lose weight, protein needs may be significantly higher, reaching up to 1.5 grams per kilogram of (adjusted) body weight per day⁴.

A combination of a calorie-restricted diet with adequate protein intake and physical activity seems to be most effective for weight management. This approach promotes fat loss while minimising muscle loss, although the exact influence of exercise on muscle preservation requires further investigation⁶.

Meal replacement products containing high-quality protein (around 15-25 grams per serving) can be a valuable tool for weight management, especially for those experiencing reduced appetite due to medications like GLP-1s⁷. This is particularly important for older adults seeking weight loss, as they are more susceptible to muscle loss (sarcopenia) due to aging [68]. Regardless of age, prioritising protein-rich foods at each meal is a practical strategy to ensure adequate protein intake for all individuals on a weight loss journey.

Dietary carbohydrate

While carbohydrates are a major source of energy, there's no need to severely restrict them while using GLP-1s. The recommended range for carbohydrate intake is 45% to 65% of daily calories,⁵. This translates to roughly 135-245 grams of carbohydrate per day for someone on a 1200-1500 calorie diet, or 170-290 grams per day for someone on a 1500-1800 calorie diet. Very low-carbohydrate diets (ketogenic) may not offer long-term weight loss benefits and can limit intake of fruits, vegetables, and whole grains - all vital sources of vitamins, minerals, and fibre⁴. If you prefer a lower-carb approach though, it's crucial to stay hydrated (drinking over 2 litres of fluids daily) and prioritise micronutrient rich vegetables and fruits to ensure you meet your dietary needs.

Dietary fat

Deciding on the right amount of dietary fat for weight loss can be individualised based on your preferences and tolerance. The recommended range is 20-35% of your daily calories, translating to roughly  25 to 60 g/day for a 1200- to 1500-kcal/day diet or 35 to 70 g/day for a 1500- to 1800-kcal/day diet⁵. Fat plays a vital role in absorbing essential vitamins and promoting healthy gallbladder function during weight loss, potentially reducing the risk of gallstones⁴. Focus on including foods rich in healthy fats like omega-3s (found in fatty fish), omega-6s (found in nuts and seeds), and monounsaturated fats (found in olive oil). Saturated fats like those from animal products and tropical oils (found in coconut oil) on the other hand should be limited. It's also recommended to avoid fried and high-fat foods to minimise potential digestive issues associated with GLP-1 medications⁸.

Dietary fibre

Many New Zealanders struggle to consume as much dietary fibre as we should. Data shows that Kiwi adults only consume around 20g per day, compared to dietary recommendations that state we should be consuming 25-30g of fibre per day⁹.  This is concerning because fibre plays a vital role in gut health and may even reduce the risk of heart disease¹⁰. Focusing on including fruits, vegetables, and whole grains at every meal can help you meet your fibre target. Check out our blog on ‘The benefits of high-fibre foods for weight management’ here (insert hyperlink) for more ideas on how to increase your intake.  Some people taking GLP-1 medications may experience constipation due to a lower food intake, and so gradually increasing fibre alongside plenty of fluids can help with this too. If dietary changes aren't enough to improve your bowel function, fibre supplements might be an option. Make sure you chat to your team about this. 

Micronutrients

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Those living with obesity are at increased risk of micronutrient deficiencies, which can further complicate health status and weight loss efforts. This heightened risk is often due to a combination of factors, including dietary choices, reduced nutrient absorption, and the increased nutritional demands of excess body weight. For instance, deficiencies in vitamins such as D, B12, and folate, as well as minerals like iron and calcium, are commonly observed in those living with excess adiposity^11,12. These deficiencies can lead to a range of health issues, from weakened immune function and fatigue to more serious conditions like anaemia and osteoporosis. When using GLP-1’s for weight loss, it is crucial to monitor and address these potential micronutrient deficiencies. GLP-1 medications can help reduce appetite and improve glycemic control, but they do not directly resolve the underlying nutritional gaps. Therefore, a comprehensive approach that includes focusing on a varied and nutritious diet, supplementation if required, and regular monitoring of nutrient levels is essential to ensure optimal health outcomes and sustainable weight loss^13,14.

Fluid intake

The daily recommended fluid intake for adult New Zealanders is 2.1 L/day for women and 2.6 L/day for men, with requirements increasing further with physical activity or hot climates⁹. Those receiving GLP-1s should be encouraged to achieve similar fluid intakes of  between 2 to 3 L/day. Ideally, fluids should mostly consist of water, low-calorie beverages (such as unsweetened coffee or tea), or nutrient-dense beverages (such as low-fat dairy or plant-based, calcium-fortified dairy alternatives). Most experts would recommend limiting or avoiding caffeine during weight loss due to the potential diuretic effect of high caffeine intake^15..

There is one fluid that would be wise to restrict, and that is alcohol. The New Zealand MInistry of Health Guidelines  state that “any alcohol consumption is risky, so if you drink alcohol, keep your intake low”, and avoid it completely during pregnancy and breastfeeding⁹ - although no one who is pregnant or breastfeeding should be taking GLP-1s!  Alcohol consumption can also slow weight loss because it adds empty calories to the diet, which can contribute to a calorie surplus and weight gain. Additionally, alcohol can impair metabolic processes, reduce fat burning, and increase appetite, leading to overeating and poor food choices¹⁶. 

The takeaway

While taking GLP-1s as a complementary therapy, focusing on a balanced and nutrient-dense diet is crucial. Incorporating plenty of vegetables, lean proteins, whole grains, and healthy fats can support satiety and help maintain stable blood sugar levels and ensure you get all the nutrients you need. Additionally, staying hydrated with water and low-calorie drinks is important, while monitoring and managing any potential nutritional deficiencies with guidance from healthcare professionals can further enhance the effectiveness of GLP-1 therapies in achieving sustainable weight loss goals.

At rfynd, we're delighted to offer our Medical Weight Loss Program clients our Wellness Essentials Package. This incorporates dietitian support as well as access to thousands of nutritious recipes and over 4000 workouts with our partners at Centr. Not only that, but you have your own health coach to guide you and keep you on track. We want to enable you to achieve the best results possible with the best support

By Kylie Russell, rfynd Dietitian, and Dr Cinthia Riguetto, rfynd Specialist Endocrinologist.

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