Coach on Call. Thank you for your interest in When the Scale Does Not Budge. I hope you find this tip sheet helpful.

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1 Coach on Call It was geat to talk with you. Thank you fo you inteest in. I hope you find this tip sheet helpful. Please give me a call if you have moe questions about this o othe topics. As you UPMC Health Plan health coach, I m eady to help in any way I can. Congatulations on getting stated losing weight and on you weight loss so fa! You have been woking had to eat fewe caloies and to be moe active. Fo quite a while, you have been losing weight. Then at some point, the scale stops moving. Sound familia? This happens to even the most successful weight loses. It can be vey fustating. You may even feel like giving up. But do not give up! Instead: Give youself cedit fo all the healthy changes you have made to lose weight so fa. Commit to maintaining those changes so they become a long-tem habits. Think about what you can do diffeently to stat losing weight again. Review the questions below to uncove some possible causes fo the scale not budging and what might help. As you do so, be kind to youself. Give youself cedit fo the healthy changes you have made so fa, no matte how small. 1. Ae you expecting to lose moe weight than is ealistic? If you ae oveweight o obese, aim to lose about 7% of you stating weight. Reseach has shown that: Losing this modest amount of weight is safe, doable, and sustainable. It can help you pevent and teat many chonic diseases. You will also have moe enegy, feel bette, and get aound moe easily. CMN i UPMC_17_1523 Copyight 2017 UPMC Health Plan Inc. All ights eseved C ON C SCALE 16WP0758 (MCG) 4/18/17 PDF

2 Page 2 of 7 Below ae some examples of stating weights, pounds to lose, and a 7% weight loss goal: Stating Weight Pounds to Lose Weight Loss Goal Fill in the blanks below to find out what a 7% weight loss means fo you: My stating weight pounds multiplied by 0.07 = pounds to lose. My stating weight pounds minus pounds to lose = a goal of pounds. What if you lose that amount, ae still oveweight, and want to lose moe? Go fo it! But fist, aim to each and maintain a 7% loss. 2. Ae you expecting to lose weight too quickly? Losing about 1 to 2 pounds pe week is best. This is an aveage. On some weeks you, may lose less. On some weeks, you may lose moe. On some weeks, you weight may level off. Losing an aveage of 1 to 2 pounds pe week is the best way to lose body fat. Faste weight losses ae often due to losing wate o muscle. Both ae unhealthy. Quicke weight losses ae common duing the ealy weeks of a weight loss pogam. This is especially tue fo those with a geat deal to lose. But, ove time, slow and steady wins the weight loss ace! Be patient. Remind youself that slow weight loss is safe and moe likely to last. Focus on building healthy eating and execise habits fo a lifetime. 3. Ae you eating moe than you think you ae? Most people eat moe than they think they do, and this is moe common in those who ae oveweight o obese. Wite down eveything you eat and dink. Fo example, it is easy to ovelook: - Second helpings, snacks, tastes of food while cooking, and nibbles at paties. - What you add to foods, such as fat used in cooking, ceam, suga, sauces, toppings, and speads.

3 Page 3 of 7 Caefully weigh and measue what you eat until you can estimate amounts coectly. Use a caloie counte to look up the caloies in what you eat. Recod the caloies, and total them fo the day. Stay at a daily caloie goal fo weight loss. If you do not aleady have one, follow these guidelines: You Stating Weight Daily Caloie Goal 174 pounds o less 1, pounds 1, pounds 1, pounds o moe 2,000 Keep in mind that you caloie goal may need to be changed ove time, as descibed below. 4. Ae you getting too hungy because of what and/o how often you eat? Being ovely hungy can lead to losing contol and eating too much o eating less healthy foods. You may not even be awae of it. Follow these guidelines to avoid becoming ovely hungy: Eat a egula patten of healthy meals and snacks. Spead you caloies thoughout the day. Eat something evey 3 to 5 hous. Eat beakfast. Limit late night eating. Many people make pooe food choices o eat too much late at night. Eat some lean potein at evey meal. It is filling. Good souces include cooked died beans, lentils, and split peas; small amounts of nuts o seeds; and fish, skinless poulty, and lean cuts of meat. Othe good souces ae eggs and fat-fee o low-fat (1%) milk, yogut, and cheese. Eat foods that will fill you up on fewe caloies: - Foods with plenty of fibe, such as fuits and vegetables (with the edible peels); whole gains; small amounts of nuts o seeds; and cooked died beans, lentils, and split peas - Foods that contain wate, such as low-fat soups (both-based, not ceam), fesh fuit, vegetables, and cooked gains 5. Ae you eating enough? Some people cut out too many caloies fo too long. This can cause the body to go into stavation mode, making it hade to lose weight. In geneal, do not eat less than 1,200 caloies pe day.

4 Page 4 of 7 6. Ae you getting enough of and the ight kind of physical activity? Physical activity buns caloies, which helps with weight loss. Being active is even moe impotant to keeping off the weight you lose. Fou types of physical activity ae impotant fo fitness: aeobic activity, muscle stengthening activities, stetching, and movement thoughout the day. Aeobic activity Slowly build up to at least 150 minutes of modeate aeobic activity pe week, such as bisk walking, swimming, o biking. Fo example, take a bisk walk fo 30 minutes on five days a week. O build up to at least 75 minutes of vigoous aeobic activity pe week, such as unning o aeobic dancing. O do a mixtue of the two! Spead the minutes ove the week, and make each session last at least 10 minutes. Fo example, on thee days a week, walk fo 10 minutes duing you coffee beak, 30 minutes duing you lunch beak, and 10 minutes afte dinne. Muscle stengthening activities Examples include using weight machines, hand weights, o esistance bands; doing push-ups; doing activities such as ock climbing o heavy gadening. Do these at least twice a week. Include all majo muscle goups, such as legs, hips, back, chest, stomach, shouldes, and ams. Execises fo each muscle goup should be epeated 8 to 12 times pe session. Stetching This includes activities such as yoga, calf stetches, and shoulde and am stetches. Stetching execises impove flexibility and help pevent injuy. Stetch when you muscles ae wamed up (afte you have been active fo awhile). Stat each stetch slowly, hold fo 30 seconds, and do not bounce. Do not stain o push a muscle to the point of pain. You should only feel a gentle stetch. Do not hold you beath. Movement thoughout the day Change inactive time to active time as often as you can (e.g., take the stais instead of an elevato; walk aound while you talk on the phone; sit less).

5 Page 5 of 7 7. Do you need to futhe lowe you caloies and/o be moe active? The less you weigh, the fewe caloies you body needs to maintain its new, lowe weight. A smalle body geneally buns fewe caloies than a lage one, just as smalle cas bun less fuel than lage ones. As you weight goes down, so do you daily caloie needs. Also, when you lose weight, you body becomes moe efficient when you ae active. Fo example, afte losing 10% of you initial weight, you bun about 30% fewe caloies walking a mile than you did befoe you lost weight. Reseaches have shown that the human body is pogammed to esist weight loss, even when you ae tying to impove you health. This is likely elated to ou ealy biological pogamming, which helped us suvive thousands of yeas ago. In those times, food was not always available and suvival equied a vey active lifestyle. But that pogamming is less helpful today because food is plentiful and ou daily lives ae vey sedentay. To keep moving towad a lowe weight: Ty eating fewe caloies each day by educing potions o limiting snacks and dessets. Ty inceasing how had you wok while you ae active. O add moe activity minutes to you day. O do both. Fo example, if you walk fo 30 minutes on most days of the week, build up ove time to 60 minutes. O build up slowly to jogging instead of walking. 8. Ae you slipping on some of the key skills fo weight loss? Many of the key skills fo weight loss may be new to you. You may have woked had to pactice them at fist. But it is common to slip back into old habits.

6 Page 6 of 7 In the chat below, cicle how often you pactice each of the skills listed: I weigh myself at least once a week. Always Vey Often Sometimes Raely Neve I wite down the caloies in what I eat and Always Vey Often Sometimes Raely Neve the minutes of activity that I do. I stay away fom the cues that pompt me Always Vey Often Sometimes Raely Neve to oveeat o to be inactive. O I espond to those things in a way that keeps me on tack. I manage stess in healthy ways, instead of Always Vey Often Sometimes Raely Neve by oveeating o being inactive. When I get off tack, I go back to my goals Always Vey Often Sometimes Raely Neve fo caloies and activity ight away. I plan ahead fo eating out, holidays, vacations, and special events. Always Vey Often Sometimes Raely Neve As you ty vaious ways to beak fee of a weight loss plateau, stay positive. Reflect on any signs of pogess that don t involve the scale. Notice you clothes fitting moe comfotably; having moe enegy o confidence; o any impovements in you blood suga, cholesteol, o blood pessue. Keep the faith. Visualize youself at a new lowe weight. Give youself cedit fo evey step you take to meet you daily caloie goal, eat healthy foods, and be active.

7 Page 7 of 7 Take Action My SMART* Goal fo This Week (Check when completed) Do you best to each the SMART* goal you set with you health coach. Wite it hee. Check the box when you have completed it. Staying on the Path to Wellness (Check when completed) When you ae eady, choose one o two ideas fom this tip sheet that you would like to put into action. Set a weekly SMART goal fo each one. Wite you goals hee. Check the boxes when you have completed them. SMART Goal 1: SMART Goal 2: *SMART goals ae Specific, Measuable, Appopiate, Realistic, and Timely. Fo example, I have been walking fo 30 minutes on five days a week. Next week, I will walk fo 35 minutes each time. I will keep adding five minutes one week at a time until I each 60 minutes. SMART goals help you succeed! If you have any touble setting you weekly SMART goals, ask you health coach fo help. The infomation in this tip sheet is fo educational puposes only. It is not intended o implied to be a substitute fo pofessional medical advice. Befoe making changes, always talk to you docto about what is ight fo you. Souce: The Univesity of Pittsbugh Obesity and Nutition Reseach Cente (gant DK fom the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases).