Group Session 4. Xertubes Pumping Rubber Workout Video (Optional)

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Group Session 4 at a Glance Key Behavioral Strategies Participant Behavioral Strategies Process Objectives & Session Content Handouts Other Materials Topics/Agenda (2 hours) Short term goals Food patterns Exercise patterns Before the next group session, the participants will: Incorporate stretching and flexing exercises into their exercise routine Substitute lower calorie foods for some higher calorie foods Evaluate progress on action plans Provide alternatives to typical high calorie meals Discuss the importance of stretching and building muscle It s Your Choice-lower calorie options Exercise Anytime My Action Plan for the Week Food and Fitness Diary (FFD) New Leaf Module Handouts: Strengthening Exercises: Stretch Band ; Stretching and Flexibility Exercises ; Chair Exercises for Strength and Flexibility Xertubes www.spriproducts.com Pumping Rubber Workout Video (Optional) CHECK-IN ~30 MINUTES Discuss lower calorie food choices TRY IT! DISCUSSION/ACTIVITIES ~30 MINUTES Demonstrate stretching exercises Demonstrate muscle building exercises DO IT! ~30 MINUTES Conduct stretching and muscle building exercises NEXT STEPS ~30 MINUTES Action plans for keeping records of food and exercise What to expect next week

Agenda for Session #4 Page 2 of 10 Check- In Your Notes: I. Check-In Eating fewer calories Success and challenges: What worked? What didn t work? Exercise progression Materials: It s Your Choice ~ 30 minutes Sample discussion approach: Last week, we spent a lot of time talking about calories, specifically high calorie foods. For almost all of us, it is important that we reduce the amount of calories that we are eating to lose weight. What are the three ways that we can reduce calories in our diet? Can someone give me an example of how we can do these things? Last week, each of you wrote down one or more of your high calorie foods and made a plan of how you would work to reduce these calories. Will someone share her plan? How did it work? What was challenging about sticking to the plan? How did you feel about making these changes? What could you try to overcome these challenges? We have talked a lot about trying to reduce the amount of high calorie foods that we eat. However, it is unrealistic to say that you will never have French fries again. But, it is important to remember that you do have choices in what you eat. Let s look at the It s Your Choice worksheet. Here, we have listed some of the common high calorie foods and other choices. Of course, these are just suggestions and sometimes there is no substitute for ice cream. Can anyone think of other substitutions for some of these foods in the left-hand column? What can you do to help reduce calories throughout the day if you do have one of these foods? (i.e. make the other meals throughout the day healthier or lower calorie) Another plan for last week was to outline an exercise plan. Remember the goal for this program is 30 minutes of exercise on 5 days of the week. Is anyone meeting this goal? What about 2 days a week? 3? 4? 5? Great (give prizes/points)! Has it been difficult to keep? How do you feel on days you exercise compared to days when you cannot? What are some of the ways you find time to exercise? Has anyone

Agenda for Session #4 Page 3 of 10 tried new activities? II. Try It The importance of stretching Building muscle Finding time to exercise Materials: Exercise Anywhere ~40 minutes 1. The importance of stretching Discuss mechanisms of stretching (don t overdo it) Explain why stretching is important Sample Discussion Approach: So far, we have talked a lot about being more physically active; specifically about exercising at a moderate intensity level. This is important as it helps our heart stay healthy and helps to burn more calories. Now, we want to introduce stretching and talk a little about why it is important. Does anyone have any ideas on why stretching is important? For starters, it helps us move a little better which in turn makes it easier for us to move more. Have you ever noticed how stiff you feel after sitting for a long period of time? We are going to demonstrate some stretches that you can do to warm up or cool down before or after exercising, but remember you want to warm up the muscles before even stretching. This can be simply standing up and moving around a little nothing too fast or too hard. Stretching can also help relieve stress and tension and help you feel relaxed. Before we demonstrate, let s write down on the board some things to keep in mind when stretching. (i.e. stretching is not a competition everyone has her own ability, remember to breathe into the stretch, a safe stretch is gentle and relaxing, hold stretches for about 15 seconds rest and then repeat, do not bounce, etc.). We are going to be demonstrating and practicing some stretches later in the session. 2.Building muscle Give overview of role of muscle in burning calories Demonstrate muscle building activities Sample discussion approach: Your Notes

Agenda for Session #4 Page 4 of 10 How many people feel like they need to gain more muscle? Why? Well, as we age, our muscle mass decreases and when we lose weight, we are likely losing our muscle mass first. This is problematic as we want to stay as strong as possible so that we are not susceptible to injuries and illnesses. Also, muscle is important in burning more calories. Have you ever wondered why it seems so much easier for men to lose weight than women? This is because, in general, they have more muscle mass than women. Muscles use more calories or burn more calories than fat. Therefore, the more muscle we have, the more calories we use. So, as you begin to lose weight, you want to make sure that you are losing fat and not muscle. To do this, you have to build up your muscles while you lose weight. Exercising is helping build muscles, but there are other things that you can do to help you keep strong. One example is walking with full water bottles while you go on a walk. You can try lifting them as you walk like this. We will practice some other techniques a little later in the session. 3. Finding Time to Exercise Review existing exercise patterns Discuss emotions related to exercising Have participants come up with ways to fit exercise in Sample discussion approach: Just like finding time to eat healthy, we often need to find time to exercise. How many people have been successful at adding exercise into their routine? What has been most successful? What time do you exercise? What pushes exercise out of the way? What helps you get it in? Visualize yourself at the end of your last exercise session. What did that feel like? What triggered you to actually get out the door? Does it help when someone else is counting on you?

Agenda for Session #4 Page 5 of 10 Here are 5 ways to increase activity throughout the day. (Distribute Exercise Anytime handout). What other ideas do you have? Where will you find the time? What other activities are you willing to give up? (E.g. 30 minute lunch versus 60 minutes, 1 hour of television watching versus 2 hours, etc.) III. DO IT!!! Stretching Strength Training ~ 30 MINUTES Instructions for the Interventionist: Optional : Familiarize yourself with the exercises in Pumping Rubber Workout Video from SPRI. The Xertube Instruction Chart is a handout available on the web as well with photos of the various exercises. Demonstrate a few of these exercises and have each participant practice certain strength training exercises. Walk around and assist where necessary and have props available for those that need additional help Materials/Equipment: - 1 Resistance tube for each participant- These can be ordered from SPRI at 1-800-222-774 or www.spriproducts.com for $4-5 each depending on quantity. I recommend ordering a combination of red and green Xertubes to accommodate both men and women at different fitness levels. - Refer to A New Leaf handouts Strengthening Exercises: Stretch Band ; Stretching and Flexibility Exercises ; Chair Exercises for Strength and Flexibility ; and select several stretches to have the class do. Your Notes

Agenda for Session #4 Page 6 of 10 IV. Next Steps Facilitate discussion: - Strength training helps us build muscle. Why is building muscle important? - You should try to strength train at least two times per week. - How do you feel about these exercises? - How do you feel about stretching? - It is good to stretch your muscles everyday and especially before and after exercising. - Do you think you will be able to do these your own? - How can you incorporate these types of exercises in your day? 1. Action Plan for the Week a. Incorporate 3 different stretches into the workout b. List 3 ways that you will try to build more muscle Plan for the Week Tracking (Self- Monitoring) What to Expect Next Week ~30 minutes 2. Tracking (Self-Monitoring) The recommended tracking for the week is: a. Write down all the food you eat and drink every day. e. Write down the minutes of exercise above your normal routine. 3. What to expect next week a. Bring your completed food diaries and summary sheets b. Bring in a package from a food you regularly eat c. Will discuss portion and serving size next week d. Keep up the great work with weight loss e. Be prepared to share your feelings

Agenda for Session #4 It s Your Choice for Calories Page 7 of 10 Original Better Even better Deep fried and Pan fried chicken Baked/grilled chicken battered chicken Ice cream Low-fat ice cream Low-fat frozen yogurt Whole milk 2% milk 1%, ½%, or skim milk Large French fries Small French fries Small baked potato with salsa or reduced fat sour cream Egg & Sausage biscuit Egg biscuit Egg on whole wheat English muffin or toast Ham & cheese croissant Caesar salad Ham & cheese on whole wheat Salad with reduced calorie ranch dressing Turkey with lettuce, tomato on whole wheat Salad with Spritzer (sprayed) vinaigrette dressing Big gulp soda Big gulp diet soda Small diet soda or water Grab bag potato chips Regular size potato chips Regular size lightly salted chips Cream of potato soup Reduced fat cream of potato soup Vegetable soup Double cheeseburger Cheeseburger Hamburger with lettuce & tomato Cream filled donut Small muffin Toast with peanut butter Bologna/hot dog Sliced deli meat Leftover chicken/turkey meat Green beans with bacon Green beans with pat of soft margarine Green beans with touch of olive oil, lemon juice or other spices WW Version 1.0 Session 4

Agenda for Session #4 Exercise Anytime Page 8 of 10 1. Walk or ride your bike to the bus stop or to work 2. Take a walk around the building or walk up and down the stairs with coworkers for half of the lunch break 3. Ride an exercise bike or lift weights in front of the television 4. Pace around the house while talking on the phone 5. Take stretch breaks instead of smoke breaks at the office What are other ways to exercise throughout the day? 6. 7. 8. 9. 10. Circle the ideas that you will try to do this week WW Version 1.0 Session 4

Agenda for Session #4 Page 9 of 10 GOAL #1: Eat less calories My high calorie foods 1. 2. 3. My Action Plan for the Week I will eat this food less often 3 ways to eat less calories I will eat less of this food at one time I will eat another food instead GOAL #2: 30 minutes of moderate physical activity on 5 days of the week Day Activity Minutes Sunday Monday Tuesday Wednesday Thursday Friday Saturday TOTAL GOAL #3: Keep track of all food/drinks and physical activity in the Food and Fitness Diary every day Things that may get in my way 1. 2. 3. How I can make sure they don t 1. 2. 3. GOAL #4: My other goal is: What I need to do to reach this goal: WW Version 1.0 Session 4

Agenda for Session #4 Page 10 of 10 WW Version 1.0 Session 4