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Session 6- Keep Your Heart in Mind: Aim for a Healthy Weight

Manual Contents

Session 6
Keep Your Heart in Mind: Aim for a Healthy Weight

Page Contents

Objectives

By the end of this session, group members will learn that:

  • Being overweight is a risk factor for high blood cholesterol, high blood pressure, diabetes, heart disease, and stroke.
  • Healthy weights are given in ranges.
  • Losing weight or keeping a healthy weight means making lifelong changes.
  • Fad diets usually do not work over the long term and can be harmful.

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Materials and Supplies

To conduct this session, you will need:

  • “Your Heart, Your Life” manual and picture cards
  • Blackboard and chalk or several large pieces of paper, a marker, and tape
  • Two bathroom scales
  • A tape measure you can attach to the wall (to measure height)
  • A cloth tape measure (to measure the waist)
  • (Optional) Curling ribbon (to measure the waist) – If you choose to use ribbon instead of measuring tape, cut one ribbon at 35 inches for women and one ribbon at 40 inches for men.
  • A food label (from a can or package)
  • (Optional) “I Don't Like That Boy At All: Watch Your Weight” telenovela or fotonovela
    Note: The telenovela is available in Spanish only.
  • (Optional) VCR or DVD and TV monitor
  • Prepare before the session:
    • 10 serving dishes
    • Four measuring cups
    • Five spoons
    • One knife
    • Food
      • A 16-ounce box of cereal
      • A 15-ounce can of fruit or vegetables
      • A block of cheddar cheese (about ½ pound)
      • 3 cups of cooked rice
      • A 15-ounce can of beans

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Handouts

Give group members these handouts during this session:

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Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session
  1. Welcome
    • Welcome group members to the session.
  2. Review of Last Week's Session
    • Say:
      Last week, we talked about why it is important to cut back on saturated fat, trans fat, and cholesterol in our diets. Can you list three things you can do to make food lower in fat?
      Note: Add these possible answers if not mentioned by group members.
      • Trim the fat from meat before cooking.
      • Take off the skin from chicken before cooking and throw it away.
      • Bake, boil, broil, or grill food instead of frying it.
    • Ask:
      At the end of the last session, you made a pledge to eat less saturated fat, trans fat, and cholesterol. What went well? Did you have any problems?
      Note: Allow 5 minutes for group members to respond.
  3. About This Session
    • Say:
      Today, we will discuss why keeping a healthy weight is important to heart health.
    • Say:
      When the session ends, you will know that:
      • Being overweight increases your chances for high blood cholesterol, high blood pressure, diabetes, heart disease, and stroke.
      • To lose weight:
        • Cut down on the calories you eat.
        • Eat smaller portions.
        • Be physically active.
      • Fad diets usually do not work over the long term and can be harmful to you.
    • Say:
      You will also find out if you need to lose weight by learning your body mass index (BMI) and your waist measure.

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Conducting the Session

  1. Facts About Overweight and Obesity
  2. (Optional) “I Don't Like That Boy At All: Watch Your Weight” Telenovela or Fotonovela
  3. Your Weight and Your Health
  4. What Is a Healthy Weight? Activity
  5. The Healthy Way To Lose Weight
  6. Beat Weight-Loss Barriers
  7. Serving Size Activity
  8. Food Label Activity — Calories
  9. Fresh Cabbage and Tomato Salad Recipe
  1. Facts About Overweight and Obesity
    • Overweight and obesity increase the risk of heart disease and stroke.
    • More than half of Latina women are overweight or obese.
    • About two of every three Latino men are overweight or obese.
    • About one of every four Latino children is overweight.
  2. (Optional) “I Don't Like That Boy At All: Watch Your Weight” Telenovela or Fotonovela
  3. Your Weight and Your Health
    • Say:
      Being overweight or obese increases your risk of heart disease and stroke. It also can contribute to the development of high blood cholesterol, high blood pressure, and diabetes. These can also cause heart disease.
    • Say:
      Being overweight can increase the risk of developing some types of cancer. It can make other health problems worse, such as arthritis and sleep disorders.
    • Say:
      Losing a small amount of weight can improve many health problems that come from being overweight.
  4. What Is a Healthy Weight? Activity
    Note: Before beginning this activity, place the scales where group members can weigh themselves in private. Write the following information on the blackboard or on a large piece of paper taped to the wall:
    • Mariano weighs 180 pounds (82 kilograms). He is 5 feet, 6 inches (1.68 meters) tall.
    • Virginia weighs 130 pounds (59 kilograms). She is 5 feet, 2 inches (1.57 meters) tall.
    • Give group members the “Body Mass Index (BMI) Chart” handout.
    • Say:
      We are going to do an activity to find out if you have a healthy weight or if you should lose weight.
    • Show picture card 6.1.
    • Say:
      First, we're going to work together to find out if Mariano and Virginia have healthy weights. We will use the Body Mass Index chart. The BMI chart lets us measure the weight of a person in relation to his or her height. The chart will help us find the BMI.
    • Say:
      Mariano weighs 180 pounds (82 kilograms), and he is 5 feet, 6 inches (1.68 meters) tall. His wife Virginia weighs 130 pounds (59 kilograms), and she is
      5 feet, 2 inches (1.57 meters) tall.
    • Say:
      Let's use the BMI chart on the handout that I gave you to find out if Mariano and Virginia have healthy weights.
    • Say:
      Look for Mariano's weight on the top of the chart, and circle it. Put your finger on the circled number, and lower your finger until you find the line that corresponds to Mariano's height. The shade of the square will tell you if his weight is healthy or if he is overweight or obese.
      Note: Allow 2 or 3 minutes for group members to look for the answer on the chart.
    • Say:
      Now we will find Virginia's BMI, following the same steps.
      Note: Allow 2 or 3 minutes for group members to look for the answer on the chart.
    • Say:
      Mariano's BMI is 29, which means he is overweight. Virginia's BMI is 24, so she has a healthy weight.
    • Say:
      Now we are going to find out if you have a healthy weight. If you do not know how much you weigh, use the scale to weigh yourself. If you do not know your height, use the wall measure.
      Note: Allow 15 minutes for group members to use the scales and wall measure.
    • Give group members the “Do You Need To Lose Weight?” handout.
    • Say:
      Now we're going to take three simple steps to learn if we need to lose weight, and then we're going to find out what actions we should take.
    • Say:
      The first step is to find out our BMI, using the chart on the handout that I gave you. We will follow the same process that we used with Mariano and Virginia.
    • Say:
      Find your weight on the top of the chart, and circle it. Put your finger on the circled number, and lower your finger until you find the line that corresponds to your height. The shade of your square will show you if your weight level is healthy, overweight, or obese. You do not have to share your BMI number with the group. Just check off your weight level on the handout.
    • Say:
      Please raise your hand if you are having trouble, and I will help you.
    • Say:
      The second step is to measure your waist.
    • Show picture card 6.2.

      Waist Measure

      Note: Have group members measure their waists by placing a tape measure around the waist just above the hip bone. Be sure the tape is snug, but not too tight on the stomach. Ask them to relax, exhale, and then measure their waists. Measuring tape position for waist measurement in adults is around the waist at the navel, under the rib cage.

    • Ask group members to measure their waists using the measuring tape.
      (Optional) Note: Some people may be sensitive about measuring their waists with a tape measure. To make this activity friendlier, you can use curling ribbon. Cut 35 inches (88 cm) for women and 40 inches (102 cm) for men, and give the ribbon to group members. Tell them how long the ribbon measures. If the ribbon does not go all the way around group members' waists, their waist measures are high.
    • Say:
      Write down your waist measure, and check off what level your waist measure is: healthy or high. A waist measure greater than 35 inches (88 cm) for women and greater than 40 inches (102 cm) for men is high. A high waist measure increases your risk for heart disease.
    • Say:
      In the third step, we will find out if you need to lose weight. Look at your weight and waist measure.
    • Say:
      If both are healthy, then you are at a healthy weight and do not need to lose weight. Good for you! Try not to gain weight.
    • Copy the text in the “Risk Factors” onto the blackboard or onto a large piece of paper taped to the wall:

      Risk Factors

      • High blood pressure
      • High LDL cholesterol (bad cholesterol)
      • Low HDL cholesterol (good cholesterol)
      • High triglycerides
      • High blood glucose
      • Family history of heart disease
      • Not being physically active
      • Smoking
    • Say:
      Let's review these risk factors.
    • Ask:
      How many risk factors do you have?
      Note: Allow a moment for group members to think about their answers to this question.
    • Say:
      If your BMI is in the overweight level, and you have two or more of the risk factors we just listed, you should lose weight. It is important not to gain more weight. You should also lose weight if you are overweight and have a high waist measure.
    • Say:
      If your BMI level is obese, you also need to lose weight. It is important to lose weight slowly – about 1 to 2 pounds a week. Ask your doctor or a registered dietitian for help.
      Note: Ask group members to look at the handout to see what actions they should take for their weight levels.

      Weight Levels and Actions

      • Healthy Weight – Good for you! Try not to gain any weight.
      • Overweight – It is important not to gain more weight. You need to lose weight if you are overweight and have two or more heart disease risk factors or have a high waist measurement. Ask your doctor or a registered dietitian for help.
      • Obese – You need to lose weight. Lose weight slowly – about 1 to 2 pounds a week. Ask your doctor or a registered dietitian for help.
    • Give group members the “Doña Fela's Healthy Lifestyle” handout.
    • Say:
      Please review the handout to find out how Doña Fela found success managing her weight.
  5. The Healthy Way To Lose Weight
    • Say:
      Let's talk about the healthy way to lose weight.
    • Say:
      The measure of energy that the body gets from food is called a calorie. People gain weight when they eat more calories than their body uses for energy.
    • Say:
      If you need to lose weight, you must choose foods with fewer calories or become more physically active. It's best to do both.
    • Say:
      To lose weight, you must burn more calories than the calories you eat. Losing 5 to 15 percent of your body weight can make a difference in your health. For example, a person who weighs 200 pounds would need to lose 10 to 30 pounds.
    • Say:
      Pregnant women should not try to lose weight.
    • Give group members the “Virginia's Habits and Her Weight” handout.
    • Say:
      This handout is about how decreasing calorie intake and adding small amounts of daily activity can lead to weight loss over time.
    • Ask for volunteers to read each scene aloud.
    • Show picture card 6.3.
    • Say:
      Like Virginia in the third scene, you can lose weight in a healthy way: Eat smaller portions, eat a variety of foods lower in fat and calories, and increase your activity level.
    • Say:
      Most people who lose weight and keep it off do so by losing the weight slowly. They learn to make lasting changes. They eat fewer calories and stay physically active. You should try to lose 1 to 2 pounds each week until you reach a healthy weight.
    • Give group members the “Tips To Help You Control Your Weight” handout. Review the tips for losing weight.
  6. Beat Weight-Loss Barriers
    • Ask:
      Have any of you ever tried to lose weight?
    • Ask people to share their experience with the group. Ask them to tell what kept them motivated to lose weight.
    • Ask:
      Why do you think it is difficult for some people to lose weight or keep off the weight they lose?
      Note: Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add some of the following answers if they are not mentioned.
    • Some people have a hard time losing weight because:
      • They lack support from family members or friends.
      • They do not know how to cook without fat or how to use a recipe.
      • They believe that healthy foods are too expensive.
      • Fruits and vegetables cost more than junk food at the local store.
      • The neighborhood is too dangerous for people to walk in for physical activity, because it lacks well-lit areas.
      • Working parents are often short on time and energy.
      • Changing behavior is difficult and takes time and effort.
      • They think that being heavy means that a person is healthy.
      • Family activities center around food.
      • Friends give the wrong message. For example, “You're better off with some extra weight.”
    • Ask:
      Have you found ways to beat the barriers to losing weight?
      Note: Allow 3 to 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add some of the following answers if they are not mentioned.
      • Find another person who also wants to lose weight. You can talk with this person to stay motivated.
      • Walk or plan other activities with another person. This makes it more fun, and the time will pass quickly.
      • Find activities that the whole family can enjoy to help others control their weight, too.
      • Look for free or low-cost physical activity facilities at local community centers or parks and recreation programs.
      • Share cooking chores and recipes with your friends. For example, if family members will not eat lower-calorie dishes, make a dish and share it with a friend. Your friend can make a dish and share it with you.
    • Say:
      Ask your doctor or a registered dietitian to help you develop a plan if you have a lot of weight to lose.
    • Show picture card 6.4.
    • Say:
      Losing weight has become a moneymaking business. You hear about miracle diets that claim to help you lose weight quickly and easily. These products make only one thing lighter – and that's your wallet. Be careful about ads that promote diets and exercise products using personal testimonies.
    • Say:
      Diets that promise quick weight loss rarely work. Many of these diets include only a few foods. People get bored with them quickly. These diets do not provide all the nutrients and energy your body needs. They are not healthy.
  7. Serving Size Activity
    • Say:
      Let's look at how big a serving is. In Session 8, “Make Heart Healthy Eating a Family Affair,” we will look at how much you should eat.

      Before the session

      1. Check the “Serving Sizes” handout for the serving size of each food. Measure one serving of each food, and put each in a separate dish or other container.
      2. Place the dishes with these premeasured foods out of sight.
      3. Place the box of cereal, a large bowl of cooked rice, a bowl of fruit or vegetables, a block of cheddar cheese, and a bowl of beans on a table with five dishes, four serving spoons, and a knife.
    • Ask five volunteers to come to the table. Ask each volunteer to do one of the following:
      1. Spoon out a serving of cereal and put it on a dish.
      2. Spoon out a serving of cooked rice and put it on a dish.
      3. Cut a serving of cheese and put it on a dish.
      4. Spoon out a serving of the fruit or vegetable and put it on a dish.
      5. Spoon out a serving of beans and put it on a dish.
    • Bring out the foods you measured before the session. Compare the volunteers' serving sizes with the true amounts.
    • Give group members the “Serving Sizes” handout. Ask volunteers to read aloud the serving sizes for each. Tell them to use this handout at home.
  8. Food Label Activity – Calories
    • Note: This activity will help group members choose foods that are lower in calories.
    • Say:
      We have learned that, to lose weight, a person must eat fewer calories than the body burns for energy. In the last session, you learned how to use the food label to choose foods that are lower in saturated fat, trans fat, and cholesterol. Today, we are going to learn how to use the food label to choose foods that are lower in calories.
    • Show picture card 6.5.
    • Say:
      Here's where you can look to find the number of calories in one serving on the food label. This food label shows the number of calories in canned peaches in heavy syrup.
    • Give group members the “Read the Food Label for Calories!” handout.
    • Say:
      Look at the food labels for canned peaches (in fruit juice) and canned peaches (in heavy syrup) at the bottom of the handout. Which canned peaches have fewer calories?
      Note: Allow 1 to 2 minutes for group members to respond.
    • Say:
      Canned peaches in fruit juice have fewer calories. There are 50 calories in one serving, or ½ cup, of canned peaches in fruit juice. There are 100 calories in one serving, or ½ cup, of canned peaches in heavy syrup – twice as many calories as canned peaches in fruit juice.
    • Say:
      “Fat-free” does not mean free of calories. You need to watch calories and fat when comparing food labels.
    • Here are a few examples:

      Calories in reduced-fat food

      • Reduced-fat chocolate chip cookies, 3 cookies (30 grams) = 118 calories
      • Baked tortilla chips, 1 ounce = 113 calories

      Calories in regular-fat food

      • Regular chocolate chip cookies, 3 cookies (30 grams) = 142 calories
      • Fried tortilla chips, 1 ounce = 143 calories
    • Say:
      Let's try another group activity. I will tell you about a common problem for families today. Then we will learn how to use food labels to help solve the problem.
    • Give group members the “Virginia's Snack Choices” handout. Read Virginia's problem. Ask group members which foods Virginia should serve.

      Virginia's Problem

      Virginia and her family like to have snacks when they watch television. Recently, Virginia has noticed that her family members have gained weight. Use the food labels to choose some tasty snacks that are lower in calories. What should Virginia serve? Write the number of your choice for each pair on the line. Then write the number of calories saved by this choice.

      • Potato chips or microwave popcorn?
        Choosing popcorn saves 130 calories.
      • An apple or shortbread cookies?
        Choosing an apple saves 70 calories.
      • Whole milk or fat-free milk?
        Choosing the fat-free milk saves 60 calories.
      • Chocolate ice cream or a popsicle?
        Choosing the popsicle saves 95 calories.
      • Salsa or jalapeño cheese dip?
        Choosing the salsa saves 25 calories.
    • Ask:
      • What is an example of a snack that is higher in calories that your family eats?
      • What is an example of a snack that is lower in calories that your family would enjoy?
      Note: Allow a few minutes for group members to respond.
  9. Fresh Cabbage and Tomato Salad Recipe

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Review of Today's Key Points

  • Say:
    Let's review what we learned today.
  • Why is it important to maintain a healthy weight?
    Being overweight may increase your risk of heart disease, high blood pressure, high blood cholesterol, diabetes, and some types of cancer.
  • What is the healthiest way to lose weight?
    Eat smaller portions of a variety of foods lower in fat and calories, and increase your physical activity.
  • How can the food label help you if you need to lose weight?
    The food label tells you the serving size and the number of calories per serving. You can compare calories on different packages to choose foods that are lower in calories.

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Weekly Pledge

  • Say:
    You have learned a lot today about losing weight the healthy way. Now, let's think about how you can apply what you have learned. Please think of one change you can make in your everyday life to reach or keep a healthy weight. This will be your pledge for the week.
  • Say:
    Be specific about what you plan to do, how you plan to do it, and when you will start. Here are some examples:
    • I will buy vegetable oil spray when I go to the grocery store next week. I will use the cooking oil spray instead of butter when I make scrambled eggs for breakfast.
    • I will walk for 30 minutes for 3 days each week during my lunch break at work, starting tomorrow.
    • I will eat only half of my entree the next time I eat out to cut down on my food portion. I will take the other half home and save it for another meal.
  • Say:
    Write your pledge on the “Doña Fela's Healthy Lifestyle” handout. Keep this handout in a special place, so you can review your pledges and keep your goals in mind.
    Note: Allow 5 minutes for group members to think of a pledge and write it down.
  • Say:
    Would anyone like to share his or her pledge with the group?
    Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
  • (Optional) Say:
  • Keeping a personal value in mind can help you make changes in your life to reach and keep a healthy weight. Remember that a personal value is a quality that you consider important.
  • Today, the value is honesty. Honesty can help you think about what makes you overeat, such as feelings of boredom, stress, or anger, or a lack of time or willpower. Honesty can also free you to talk about your struggles and successes with your friends or loved ones who can support you. Finally, honesty can guide you to choose goals that are realistic for you as you work to change your eating and activity habits for the better.
  • Ask:
  • How can you use honesty, or another value, to help you keep your pledge?
  • Note: Allow 3 minutes for group members to share their thoughts.
  • Say:
  • We will discuss the results of your pledges next week. Don't forget to continue working on your pledges to be more physically active and to cut back on salt, sodium, saturated fat, trans fat, and cholesterol.

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Closing

  • Say:
    Thank you for coming today. What did you think of today's session?
    Note: Allow a moment for group members to respond.
  • Say:
    I am looking forward to seeing you at the next session. The next session will be about diabetes and how it relates to heart disease.
    Note: Think about today's session. What worked and didn't work? Have you made any changes in your own life that were covered in today's session?

Go to Session 5

Go to Session 7


Information on this page is taken from the English print version of “Your Heart, Your Life, A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.

Last Updated March 2012

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