Table 1

Behavioural modification strategies used within the SLiM programme

Behavioural modification techniqueDescription of specific tools within techniques
Self-monitoringFood and mood diary used to record foods eaten, when, where, with whom and relation with mood
Used to identify triggers and help the patient become more conscious about their eating behaviour
Techniques to help control perceived hunger
Goal settingSMART goals are explained and a game is used to help patients' understanding
Patients encouraged to make long-term goals within brainstorming session and then encouraged to make individualised goals each month with regard to diet and physical activity
Realistic personalised weight loss goal targets set at 5%, weight monitoring chart given
Stimulus controlIdentification of external and internal triggers using an association game
Use of distraction techniques to help patients avoid excessive eating
Cognitive restructuringDiscussions about negative thoughts and beliefs can inhibit the use of behavioural change, eg, ‘I've had one biscuit, so I've ruined my diet’
Patients encouraged to change negative, unhelpful thoughts to more useful, positive ones, eg, ‘One biscuit is not the end of the world and I can go for a walk tomorrow to burn it off’
Patients trained to use positive self-talk and diaries to help with the process
Eating behaviourPatients educated on healthy eating using the principles of the eatwell plate
Stabilisation of eating—regular meals
Portion size control discussed
Patients taught to read and interpret food labels using resources and labelling game
MaintenancePatients taught the difference between a slip-up and a setback and to avoid using terms that can encourage relapse, eg, failure
All or nothing beliefsPatients encouraged to avoid all or nothing beliefs and shown how these affect food intake and achieving goals, eg, avoid the use of ‘always’ or ‘never’ or ‘have to’
Reward and supportNon-food-related rewards are actively encouraged to aid motivation and help patients to move away from seeing food this way
Support is discussed along with getting patients to ask for this from family, friends and colleagues
How to identify negative support and deal with it to make it positive
Problem solvingPatients given skills and techniques to help with problem solving
Patients taught to plan for high-risk situations that could cause emotional or maladaptive eating
Self-esteemBrief discussion on how to improve self-esteem and feel good about one's self
  • SLiM, Specialist Lifestyle Management; SMART, Specific, Measurable, Achievable, Relevant and Time-Bound.