Recap: Last October we introduced the Morfidis family of Bowmanville, Ont., (George, 41, Despina, 42, Ria, 14 and Stefi, 11) as they started a yearlong health makeover program with Canadian Living.

Though they are eight months into the program, the Morfidises are still discovering what works for them and what doesn't.

Making changes to lose weight and get healthy isn't a simple task – even if you are being featured in a magazine and things appear to be going well. Here are some of the biggest hurdles the family has stumbled on, what the experts have advised to get over them, and what the Morfidises have learned. Working with our team of professionals – dietitian Fran Berkoff, physician Dr. Suzanne Buchanan, personal trainer Sue Forest and life coach Cassandra Gierden – the family identified goals to get healthier through exercise, healthy eating and weight loss.

HURDLE: Lack of support for healthy choices, which can sabotage efforts
When Ria packed leftover salad with goat cheese, apples, tomatoes and oranges for lunch one day, kids in the cafeteria made fun of her (“Why'd you bring salad, it looks gross?”). One of her good friends came to her defence, but Ria still didn't like being teased about what she was eating and wondered, “why would they say that?”

Perhaps it's because they don't know any better. There's a whole world out there that doesn't encourage healthy eating habits. There are many people, young and old, who don't practise healthy
eating – and they may be asking for an unhealthy future. But it's important that the Morfidises build confidence around healthy choices in their children, say the coaches. Here's how.

• Talk about healthy eating at every opportunity. Perhaps Ria has a slim friend who always has fries and pop for lunch. Explain that the friend may stay skinny but that doesn't mean she's healthy from the inside.
• Encourage Ria to join friends for healthier favourite teen foods such as pizza (she can select vegetarian or one with whole wheat crust).
• Suggest Ria sometimes share her healthier choices. (She could invite some of her better friends to try the salad. She has also invited those friends home for dinner – and made sure salad was on the menu.)
• Communicate boundaries, says Gierden. Suggest that Ria let friends know this is how she prefers to eat and tell them, “I'd like it if you'd not make fun of what I'm eating.” Suggest that Ria invite friends to try her food.
• Lobby the school to provide healthier choices in the cafeteria and in snack machines, if it doesn't already.

HURDLE: Long-established relationships with food
“Food is still a huge problem for me,” says George, who adds that he's worried because he still has cravings for foods he knows are unhealthy, such as chips, chocolate and doughnuts.

Everyone has their own distinct and complex relationship with food that has been shaped and reshaped over a lifetime, says Berkoff. “We all eat in response to different emotional and situational cues – and these become habits.” For this hurdle, here's what the coaches recommend.

• Include emotional triggers for eating in food journals. This will make you aware of these triggers (for instance, if George has a bad day at work and reaches for a chocolate bar), which is the first step to changing them.
• Explore eating behaviours. When George asked Gierden to help him adhere to various healthy eating habits (for instance, “How do I cut out snacking after dinner?”), she suggested he ask himself a number of questions: What are the benefits of reducing snacking? What's going to help you do it? (In George's case, going to the gym after dinner instead of snacking in front of the TV.) Why do you snack so much? Talking through the answers reminded George of his big goals again (to lose weight and lower cholesterol) and his own accountability and control in making choices to succeed.
• Research the subject of overeating; there is a lot of information on the Internet and at libraries about overcoming food obsessions.
• Look for groups such as Overeaters Anonymous in their community.
• Get a referral to a health professional who is trained in issues related
to overeating.

HURDLE: Food-focused social life
Several times a month the Morfidises host a major meal for friends or family. Despina loves doing this and says, “I'm not going to change.” (Of course, when food is the focus of socializing, it may be easier to overeat.) Here's what the coaches suggest.

• Institute healthy eating rules around entertaining: always use lower fat/lower calorie recipes, serve dinner early and no snacking after nine.
• Send friends and family home with doggy bags (and the tempting leftovers).
• Curtail alcohol. Drinking adds empty calories (five ounces of white wine has 100 calories) and lowers defenses (which may mean eating more).
• Being squeezed for time (because they are so busy planning dinner parties) can lead to fast and unhealthy food choices. Always have healthy food on hand.
• If possible, visit friends after dinner rather than eat a meal at their home – to stay in control of food choices. (Tell them why and they may start providing healthier choices for you, too.)
• Plan activities (bowling, skiing) rather than meals with friends.
• At least once a month, substitute a family activity day – a visit to the zoo, a long bike ride or attending a music festival – in place of hosting a meal. (To Despina's surprise, the kids loved this idea.) Take turns choosing the activity.

HURDLE: Fitness-related injuries
When Stefi fell off the balance beam at gymnastics and landed on the side of her foot, “I thought I could get right back on. But it hurt to walk.” Not surprising since she injured a ligament. What can the Morfidises do to prevent an injury from sidelining one of them indefinitely in the future?

• Treat the injury right away. Darren Vine, owner of Courtice Physiotherapy in Courtice, Ont., treated Stefi's overstretched ligament with electrotherapy and laser (which promote healing of tissue). He advised her to sit out a few classes, which she did. She's now back to full steam.
• Encourage one another to listen to their body; an injury may be a sign to slow down or focus on strengthening another part of the body.
• Check that everyone is properly outfitted. When Despina first started her walking routine, she developed plantar fasciitis (inflammation of the tissue that runs from the heel to the base of the toes) on one foot. She went to an athletic footwear retailer and was properly fitted for walking shoes – and hasn't had any problems since.
• In the event of an injury, find another way to exercise if possible. When Ria twisted her ankle running, she stopped running and worked on her flexibility while it healed.

HURDLE: Weight plateau
When George and Despina weighed in and saw that they hadn't lost one pound between the two of them for an entire month, “I was so frustrated and disappointed,” says George, “I almost wanted to give up.”

Despina agrees. “It was such a slap in the face. I couldn't make the connection between all the exercising I was doing and not losing more weight.”
When George and Despina's slow and steady weight loss came to a grinding halt, Berkoff and Forest quickly reassured them that this was normal: in the course of altering diet and exercise, weight plateaus can occur as the body is adapting to the new regimes. Also, weight loss is never a straight line down, says Berkoff. “You lose, then gain, then lose again…remember, you didn't gain in a straight line up either.”

At the same time, if people are trying to change and not succeeding, says Buchanan, they need to look at everything they are doing and see what they need to adjust. Here are the coaches' recommendations.

• Revisit diet strategies to lose weight. Keep trimming fat and calories, and be vigilant about reducing portion size.
• At every snack and meal, ask yourself: “Will this food help me achieve my goal?” says Berkoff.
• Write down everything you eat in daily food journals, to stay honest (it's easy to fool yourself) and to discourage the tendency to slip back into old eating/snacking habits.
• Increase (calorie-burning) aerobic activity. Forest added cardiovascular exercise to their gym program (George and Despina weren't able to fit enough aerobic activity into their lives outside of the gym). Now they're at the gym five or more times a week, alternating resistance training days with cardiovascular exercise days (George does 30 to 45 minutes on the treadmill and Despina does 30 minutes on the cross trainer or treadmill).
• Keep life as stress-free as possible. Stress and fatigue lower resolve, and that's when overeating can occur. (One of George's winning strategies
is to exercise at night when he has the time, rather than in the morning when he would feel rushed and stressed all day.)
• Use small daily steps to achieve your goal, says Gierden. Take the stairs instead of the elevator at work, skip your morning snack and drink water instead, and switch to milk if you usually take cream in your coffee.

HURDLE: Staying motivated
Working out together on cross-training equipment at the gym, Despina told Ria she felt so overwhelmed by everything she had to do that day that she wanted to cut her workout short and do 20 minutes not 30. Ria was quiet for a few seconds, “then, in so many words, told me that she was so proud of everything I had done so far, and she knew I could do the 30 minutes…it was all I needed to hear to do the whole workout.”

Here are other motivation strategies that are working for the Morfidises.

• Acknowledging their achievements.
• George and especially Despina are now working out regularly, and they are both in far better shape than when they started. “I've seen such great improvements in my skiing,” says George. And Despina is skiing with her family, not watching from the chalet! “I have never been successful at an exercise program before,” says Despina. “I feel I can do anything right now.”
• Seeing improved fitness. Both girls went to higher levels in ski lessons.
• George and Despina have become the role models they wanted to be –
to their children and colleagues. Despite his cravings, George does pack healthy lunches and snacks and says, “People look up to me at work. I'm actually influencing people around me to eat differently.”

• Challenging themselves. Now that exercise is a part of their lives, George and Despina have revised their overall get-healthy goals to include specific weight-loss goals. George is aiming to reach 210 pounds (down from an original 250) by the end of the yearlong program, while Despina (who started at 228.5 pounds) wants to get to 180 pounds (with a longer-term goal of 160 pounds).
• Sharing goals with other people. The whole family says that telling other people (through the magazine, at work and socially) what they want to achieve makes them feel more accountable – and that's motivating.
• Exploring other methods to succeed. Despina is working more closely with Buchanan and Berkoff to lower fats and calories in her diet.
• Rewarding themselves. The family took a ski vacation in Quebec.
• Checking in with their doctor. George gets a real boost when Buchanan explains how his new lifestyle is affecting his health – his cholesterol and blood pressure have both improved.
• Using all resources available. Knowing Forest is waiting for her at the gym gets Despina out of bed early in the morning. Also, both George and Despina are working with the coaches as much as possible to get closer to their goals. And they're asking for long-term strategies (for when the program is over.)
• Saying it out loud: “I wanted to be more physically fit, and now I am,” says Despina. “But people who are fit don't look like me. Now I want my body to look more physically fit too. In fact, I'd love to be a size 12.”

Canadian Living June 2006