Trevose Observation Paper

I observed the Trevose Behavior Modification Program. I chose this wellness class because I personally have seen many people around me be successful on the program. Trevose is an intense weight loss program that’s main focus is behavioral modification. When David Zelitch started Trevose in 1970 in Philadelphia there were only ten members. David suffered a myocardial infarction and soon after his medical scare lost nearly one hundred pounds. David lost the weight by following the behavioral modifications taught by Dr. Stunkard of the University of Pennsylvania School of Medicine.
Today Trevose has thousands of successful members and is still growing. The intended audience of Trevose Behavioral Modification Program is people who are overweight and seeking help to lose the extra pounds they have, and maintain their weight once they do. Each group consists of ten members. The group I monitored contained nine middle-aged Caucasian women and one middle-aged Caucasian male, each with one common goal: lose weight and then keep it off. Each week the group meets for an hour; during the first six months of the program, that hour is used to complete an intensive study of each member’s

eating habits.
During this time, the group leaders are educating the participants about good food choices and portion control. The ultimate goal is to swap bad behaviors for good ones. Each of the first six months, members learn about and practice a different behavioral modification. Each modification is geared toward changing a habit that has been established over a lifetime. The first four weeks of the program are used to teach members the documentation process. The group documents: how hungry they were when they started to eat, where they ate, their position while eating, time spent eating, average daily calories, etc. Documenting their intake of food helps the group to increase their awareness of what’s going into their mouths.
Eating in the same place is the behavior modification that the group works on during month two. This behavior aids in getting the group to associate eating with only one place so that they aren’t eating in their cars, or in front of the TV. Next is “no sheet, no eat.” If members do not have their sheet to document what they are eating they are not supposed to eat. This behavior enforces the accountability for the food they are eating. Month four is used to teach members to slow down their eating and enjoy the food that they are taking in. Month five is all about breaking the “Clean Plate Club” habit. Essentially members are learning self-control. They are practicing leaving a small amount of food on their plates each time they eat. These two modifications show members that if they slow down while eating, they only eat until they are satisfied, not until their plates are empty. Lastly month six is used to implement simple lifestyle changes to bring exercise into the week. For example doing things like taking the stairs, parking far away, taking a walk after dinner, etc, brings more movement into their lives.
The behavioral modification part of Trevose is what differentiates this program from its competitors such as Weight Watchers or Jenny Craig.

Behavioral modification is used to change group members’ ways to deal with food and to promote weight loss. Trevose stresses that the program is a complete lifestyle change, not a diet one does for a couple of months. Part of what makes Trevose so successful is the program rules. Trevose is strict, which keeps members accountable for their weight loss each month. The rules include: perfect attendance at the weekly meetings, keeping a weekly food journal, meeting the established monthly weight loss goals, maintaining weight loss once their goal weight is reached, and teaching what they have learned through the program to others on their weight loss

journey.
My own mother and three other women in my neighborhood were successful using the behavior modifications used in Trevose. When I talked to each of these women, they all expressed the struggle they had with weight loss throughout their lives. Many of the women shared their experiences trying other programs and the difficulties they had with those programs. Something that all the women had in common was that they had marginal success with other programs. Specifically, they were able to lose weight, but were not able to keep it off once they stopped following the program. With Trevose, they were able to change the way they dealt with food. One thing that I heard members say was it is about the family and friends you are eating with, not the food.
In the Trevose group I observed two leaders. Both of the leaders are registered nurses and have found success through the Trevose Behavioral Modification Program. When I talked to them after the meeting they both expressed to me the hardships they endured throughout their lives with their weight. Like many of the other members I talked to, both the leaders have tried everything from Weight Watchers and Slim Fast to Jenny Craig without much success. Each leader has lost over eighty pounds since starting the program. Now they want to share their successes with other people and help people reach their own weight loss victories.
Before becoming Trevose leaders the two nurses had to have been successful in the program, continue to keep the weight off, and complete a training program on becoming a Trevose leader. After completing those tasks they were qualified to teach others about the program and have been doing it for over five years. The leaders voiced that they thought people were more successful in this program because of the behavioral modifications. They said that the behavioral modifications fix the mental issues some people have with food, rather than teaching them a specific diet. The leaders also stressed to the members to look at Trevose as a life long change, not just a diet they’re going do for a month or so.
The leaders in this group use lecture and group discussion as the major teaching strategies. When the group meets each, week ten minutes are spent on lecturing about the different behavioral modifications, and motivational weight loss stories. The lecture aspect of the group meeting falls under the cognitive area of Blooms Taxonomy of Learning Domains. Lecture is used to help members understand the rules of the program, evaluate their eating patterns, and create a new way of healthy eating. Members also are reminded of the behavioral modifications that are so important throughout the program and their lives. Lecture is the best way of increasing knowledge in all members effectively.
Affective learning approach also used in the weekly Trevose meeting. When the group meets each week the remaining time is spent on group discussion. During the discussion the members all communicate the ups and downs of their week. For example: one of the group members stated that during the past weekend she was invited to a party at the last minute. Although the member used her daily calorie allotment she ate while at the party. After she told the group the error she made the other group members gave her ideas on how to deal with something like this if it were to come up again. They discuss ways to tackle situations like attendance at parties and eating in restaurants. Becoming aware of these problems helps the other members of the group support their colleagues during their time of struggle.
The information I learned during this class helped me to understand different eating behaviors that I have been doing wrong that I didn’t even realize. It has been proven that people eat more when they eat in front of the TV because they lose track of how much they are eating. Therefore eating becomes mindless and one eats a lot more than he or she even realizes. Also, eating when one is not hungry isn’t necessary. Many people taste things while they are cooking, or just have one bite of someone else’s food, and those calories add up. As a nurse I can pass on the information I learned from the Trevose program to overweight patients in the hopes of helping them become aware of the mistakes they may be making. For example sharing ideas such as not eating in front of the TV and counting ones daily calories to keep track of what’s going into ones mouth.