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January 28, 2013

Getting Lean on New Years Resolutions

In early 2013, around 25,000 Oshkosh residents made a New Year’s resolution. Only about 15,000 of us will end up keeping them.

In early 2013, around 25,000 Oshkosh residents made a New Year’s resolution.  Only about 15,000 of us will end up keeping them.  Several weeks into the new year, many resolutions are already in jeopardy of going the way of Aunt Gladys’s fruit cake.

As a family doctor at ThedaCare Physicians in Oshkosh, my job is helping people with health goals.   From goals as complex as delivering a healthy baby into a young family to goals as simple as delivering a baby carrot to the dinner plate, there are techniques to help you succeed in having a healthier 2013.

Lean methodology was developed by Toyota for continuous improvement in manufacturing processes.  In the early 2000s, ThedaCare began using lean to improve health care delivery.  A tool of lean thinking called Plan, Do, Study and Act (PDSA) may help save your resolution.  We will use the most common resolution of losing weight as an example.


Most people skip this step because they are excited about doing their resolution, but having a good plan is the key for success.  The plan involves revising your resolution into a concrete goal and setting a deadline.  For example,” lose weight “changes to “lose 15 lbs. by March 1.”  Planning also involves forming a support team.  Team members can include support groups, friends and family, and professionals (such as a personal trainer or primary care provider).  Communicate your goal with your team and give them permission to help you.  If your sister gave you a gym membership for Christmas, she can bug you about using it. 

The next part of the plan is examining motivation and barriers.  In our example, motivation could be looking better for spring break, having more energy for spring cleaning, or being stronger for softball season.  Barriers could be a work place surrounded by fast food restaurants, a busy time at work, feeling too tired to exercise, or that your scale is broke and so are you after holiday spending.  

The plan also involves forming action steps.  For weight loss, this could include exercise for 150 minutes per week, eating vegetables instead of candy bars, or substituting lean meats for red meat.  

The last step in planning is measuring progress.  This can be as simple as tallies on a notepad or as sophisticated as smart phone apps.  The better you do at measuring progress, the easier adjusting your plan with be.


It is time to put your plan into action. You go to the gym, buy carrots and broccoli, and replace the steak in your freezer with chicken. During this stage engage your support system, and record progress on your action steps.  Set up rewards to encourage you to keep going.  For example, for every 300 minutes at the gym, you get a night at the movies.  It is also important to acknowledge and record set backs.


At regular intervals, it is important to study the progress being made.  For weight loss, this includes weekly weigh-ins and reviews of work outs and snack choices.  Study of your progress may reveal that although you lost 5 lbs. the first two weeks, you did not lose any in the third week.  This could be a result of running out of veggies, as they are not in season in January.  For many people, this is when resolutions start to unravel, but the study part allows for adjustment. 


In the act stage, adjusted action steps are initiated.   A simple switch from veggies to unbuttered popcorn as a treat could still save calories and avoid derailment.  This is also where goals are realized and work begins on a maintenance plan.  New goals can be set and the process resets.  In our example, you have lost 15 lbs and had a great spring break.  Now it is time to get ready for summer.  You add back some non-popcorn snacks, but decide to set a new goal of running the Oshkosh triathalon.

For more information about keeping New Year’s resolutions or a template to help you get the process started, feel free to contact me at (920)237-5000 or

By Eric Smiltneek, MD, family physician, ThedaCare Physicians-Oshkosh.