It’s the little things. Small steps, taken more than yesterday. Over time, a couple of months, that makes a big difference.
This is not a ground-breaking case study, but IT IS in the sense that what my client and I did produce ground-breaking results.
The short story is this…
I had the opportunity to work with a young lady, helped her walk more, she feels better, lost 17 pounds, is no longer considered “prediabetic” and stopped taking diabetes medication.
Huge wins!!!
Meet the Client
Meet Tina. She is a road-warrior that provides clinical services to families in their homes. The work is tough. Tina has to spend several hours a day in her car (lots of sitting time). And some days, the clients that she works with are often sedentary, so she too spends time teaching, while sitting at a desk.
This combination of sitting while commuting and working all days spells trouble for us all.
Tina came to BehaviorFit wanting to become more active, lose weight, and basically, needed a plan of attack.
Here are a couple of key characteristics of Tina that we should know:
- she is overweight with some knee pain,
- considered pre-diabetic (taking medication), and
- had no exercise plan.
What We Did
Just like many of my previous clients (see Case Study 2, Case Study 3, Case Study 4), Tina had an Apple Watch. The Apple Watch does not sync online, so getting the data was a little effortful (Tina had to self manage).
Step 1: Getting A Baseline
As with any data-based decision practice, we needed some baseline data. This means that I have to see how much or how little Tina walked on a regular basis. So Tina, wore her Apple Watch every day, kept it charged, and logged her daily steps and exercise minutes in a shared google sheets document.
Step 2: Setting a few goals
After the first few weeks, Tina averaged just under 3,000 steps. If you are familiar with common physical activity guidelines then you will know that achieving 7,000 steps is where most of should land most days.
Consistency is very important for Tina, so we set a goal of taking at least 3000 steps EVERY day. Given the importance of Tina wanting to lose weight, we chose EVERY day instead of just a couple days. We chose walking as the exercise of choice because it fit easiest with Tina’s schedule and was the most accessible activity for her.
We also set a goal of exercising 4 times per week.
These goals boiled down to this: walking for 30 minutes AT LEAST 4 times per week.
Step 3: Tweaking with Text Messages + Morning Walks
After a couple of weeks, we noticed that Tina still had a couple of very low step count days.
We modified her physical activity plan to include a 20-30 minute walk every morning. To help her with this, I gave her text message reminders every morning during the following week, and every other day the week after.
With those three steps, we can how she progressed in this chart:
By adding a goal, it got Tina moving more in the middle phase. Then, adding a few prompts got a little more activity. The green dots are the weekly averages, and….over time, we see Tina’s average moving up and up!
You can see it simpler here:
Without any intervention (the BL; baseline), her average was 2,616 steps per day. With the interventions described above, her average bumped up to 3,795 per day. A 45% improvement!
The Analysis
Over the past 2 months, our goal was to create a more physically active day for Tina. In a little comparison, we see that increased her step counts by over 1.5X!!!! From an average of 2,800 daily steps to over 4,800! Way to go Tina!!!
Tina is feeling better, getting compliments on her physical appearance, and her once nagging knee pain is going away…
Here are a couple of extra fun analyses…
In the chart on the left, we see that Tina’s average exercise minutes per day increased by 3 minutes (15 to 18).
In the chart on the right, we can that, on the COUCH POTATO SCALE, the percentage of days on the couch decreased from (50% – 37%).
THE BONUS!!!
Now, when we started working together, we didn’t have all of the data and blood results in. But, we did have regular weigh-ins.
In a span of just under 2 months, Tina lost 17 pounds!!!
I attribute most of this change to the increase in physical activity. Why? 
Because we have the data to tell us so!!!
Since we began working together, Tina visited her doctor once again and found that her hA1C (hemoglobin metric commonly used to assess diabetes) dropped from 6.2% to 5.6%. She went from “pre-diabetic” to “normal”.
Can we say that we reversed prediabetes? I think so.
Tina nice work!
Plus, Tina no longer takes Metformin (a medication used to control blood sugar/manage diabetes)
What We Do Now
Tina is just beginning the process of establishing her regular fitness routine. I often joke with her…are you ready to take a 20-30 minute every day this week, next week, and the rest of your life? Because those are the decisions that have to be made.
I’m not interested in 2-month or even 2-year data.
Give me 2-decade data!!! Then let’s have a conversation.
Closing Thoughts
I am very proud of Tina and taking small steps towards her health. I am excited about her progress moving forward. Steps, data, and regular coaching visits make all the difference.
I am humbled to her coach.
Keep moving,
Nick
