My health coaching patient is a pleasant retired lady with no major health concerns. She has well-controlled high blood pressure and adheres to her medication. She has allergies, which she manages with antihistamines and dietary modification. She is active twice a week at a community exercise program and otherwise walks often. She reads nutritional information and practices portion control. For example, she only buys the small York patties instead of large candy bars. As another example, while she enjoys ice cream, she does not keep it in her home. Instead, she only has a small serving of ice cream 1-2 times a week as a social activity with friends.

It was a challenge to come up with a health goal that she wanted to work on, as her health is already so thoughtfully managed. While she said that she could probably lose a few pounds, as she is currently between a medium and large in clothing sizes, and she finds that inconvenient when shopping, she did not seem super interested in losing weight. She said that, at her age, she doesn’t see why she shouldn’t indulge herself, and she has already cut back so much as it is. As such, she demonstrated ambivalence.

Eventually, she decided on a goal to try to maintain and/or lose weight. She decided that she would try to walk more. Her diet is already modest. Her community center does not offer many other classes that interest her. Thus, walking more was the most obvious choice. She is going to try to track her walking, either by a pedometer or just writing down her walks. There are not many enclosed malls near her, and she dislikes freeways, which may make walking in the winter difficult, but she does have the option of walking in the grocery store. Overall, she successfully came up with a plan.

An important lesson is to stay open-minded and handle each person one encounters as a unique person. My patient said that she wants to prove to young people that one can be old and healthy, and I believe that she has succeeded. Not everyone absolutely needs to lose weight. Not everyone needs a diet overhaul. Some people are doing well, and if one enters every encounter with the thought, “What is wrong?” one has already made a mistake.