Wait on Your Weight Goal

 

A new dieter, Alan, consulted me this week. He weighs 265 pounds and is 5’6”. He would like to weigh 100 pounds less. “It’s a mistake,” I told him, “to set a big goal like that. First, we really don’t know whether 165 pounds is a reasonable weight for you to get down to and maintain. Second, it’s too far away.” Alan immediately became discouraged and we had the following discussion (see pages 113-114 of the Beck Diet Solution).

 

Alan: But that was my weight 18 years ago. Why can’t I try for it again?”

 

Dr. Beck: Can I give you an analogy? You have a ten year old daughter, right? What if your daughter came to you and said, ‘Dad, I want to become a nationally ranked gymnast.’ Would you say, “Hey, that’s a great goal!”

 

Alan: No.

 

Dr. Beck: Why not?

 

Alan: Because I don’t think she has the genetics for it. She’s a big girl.

 

Dr. Beck: Any other reasons?

 

Alan: I wouldn’t want her to set her sights on something unreasonable and then feel badly when she couldn’t do it.

 

Dr. Beck: But what if she likes gymnastics? Do you think she shouldn’t pursue it at all?

 

Alan: No, but…..I guess I’d want her to just have fun doing it—and not try for something too hard.

 

Dr. Beck: Well, it’s the same with weight loss. I have no doubt that you can lose weight if you learn the skills you need, but I don’t know now how much weight you can lose. It’s not entirely under your control. I don’t know how big your natural appetite is, how fast your metabolism is, what your lifestyle is like, how much exercise you do consistently, what your favorite foods are, how much access you have to selecting your food, how much stress you’re under, how much time and energy you have for dieting, and so forth.

 

Alan: Oh.

 

Dr. Beck: You know, most people think, “I should just be able to set a weight loss goal and achieve it.” But like gymnastics, certain factors aren’t completely under people’s control. Now it’s possible that you can lose 100 pounds. It’s also possible that you could maintain your 100 pound weight loss. But to be honest with you, it’s not likely…..For one thing, you don’t have the same metabolism as you did 18 years ago….Now does that mean you shouldn’t try at all?

 

Alan: I guess not.

 

Dr. Beck: So are you willing to set a goal just to lose five pounds? When you do, you’ll celebrate and then you can see whether it’s reasonable to set a goal to lose another five pounds, and so on. How does that sound?

 

Alan: Okay, I guess.

 

Dr. Beck: I know, I know, it’s disappointing. I think the media usually makes it sound as if people can lose as much as they want, that they can override their biology. I can help people overcome their psychology, help them stick to an eating plan that’s reasonable for them, but biology is another matter. And I’d rather have you set your sights lower now, even if it’s disappointing, than have an unreasonable goal that you can’t achieve and get so disappointed later that you gain back whatever weight you lose.

 

Alan: Fair enough.

 

I hope this dose of realism doesn’t dissuade Alan from trying the cognitive behavioral approach. If it does, he may try another approach and end up back in my office within a year or two. Sometimes people just have to give other things a try before they’re ready to settle down and be realistic.

Reworking the Plan

Melanie, a dieter who consulted me a few months ago, recently contacted me for a “booster” session. She was doing great, still losing about 3 pounds a month. She was no longer writing down her food plan in advance, nor did she need to. Instead, she was able to decide at each meal and snack what she wanted to have and to eyeball her portions instead of measuring her food. She made sure to have plenty of (usually) lean protein and vegetables for lunch and dinner (along with a portion of healthy fat and a grain or starch). She mostly ate fruit or nuts for snacks. And she continued to eat whatever junk food she wanted (about 200-250 calories) at night. Melanie wanted to branch out in her selection of dinner entrees. Her husband wanted her to start cooking some old favorites such as lasagna and corned beef brisket. We had the following conversation:

Melanie: I’m afraid if I start to eat foods like that, I’ll gain weight.

Dr. Beck: Not if you keep your portion small.

Melanie: I’m afraid if I have less protein, I’ll be hungry.

Dr. Beck: And what are you afraid will happen if you’re hungry?

Melanie: I don’t know. I guess I just don’t like the thought of it.

Dr. Beck: Do you remember when you did the hunger experiment? (pages 121-125) What did you find out?

Melanie: I know, I know. Hunger is never an emergency. I do remind myself of that some times. But, I don’t know, it seems worse at night.

Dr. Beck: Well, do you want to do some experiments? For example, you could use your protein calories for corned beef. It will be a smaller portion than chicken. But here’s what I want you to do. Don’t linger at the table when you’re finished. Plan an activity beforehand to do right after dinner. And set a timer for 20 minutes. When the timer goes off, check your hunger level. If you’re still hungry, just tolerate it—leave the house if you think you need to. And the next day, do a similar experiment. But this time, skip your morning snack and have it sometime after dinner (immediately if you want to or later on). Plus you’ll still have your regular evening snack. What do you think?

Melanie tried the experiment with various dinner entrees, and to her relief, found that she wasn’t overcome with hunger. But she really liked the idea of eliminating her morning snack so she could have two evening snacks. She’s been sticking with her new plan for a couple of weeks now and is glad to be able to branch out and eat more in the evening.

Talk Back to Cravings

 

This past week, I met Jon socially, at a party. We had known each other slightly. He told me he had read my cognitive therapy books on dieting and wanted me to know which technique had helped him the most. It had been emailing his “diet buddy,” when he was tempted to eat something he wasn’t supposed to. With his permission, I cut and pasted below an old email he forwarded to me.

Okay, I really want to eat the pizza in the kitchen. Everyone (okay, not everyone) in the office is having some but I already had lunch. My sabotaging thoughts are back….It’ll be okay. I’ll make up for it later.
But I really know it’s NOT okay. Not if my goal is to lose weight. I don’t want to fall back in to the habit of eating extra food just because it’s there. It’s what I used to do.

Hey, it happened again. The craving went away as I was typing this email. I’m actually fine. I feel like…it’d be nice to eat the pizza. But I know I won’t. Back to work.

It was important for Jon to email his diet buddy like this. After doing so about ten times in a row (over the course of several days), he really learned that cravings do go away. He doesn’t have to eat. Now he doesn’t need to email his diet buddy very often, either. He knows that telling himself, “No choice. I’m not eating this [food] I hadn’t planned” and engaging in a compelling activity makes his cravings go away, every time.

Spring Holiday Eating

 

A number of dieters have come to see me in anticipation of the holidays. Here’s what I asked them:

 

When Passover or Easter is over, how do you want to feel about yourself?

 

Proud that you followed your holiday eating plan? Motivated and in control? Pleased with yourself?  Confident that you’ll return to your usual eating routine?

OR

 

Upset that you abandoned your plan, distressed that you gained a significant amount of weight, and unsure that you can get back on track? 

 

We then discussed, among other topics, four major strategies they could use to maximize the chance that they’ll feel good when the holiday is over. Here’s what I told them.

 

(1) Develop a reasonable holiday eating plan. 

 

For example, if you celebrate Easter, you might decide to follow your usual plan but add a specific amount of extra calories for chocolate eggs on several days during the holiday. Or follow your regular plan but allow yourself to eat 500 extra calories during your big family dinner. Your weight loss will slow (unless you’re exercising more) or you may gain a little weight, but so what? You may be able to stick to your regular eating plan better if you know you can splurge a little.

 

Passover is more difficult, especially if you follow the holiday dietary laws for eight days and have large ritualistic meals. Again, the most important guideline is to figure out in advance what variation of your usual eating plan is reasonable. Trying to stick to your usual plan for every meal is probably unrealistic.

 

(2) Continue your good eating habits

 

Even if you’re rushed and life is frenetic, take the time to eat ALL your food sitting down and slowly, while enjoying every bite. Plan your day so you have enough time to do so. Drink a glass of water before you eat and take a few deep breaths to calm down so you can fully enjoy what you’re eating.

 

(3) Watch out for too much or too little entitlement

A key sabotaging thought is: “It’s a holiday. I deserve to eat whatever I want.” Face the fact that you have a choice. You can eat whatever you want and feel badly about the consequences OR you can stick to your holiday eating plan and feel good about the consequences.

 

Another key sabotaging thought is: “I have so much to do. I don’t have time to….exercise, sit down to eat, prepare the food on my plan, read my Advantages Cards and Response Cards.” You need to build a sense of entitlement: “I deserve to take the time I need for my important goal of healthy eating, even if other people are momentarily displeased or inconvenienced.”

 

(4) Get right back on track when you make a mistake

 

It may be unrealistic to think that you won’t slip up at all during the holidays, especially if your new ways of thinking and your new behaviors aren’t firmly in place. If you eat something you hadn’t planned, tell yourself, “Big deal. I made a mistake. I’m only human. But I’m not going to fall into my old habit of waiting until tomorrow to start again because that has NEVER worked to my advantage in the past. I’m going to get away from food and distract myself in a compelling way until the urge to keep eating goes away.”