Ask the Diet Program Coordinator

We received a lot of great questions after the latest issue of our newsletter went out which is wonderful because it helps us know what you would like to hear about on the blog and in future editions of our newsletter.  Today I’m responding to a question that many dieters submitted to us in one form or another.

Q: Right now I eat in a pretty controlled and healthy way for meals but in between meals I’m struggling a lot to get my eating under control. I eat way too much for snacks, especially in the late afternoons, and it is very hard for me to control it. How can I overcome this?

A:  Sometimes we find that if our dieters are eating too much for snacks, it means that they did not eat enough during meals and/or they didn’t eat enough lean protein and healthy fats to keep them feeling full.  The first thing we suggest is that you look at the content of your meals – are you eating a healthy enough balance of foods?  Yes, vegetables are VERY healthy but if that is all you’re eating for a meal, then no wonder you will want to eat a short time after.

Another thing that could be going on is that you’re not actually hungry, you’re experiencing the desire to eat. This could be for any number of reasons – you’re craving something, you’re stressed, you’re emotional, you’re tired, etc., and there are two very effective tools that you can use to combat this desire to eat.  First, try eating according to a schedule.  You don’t necessarily (right now, anyway) have to decide in advance what you’re going to eat, but decide in advance when you’re going to eat, including snacks between meals.  This way if you’re having a strong craving to eat at 3:00, you can remind yourself that you have a snack coming at 4:00 and you only have to hold out 60 more minutes.

Second, spend some time identifying your sabotaging thoughts and coming up with strong responses to them.  If you’re thinking, “Just this one little snack won’t make a difference,” remind yourself that it absolutely DOES make a difference and that every single unplanned snack counts because it helps reinforce old, unhelpful habits. Try writing these responses on 3×5 cards (we call them Response Cards) and read them every morning with your Advantages List so that they are fresh in your mind when you need to call upon them.  When our dieters have identified a problem time, like in the afternoon or after dinner, we always have them prepare themselves in advance for that time by reading their Advantages List and Response Cards right before so it is most clear in their mind just why it’s worth it to them to resist.

And most importantly – don’t give up!  Dieting is hard work and it takes practice, but the more you do it the easier it gets.   Each and every time you stand firm and don’t eat unplanned food in the afternoon, you increase your chances of resisting the next time, and the time after that, and the time after that.

Eating with Distractions

Since getting back on track, one of the hardest things for Jamie has been to try to eat things without too many distractions.  She has a very busy professional life and (especially during lunch time) she does not want to take a break from what she is doing to eat and will often try to work and eat simultaneously.  In session Jamie told me that the day before she was reading a research article while she was eating her prepared soup and sandwich.   Since the article was somewhat hard to understand and took a lot of concentration, most of Jamie’s focus was going towards that. 

After about three minutes Jamie tuned back into what she was eating and realized that she had eaten just over half her lunch and had barely noticed or tasted it at all.  Jamie immediately became annoyed and chastised herself, saying “You should know better than this.  I can’t believe you just ate half your lunch without paying any attention to it.”  However, Jamie told me that as soon as she noticed what she was saying to herself, she thought about to things we had discussed in other sessions and reminded herself that beating herself up for mistakes will serve no positive function at all. She knew that the only thing it would do would be to make her feel worse and erode her confidence, which might then make it harder to get back and stay on track the rest of the day because it would cause her to doubt whether or not she was capable of it.

Jamie told me that she realized that what she had to do was take a moment to re-group and get over the fact that half her lunch was now gone, learn from the experience, and do things differently next time.  Jamie then turned off her computer monitor and made sure that she ate the rest of her lunch slowly, while noticing and enjoying every bite.  Jamie was once again reminded how crucial it is to enjoy ever y bite because she ended up feeling satisfied at  the end of her lunch, but knew that she would not be feeling this way if she had continued to mindlessly eat while reading the article.

In session I gave Jamie a LOT of credit for being able to make a mistake and then recover from it right away.  We discussed the fact that even successful dieters and maintainers make mistakes (because no one is perfect), but the difference is that they are able to recover from them immediately.  Jamie and I also discussed how much confidence this situation gave her because she proved to herself that she could make a mistake, identify and respond to her sabotaging thinking, and get right back on track.  I pointed out to Jamie that this situation is also interesting because it started out as something that could have made her feel bad and guilty – eating half her lunch without noticing or enjoying it – and because she was able to recover right away it actually ended up making her feel really good about herself.

Jamie and I also did some problem-solving and she decided that until she was able to split her focus better, for the time being she would work on not doing anything distracting while eating lunch and would instead focus on enjoying her eating.  I helped Jamie formulate responses to some sabotaging thinking we predicted she might have about taking time away from work to eat so that she would be able to strongly remind herself just why it was worth it to turn off her computer monitor and take time to ensure that her lunch gave her both physical and psychological satisfaction.

Ask the Diet Program Coordinator

Q: How do I get myself back on track after I slipped up on my diet and not just give up? This is something I have really struggled with over the years and has stopped me from keeping off any weight that I lose.

A: You’ve hit the nail on the head because being able to recover from mistakes right away is one of the most important skills needed for permanent weight loss.  Our most successful dieters are not those who never make mistakes (because, let’s be real, we’re all human and we all make mistakes), but those who can get themselves back on track right after.  How do we teach our dieters to do this?

One of the first things we do is help dieters identify and respond to their sabotaging thinking about making mistakes.  Usually after they slip up they are having thoughts in one of two categories.  Either they’re thinking something along the lines of “Oh I’ve really screwed up this time, I guess it means I can’t do this,” and having a lot of defeatist thinking, or they’re tell themselves “Since I made a mistake today I might as well just continue eating and get started back on my diet tomorrow,” and are having a lot of ‘fooling themselves’ thinking.

For those in the first category, we remind our dieters that one mistake does not mean that they’re a total failure but it would be a failure if they used that as an excuse to give up completely.  We help dieters to see that if they were learning a different skill, like how to play the piano, they would not think that hitting one wrong key meant they should give it up completely because they wouldn’t have the expectation of being perfect; rather they would most likely just take it as a sign that they need to practice the piece more to get it right and learn from their mistakes.

Often dieters have years and years of failed dieting attempts behind them so it makes sense that they would catastrophize about a mistake because in the past it might very well have derailed them.  We help dieters learn to forgive themselves for making a mistake, which then allows them to be able to look at the situation more objectively so we can learn from it.  Frequently dieters make mistakes because they weren’t properly prepared ahead of time and weren’t able to respond effectively enough to sabotaging thinking in the moment.  We help dieters figure out how they can be more prepared for similar situations in the future and what new responses they need to formulate and practice.  The truth of the matter is that mistakes can be extremely useful because we can learn invaluable things from them which helps prepare the dieter for future successes.  So, no, one mistake never means total failure unless dieters allow it to become that way and they are a natural and unavoidable part of the learning process.

For dieters in the second category, we help them realize that the thought “I’ll start again tomorrow” makes no sense because it’s not like at a certain point the calories stop adding up.  One mistake, like eating a piece of unplanned cake, will probably not show up on the scale at the end of the week.  However, one piece of cake, a bag of chips, a donut, and a piece of pizza probably will.  And one piece of cake, a bag of chips, a donut, a piece of pizza, some candy, ice cream, chocolate, etc etc definitely will so the sooner they can get themselves back under control the better.  We always tell dieters that there’s no such thing as blowing it for the day because at ANY point they can decide to draw the line and get back on track.

We discuss with dieters the fact that there are very few (if any) other areas in life where people think it makes sense to compound one mistake with another.  We give dieters the red light analogy: imagine you are driving in your car, run a red light, and get pulled over by a cop who then gives you a ticket.  You wouldn’t think, “Well I’ve messed up today, I might as well run red lights for the rest of the day and then start driving carefully again tomorrow.” No! You would stop at the very next red light and get on with your day.  Dieting is the same thing – one mistake never justifies continuing to make more.  Another analogy I like is reminding dieters that if they fell down a few stairs, they wouldn’t say “screw it” and then throw themselves down the rest of the flight of stairs.  Of course what they would do is pick themselves back up and walk down the rest of the way. Continuing to eat off track once dieters make a mistake is like continuing to run red lights or throwing themselves down the rest of the stairs – completely irrational.

We also help dieters realized that the thought “I’ve messed up so I might as well just give it up for the day,” is a classic example of all-or-nothing thinking.  All or nothing thinkers see situations as completely one way or the other, not realizing how much middle ground there is in between.  All-or-nothing dieters think that they are either completely perfect on their diet, or they are totally off of it, not realizing that dieting is never black or white because everybody makes mistakes.  We examine with dieters the costs and benefits of continuing to hold onto this all or nothing thinking, and help them make cognitive shifts away from it.

Lastly, we remind dieters that thinking they’ll just start again tomorrow has NEVER helped them to lose weight in the past and keep it off.  And a lot of times it doesn’t work that way and it may take dieters several days or months to get themselves back on track.  The sooner they can recover from mistakes the better and they never have to wait until the next day/month/year to do it. Dieters often need many, many experiences of getting themselves right back on track to prove to themselves that they can do it effectively.  And the more times they successfully get back on track, the more confident they become and the easier it is to do the next time.  As I said in the beginning, ALL successful dieters and maintainers make mistakes, they just recover from them right away.

Ice Cream and Regrets

Jamie came into session today and reported that she had a significant experience over the weekend at an ice cream parlor.  She explained to me that she had planned in advance to go and have a small size ice cream so that she could still have a drink with dinner.  However, when Jamie and her friend were waiting in line at the ice cream counter, they discussed what they were going to have and her friend said he was going to have a medium-sized cup. Immediately Jamie’s sabotaging thoughts started kicking in – “If he’s having a medium, then so can I; It’s not fair that I should have to get a smaller size; I’ll enjoy it more if I get the bigger size; I know I planned to have a small but it won’t really matter if I get a medium” and so on and so on. 

Jamie reported that she did not at that moment take the time to identify what thoughts she was having and come up with responses to them, and so she ended up ordering a medium despite her initial plan to get a small. I asked Jamie how she felt after finishing her ice cream and she said that she felt bad about herself and guilty because she went off plan.  Jamie also believes she would have actually been happier ordering the smaller size because then she would have been able to enjoy each bite knowing she had planned for it, instead of feeling guilty about the extra ice cream she was consuming.  And because Jamie continued to feel bad about the situation and let her sabotaging thoughts go unchecked, she also ended up eating more at dinner than she had planned.

Jamie and I discussed this situation in depth during her session to see what we could learn from it.  First I asked Jamie if she had done any preparing before she went out for ice cream, such as reading her Advantages List or Response Cards which would remind her how and why to not give in to cravings.  Jamie told me that she thought about the ideas but didn’t actually read the cards, assuming the messages were well-enough engrained.  I explained to Jamie we’ve found this to be true for the majority of the dieters we work with – that just thinking about the response cards is not good enough; something about actually reading them seems to enter the brain in a different and more substantial way. 

Jamie and I also discussed the paradox that she thought she would be happier with the larger size, and then ended up enjoying it less because she felt guilty about going off her plan.  I reminded Jamie of her previous experience with the french fries and how good it felt to eat a smaller, planned portion, and how much she enjoyed each one.  I asked Jamie if she regretted not eating more fries on that day and Jamie realized that while she did not regret not eating more fries, she did regret eating more ice cream.

Lastly, Jamie and talked about how this one experience of giving in to sabotaging thinking led her then to give in to more sabotaging thoughts later in the day.  I reminded Jamie that this experience wasn’t only significant because she took in extra ice cream calories, it was also important because this one time of giving in led her to give in again later that day.  Jamie agreed, saying that if she had stuck with the small ice cream, she thinks it would have been easier for her to stay on plan the rest of the day because she would be feeling good about herself and her eating and would already have experiences from that day of not giving in.

I asked Jamie to think about what she would away from this discussion and she listed:

1. It’s important to actually READ her Advantages List and Response Cards before going into a challenging situation

2. Make a new Response Card reminding her that when she sticks to her planned portion of food, she feels much better about it, is able to enjoy it more, and absolutely does not regret not eating more

3. Remember that every time does matter, and going off her plan earlier in the day strengthened her giving-in muscle and triggered her to eat off track later in the day.

I ended by giving Jamie a whole lot of credit for not allowing herself to continue eating out of hand the next day and for getting back on track.  I reminded her that even experiences where she doesn’t do as well are extremely important because we can learn as much from them (and sometimes more) as from successful ones.

5 Ways to Gain Weight When You Don’t Want To

How often have you noticed that formerly normal weight people have gradually gained weight throughout the years? Or dieters who have lost a significant amount of weight and then gained it back quickly? Should people even try to lose weight at all? The answer is yes, if they are already having weight-related health problems or if they are putting on extra weight every year and so are likely to have health problems in the future. On the other hand, studies that have examined how much weight people are able to lose and how much they are able to keep off long term are fairly dismal. Most people gain weight back. Here is a sure fire formula for gaining weight:

  1. Lose weight quickly.
  2. Go back to your old way of eating when you lose weight.
  3. Continue to eat and exercise exactly as you have been as you get older.
  4. Eat in the way “everyone else” is.
  5. Make excuses for why it’s okay to eat when you shouldn’t.

Each of these items is explained below.

  1. Lose weight quickly: One of the best ways to gain weight quickly is to drastically cut your calories. Research shows that the faster people lose weight, the faster they tend to regain it.
  2. Go back to your old way of eating when you lose weight: It’s plain biology. If you lose weight on 1200 calories a day, for example, and then your weight plateaus, you will start to gain weight back once you go up to 1300 calories a day. That’s the equivalent of one good sized apple or four crackers. And if you return to eating 2,000 or 3,000 calories, as perhaps you did before, of course your weight will increase.
  3. Continue to eat and exercise exactly as you have been as you get older: It seems unfair, but it’s true. Metabolism tends to decrease with age. If you don’t start eating less and/or exercising more, you’ll gain weight. Now it’s reasonable to gain a little weight, especially if you’re eating in a healthy way, but those pounds can really add up as the decades go by.
  4. Eat in the same way you assume everyone else is: It’s possible that you know the rare person who can consume a great number of calories a day and not gain weight. But it’s more likely that the people you know (especially if they’re over 40), are either restricting their eating in some way or are themselves gaining weight each year. In any case, it’s irrelevant. If you don’t want to gain weight, you’ll need to figure out what’s right for you to eat—which isn’t necessarily right for another person.
  5. Make excuses for why it’s okay to eat when you shouldn’t: Your body processes calories in exactly the same way, regardless of circumstances. It doesn’t care if you’re stressed, tired, or celebrating; if it’s a special occasion; if no one is watching you eat; or if the food is free. It may be reasonable to plan in advance to eat a little more in some circumstances but understand that if you don’t compensate by exercising more or cutting an equivalent number of calories another time, you will gain weight.

It seems unfair. It’s so hard to lose weight and so easy to gain it back. But once you learn the cognitive (thinking) and behavioral skills you need, the process of losing and maintaining a weight loss (it’s the same process!) becomes much easier.

Slippery Slope

I hadn’t seen Ellie for several months. At our last appointment, she had been doing quite well, having lost 30 pounds in 7 months. She called me up one Monday, several weeks ago, because she had gained weight after a weekend of eating more than usual.

When we analyzed what had happened, it became apparent that Ellie had not only overeaten over the weekend, but that she had also gradually returned to some of her previous unhelpful eating behaviors. She had been on a slippery slope for about a month. For example, she was nibbling on food leftover from her family’s dinner plates. She was eating snacks standing up at the cabinet or refrigerator, instead of setting one portion on the table and sitting down to eat it. She hadn’t read her list of reasons to lose weight for a couple of months. No wonder she was having trouble!

Together we developed a plan of action. Ellie committed to reading a new Response Card (pages 20-21 of The Complete Beck Diet for Life) every morning. It said:

“I can nibble on leftover food and eat standing up OR I can continue to lose weight. I’m much happier with myself when I don’t do those things.”

Ellie also decided to go back to filling out a Success Skills Sheet (pages 274-275) every night for two weeks.

When Ellie called me this week, she was happy to report that she was once again easily using good eating habits and following her eating plan, and that she was continuing to lose weight. Now she knows precisely what to do in the future to get back on track.

Turning Challenge into Success

cake.jpgOur dieter, Rebecca, told us this week that she had given in to an impulse and bought a large slice of chocolate cake that she hadn’t planned for.   Because the slice constituted two portions, Rebecca decided to have half of it that afternoon and save the rest for the next day.  Once she started eating the cake, Rebecca was struck by two things: the cake didn’t taste nearly as good as she thought it would, and her sabotaging thoughts nevertheless urged her to keep eating. Rebecca ended up finishing the piece of cake and soon felt extremely bad about it.

Rebecca had characterized this experience as a complete failure on her part. We helped her see, though, that the situation wasn’t nearly as bad as she believed and in fact, she deserved credit for many things she did afterwards. 

First, Rebecca didn’t continue to eat out of hand for the rest of the day, let alone the rest of the week or month, as she likely would have in the past.  Second, Rebecca adjusted her eating for the rest of day by marginally cutting down dinner and skipping her evening sweet snack.  Most important, Rebecca learned a lot from the experience.  She learned that she doesn’t like eating off her plan because it undermines her confidence and makes her feel weak.  She learned that if she’s not enjoying something very much, it’s better to get rid of it immediately than to waste her calories unnecessarily.  She also proved to herself that she can get right back on track immediately. Rebecca made herself new Response Cards to prepare her for future times of temptation.  All in all, although it wasn’t ideal that she ate off plan, the event was actually an important experience for Rebecca and she deserves a lot of credit for how she handled it. 

Recapturing Confidence: Rose

Rose has returned to diet counseling after having been away for two and a half months, dealing with a family crisis. She regained 5 of the 21 pounds she originally lost. She can’t wait to lose the 5 pounds again, predicting that she won’t feel good about herself until she does. We discussed with Rose that what shows up on the scale is just a number and that part of her feeling so good before was not only feeling thinner but also feeling confident and in control. We decided that it would be good for Rose to immediately recapture the confidence she had three months ago. We made a list of all the things she had been doing but is no longer doing, or no longer consistently doing.  In this spirit, Rose is going back to the basics. She has committed to reading her Advantages List and other response cards at least twice a day every day and she’s also going to go back and reread measuring1.jpgsections from The Beck Diet Solution.  Although she has returned to making food plans, this week she’s going to start measuring her food again to ensure that her portion size hasn’t crept up and she’s committed to at least a five minute walk every day.  Finally, Rose is going to try to give herself credit for all the dozens of small things she’s doing right every day to raise her awareness of how well she is doing. 

With these strategies in place, Rose is already feeling more confident and in control, even though she’s five pounds heavier. 

Regaining Momentum: Jenny

Our dieter Jenny has been going through a rough time because her step-mother (whom she was very close to) passed away recently.  Jenny was having a very tough time staying motivated to stick to her diet.  She told us that although she’s still reading her Advantages List every day (Day 1 of The Beck Diet Solution), most of the items no longer feel important to her. “What does being thinner really matter anyway, compared to my step-mother’s death?” she asked us. 

To help Jenny, we asked her to imagine her life a couple of months from now and consider how she might feel then.  She was able to see that while being thinner doesn’t feel important to her right now, it will later on. We asked for some specific examples of when it might feel important. Jenny said that she had a special meeting coming up and that she did want to feel more self-confident for it. She also told us about a high school reunion that will take place soon and that it felt important to her to be thinner and more self-assured  when meeting her old classmates. 

We also asked Jenny to reflect back on what her life was like before she lost weight and consider how being thinner positively impacts her life today.  Jenny thought about it and realized that even now, among other things, she did enjoy being able to fit comfortably into chairs, being able to move around easily without getting tired, and she certainly enjoyed the fact that her weight loss enabled her to stop using her sleep apnea machine.

Jenny concluded that even though sticking to her diet had currently stopped feeling important to her, it was only temporary and she definitely would care in the months and years to come.  She also realized that she never wanted to go back to how things were before she lost weight, and that alone was enough to bring back her motivation and sense of purpose. 

Always Have a Plan

fair-food.jpgA few months ago, our dieter Jennifer attended a local festival in her town.  Before she went, she wrote down her plan. She had no trouble resisting all sorts of fried foods and local goodies and she was able to stay in control.  However, Jennifer brought food home for her family to sample and ended up eating some unplanned treats.  Because Jennifer had been working with us, though, she knew exactly what to say to herself to get back on track immediately (discussed on Day 20 of The Beck Diet Solution).

Jennifer has plans to attend a similar festival this weekend. When we asked her what her plan was, she related a sabotaging thought that was, “I’ve gotten so good at getting back on track, that I’m not going to make a plan in advance.” We went over the importance of always having a plan, even if it’s a special occasion. For example, Jennifer could plan in advance to eat four hundred calories more than usual. But we didn’t want her to go without a plan and end up eating thousands of extra calories.

Jennifer seemed unconvinced, so we decided to make a list of the advantages and disadvantages of making a plan for the festival.  Looking at them in black and white convinced her that she did indeed want to have a plan. One of the most compelling advantages was that she would be able to enjoy her splurge thoroughly and not feel guilty and out of control. Jennifer concluded that she will definitely go to the festival with a clear plan in mind.