A Peek Inside a Diet Session: Cravings

I recently had a session with one of my dieters centered on cravings and we came up with a “Cheat Sheet” of important things for him to remember about cravings based on his own experiences and new things we discussed in session.  I sent him home with the homework of reading this at least once a day for the next week so that he becomes more and more familiarized with these ideas.  Here it is:

CRAVINGS

Cravings go away one of two ways: either when I decide to definitely give in to it, OR when I decide definitely not to give in to it.

Usually when I’m having a craving there is a sense of anxiety attached to it (Will I give in? Will I stand strong?). The moment I decide one way or the other, the craving starts to diminish. If I decide to give in to the craving, it starts to go away even before I put food in my mouth because the anxiety related to having to make the decision goes away.

Cravings do not just get worse and worse and worse until I can’t stand them.  They will ALWAYS go away, even if I never eat a bite of food.

The more and more times I resist cravings, the easier it will be for me to do so because I build up evidence that proves that I can withstand them and that they do always go away.

At worst, a craving might last 15 minutes, but it will go away MUCH more quickly if I distract myself.

What to do when I’m having a craving:

1. Label it.  This is just a craving, it doesn’t mean I have to give in. Just because I want to eat this right now doesn’t mean I should.

2. Firmly make the decision to NOT give in. 

3. Distract myself.  The moment my attention is on something else is the moment the craving starts to go away. If I’m highly distracted, there is no way I’ll be able to focus on the craving.

Things to try to distract myself: check emails, search the internet for interesting things, take a walk, call a friend, play a word game on my phone.

When I’m having a craving, remind myself, “THIS IS TIME LIMITED.  I will not be feeling this craving forever.”

Every single time I have a craving I have the opportunity to either strengthen my tendency to give in, or my tendency to not give in. This is why every single time matters because every single time will reinforce one of these things.

When I’m having a craving, the more I focus on that craving, the worse it will get.  The more I distract myself, the less and less I’ll think about it.  Just like an itch – the more you focus on an itch the itchier it becomes.  When I get distracted, the itch goes away.

It’s worth it to me to not give in to cravings because it will enable me to get everything on my Advantages List!

When the Struggle Just Isn’t Worth It

Jamie came to see me a few weeks ago and one of the items she wanted to put on our agenda for the session was her trouble with ice cream. In the past Jamie has described ice cream as her Achilles heel, and it seemed that it had once again become problematic for her. Jamie told me that she was having difficulty keeping ice cream in her house because she would end up eating way more than one serving at a time, and way more than she had planned.

At that point, Jamie and I had discussed several strategies for her to try. I helped Jamie to identify some of the sabotaging thinking she was having in the moment she was tempted to eat more ice cream than she had planned and came up with responses to them. Some of Jamie’s sabotaging thoughts and helpful responses were:

Sabotaging thought: “It’s okay to eat more than I had planned just this one time”

Response: “It’s not okay to do it this one time because every single time matters. Every time I eat more ice cream than I had planned, I make it more likely I will eat more the next time, too. I need to exercise my resistance muscle, not my giving in muscle.”

Sabotaging Thought: “I deserve more ice cream at night because I was so good during the day and I turned down lots of holiday treats.”

Response: “My body doesn’t know or care how many things I didn’t eat today, it only knows how much I did eat. If I eat more calories than I had planned, I will gain weight.”

In session, Jamie made some new Response Cards with these helpful ideas on them and committed to reading them right before she had her nightly ice cream treat. Jamie and I also devised a plan for what she would do when she finished her serving of ice cream, including immediately putting her bowl and spoon in the dishwasher and turning to a list of distraction techniques to employ until the craving for more had passed.

Jamie came back to see me the following week and reported that ice cream continued to be a problem for her and she was feeling bad about her lack of control. Jamie reported that even though she was reading her Response Cards, sabotaging thoughts were continuing to hound her and she was struggling on an almost nightly basis. She said that every time she set out to have ice cream, she would have the thought, “I’ll be able to stop after one serving,” although that rarely was the case.

Jamie and I then talked about what our next plan of attack should be. I reminded Jamie that, while the ultimate goal is for her to be able to keep anything in the house and know she can stay in control, if a particular food item is consistently giving her trouble it can be a good idea to just not keep it in the house for the time being. Jamie and I discussed the fact that she was constantly putting herself through a struggle each night because even when she was able to limit her intake to one serving, it was very hard for her to do so. On any given night, the thought, “I’ll be able to stop after one serving,” was either not true, or it was true but required a lot of struggle and effort on Jamie’s part.

By the end of the session, Jamie came to the conclusion that right now, even though she really liked ice cream, it just wasn’t worth it to her to keep it in the house. I reminded Jamie that she doesn’t have to keep ice cream out of her house forever; rather this is just for a limited time while she builds back up her resistance muscle. Jamie also decided that if she really wanted ice cream, she could go out and buy a single serving of it so she wouldn’t have to struggle to stop eating. Undoubtedly Jamie will keep ice cream in her house in the future, but for right now the negatives outweigh the positives.

Sabotaging Thoughts and Unhelpful Cognitions

When dieters first come into our office, they have all kinds of unhelpful cognitions (which we call “sabotaging thoughts”) about everything related to diet, food, and weight loss:

Dieters have unhelpful cognitions about Dieting

Once I lose weight I won’t have to diet anymore

Dieting should be easy

Dieting should not take a long time

Dieters have unhelpful cognitions about Food

I should eat as little as possible to help me lose weight more quickly

I should cut out all high-fat or high-calorie foods while I’m dieting

It’s not okay to waste food

Dieters have unhelpful cognitions about Hunger

Hunger is bad and something bad will happen to me if I get too hungry

If I get hungry, the hunger will just get worse and worse until I eat something

I shouldn’t ever be hungry

Dieters have unhelpful cognitions about Cravings

If I am really craving something, it means I need to eat it

I might as well eat what I’m craving now because I will just end up eating it eventually

There is nothing I can do to make cravings go away

Dieters have unhelpful cognitions about Weight Loss

Weight loss should be really fast – all the magazines say that it is

Weight loss should be easy – all the magazines say that it is

If I’m dieting, I need to lose weight every day/week or it means it’s not working

Dieters have unhelpful cognitions about Permission

It’s okay to eat this food because….I’m stressed; I’m tired; everybody else is eating it; it’s just a little piece; it’s free; I’ll make up for it later; I’ll exercise more later; someone will be disappointed if I don’t have it; no one is watching; I’ve already blown it for the day so I’ll start again tomorrow; I’m celebrating; it will go to waste; I’m really upset; I’ve been so good lately, etc.

Dieters have unhelpful cognitions about Perfectionism and Cheating

Either I’m 100% perfect on my diet or I’m totally off of it

I’ve already eaten too much today so I’ll continue to eat whatever I want and start again tomorrow

If I make mistakes while dieting, it means that I just can’t do it

Sabotaging thoughts like these are at the root of why dieters are overweight in the first place because they cause dieters to act in a certain way. Let’s say it’s 4:00pm and a dieter passes by a vending machine on the way to the bathroom. If she says to herself, “Those cookies look really good. I’m really hungry and dinner won’t be for another few hours and since there’s no way I’ll be able to hold out, I might as well just have these cookies now,” she’s probably going to end up having them.

But take the same situation – it’s 4:00 and a dieter passes by the vending machine on the way to the bathroom but this time she says to herself, “Those cookies look really good. I’m really hungry but I know that if I have these now, then I can’t have the dessert I’ve already planned to have after dinner. I absolutely don’t need these cookies and I just need to either go have the healthy snack I have at my desk or wait until dinner,” then she’s probably NOT going to have them.

Once we help dieters figure out which sabotaging thoughts they are having in any particular situation, we can help them come up with really strong responses to them so that dieters are no longer at the mercy of these thoughts.

 

 

 

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.

Holding Out

After dinner and evenings have always been the hardest times for Jamie to maintain her control.  She finds that she has the urge to snack all evening long and often struggles very hard to not overeat after dinner. For Jamie, it wasn’t that she kept getting hungry over and over after dinner; rather she had a very strong and compelling urge to eat at those times which didn’t seem to have much to do with hunger.  Jamie finally sat down to try to figure out what was going on in the evenings so that she could get her eating under control during that time. 

Jamie thought about the rest of the day and realized that it was much easier for her to maintain her control up to and during dinner, and that she was often pretty easily able to stick to her planned meals and snacks.  Upon further reflection, Jamie began to formulate the hypothesis that the reason the day was so much easier for her than the night is because during the day she always knows when her next meal or snack is coming, and therefore she is able to “hold out” until then.  Jamie knows that food tastes better when she is hungry and she enjoys sitting down to meals and snacks with a reasonable degree of hunger.  Jamie realized that her biggest pitfall was not planning her evening snack or snacks well enough (because she would often just have a general plan of having some snack sometime) so therefore she wasn’t able to tell herself to just hold out until the next planned time to eat, because there wasn’t necessarily a next planned time to eat. 

This concept of “holding out” was very important for Jamie because it shows that she clearly has the ability to exert control over herself and her actions.  Jamie realized that it wasn’t that something suddenly overtook her in the evenings which made her want to eat constantly, it was just that subconsciously she didn’t know when her next meal or snack was coming so she wasn’t able to respond effectively enough to the sabotaging thoughts that were urging her to eat.

Once Jamie figured out what was going on, it made figuring out a way to solve the problem pretty easy, and she gave herself a lot of credit for being able to do this. Jamie decided that it would probably work best for her to plan two evening snacks – one a little while after dinner and one right before bed so that she would always have a next snack for  hold out for during the evening and night.

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.

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. 

Holiday Cookies

choccookies.jpgThis week, our dieter Alex walked into his office kitchen to make a cup of coffee and discovered a big plate of homemade holiday cookies one of his coworkers had brought in.  Seeing and smelling the cookies set up a craving for Alex and he had the sabotaging thought, “It’s ok to have a cookie because it’s holiday time and everyone is eating them.”  Alex had to remind himself that the fact that it’s holiday time is not a reason to eat unplanned cookies, and he’d much rather be thinner.  He firmly told himself, “If I hadn’t walked in the kitchen I would never have seen the cookies and would never have wanted them.  Just make your coffee as planned and leave the kitchen.”  Alex did exactly that, and five minutes later was glad he had resisted. 

This is a good strategy for dieters to employ this time of year when they are faced with a multitude of special holiday foods in stores, at the office, at parties—not to mention the gifts of food they may receive.  Just as Alex did, it’s useful for dieters to remind themselves that if they hadn’t seen the goodies, they may not even have thought of them or wanted them. This helps diminish their sense of entitlement and if dieters can say to themselves, “I only want [this food] because I’m seeing it right now, but I can move on, as if I’d never seen it,” it will be easier to resist.

Dealing with Hunger

Mark, a dieter that we recently began working with, reported that during the past week he’s been feeling extra hungry, which is making it more difficult for him to stay within his calorie limit for the day.  The first thing we discussed with Mark is the fact that this is completely normal.  All of our dieters have periods of time when they are hungrier than others. Although they often say, “I had such a hard week; I was hungry all the time,” it usually turns out they were only hungry for a couple of hours during a few days that week, but let the memory of that hunger color the entire week.

We told Mark that if it’s not time for one of his preplanned snacks or meals and he’s feeling hungry, there are lots of things he can say to himself.  First he can remind himself that hunger is never an emergency – it can be somewhat uncomfortable but he’s lived through much worse physical discomfort in the past (a badly broken arm, a root canal, and a popped kneecap).  Mark can also remind himself that there’s always another meal coming and that he’s going to be eating again fairly soon. Last, Mark can tell himself that just because he’s hungry doesn’t mean he should eat – if he wants to get and stay thinner, he simply can’t eat every time he feels like it. 

We also asked Mark if what he’s been feeling lately is always hunger, or whether he might be confusing it with a craving or a desire to eat (Day 11 of The Beck Diet Solution).  We urged Mark to pay attention to the physical sensations attached to his “hunger” and try to discern whether it really is true hunger.  Mark related that he had been working fewer hours this week, and it’s possible that he felt at loose ends and therefore felt like eating, as opposed to being hungry.   

We proposed an experiment for Mark to try: for one or two days this week, he’s going to spend almost all of his calories on protein and vegetables and limit carbohydrates and starches.  Many of our dieters have tried this experiment and were surprised to see how much more full and satisfied they felt when they varied their diet in this way.  We told Mark to give it a try, and if the same is true for him then at least for now, when he’s feeling more hungry, it’s probably worth his while to incorporate more protein into his diet. 

The First Session

We recently started working with three new dieters and, as always, we covered a lot of material in the first session.  The first thing we go over with new dieters is the importance of making their Advantages List – a card that lists all of the reasons they want to lose weight.  Most dieters can come up with fifteen to twenty reasons for their Advantages List, among them being such things as:

  • I want to have more self-confidence
  • I want to look better.
  • I want to be healthier.
  • I want to have more energy.
  • I want to be less self-conscience.
  • I want to wear more fashionable clothes.

In the beginning, dieters need to read their Advantages Card every single morning so it is always fresh in their mind exactly why they are putting forth all this effort.  Dieters also need to read the card every time they are tempted to eat something they shouldn’t.  This way, they have to squarely face the question, “Do I want the momentary pleasure from eating [this food] or do I want all the advantages on my list – to feel better, to look better, to be healthier, to be able to keep up with my kids, etc.”  In this way, it’s much easier for dieters to resist tempting food, even in the moment, because they are able to see that they’d much rather have all the things on their list. 

Another important topic in our first session is the importance of eating everything slowly, while sitting down, and enjoying every bite.  For some dieters, eating everything sitting down can be a big adjustment, because whether they realize it or not, many people do a significant amount of eating standing up.  Opportunities to eat standing up abound – hor d’oeuvres at cocktail parties, free samples at the grocery store, taste-testing while cooking, picking at leftovers when clearing the table, etc.  And many times dieters just simply don’t remember the food they eat while standing up.  Eating everything slowly, while sitting down, and enjoying every bite is crucial not only so that dieters can be aware of everything they’re eating, but also so that they feel both physically and psychologically satisfied by their meals.   

We also discuss how important it is that dieters not be ashamed of themselves or see themselves as failures because they’re overweight. We emphasize that the reason they haven’t been able to lose weight and keep it off in the past is because they didn’t know how.  Dieting is a skill just like any other, and it takes instruction and practice to become adept at it.  No one would expect to be able to sit behind the wheel of a car for the first time and drive perfectly.  They would need a teacher, practice, and road experience before they became good at driving.  Dieting works in exactly the same way; it’s comprised of a specific set of thinking and behavioral skills. We always leave our dieters with a sense of hope, that this time is going to be different, that this time they can be successful, because this time they are going to learn how!