In Session with Debbie: Slowing Down

This week, my client, Theresa told me that she was having trouble controlling portions at dinnertime.  I asked her to describe what specifically was happening in the evening, and she told me that often she would finish her planned meal, feel unsatisfied, and then go back and eat more. I asked Theresa if she was taking the time at dinner to eat slowly and really enjoy every bite that she took, and Theresa answered that she wasn’t. She told me that she often sat down to dinner right when she got home and then proceeded to eat very quickly.

I discussed with Theresa that there is a difference between feeling physically satisfied after eating and feeling psychologically satisfied. Because Theresa was planning a reasonable dinner, she likely felt physically satisfied after eating (once her stomach and brain registered satiety), but because she was eating too quickly and not paying enough attention to her food, what she was really lacking was psychological satisfaction. Because of this, we knew that what Theresa didn’t need was to plan more food; rather, what she did need was to get more enjoyment from the food she was eating.

Mindful Eating

Theresa and I came up with a plan for how she would get more psychological satisfaction from dinner. The first part of the plan involved not sitting down to dinner right away because if she did, it often meant she was still in work mode, and work mode was fast-paced and unrelaxed. Theresa decided that as a rule she would change out of her work clothes and spend at least 10 minutes doing some type of relaxing activity before she would put a single bite of food in her mouth, no matter how hungry she was.  Doing so would allow her to transition from work mode to home mode, which would enable her to enjoy her food more.

The next part of the plan involved Theresa slowing down and really taking the time to enjoy what she was eating so that she could maximize physical and psychological satisfaction.  Theresa decided that, before sitting down to dinner, the first thing she would do is read a Response Card that reminded her of the importance of eating slowly and mindfully.  She also made a commitment to not put a new bite of food on her fork until she swallowed the bite she was eating – which would enable her to pay attention to what she was currently eating as opposed to having her attention be on what she was eating next.  Then we discussed a number of strategies she could try to help her slow down:

  1. She could try eating a few meals with her non-dominant hand, just to help knock her out of her fast-eating habit.
  2. She could eat dinner with chopsticks, which would force her to slow down.
  3. She could take sips of water in between each bite.
  4. She could set a timer to go off every few minutes and each time it went off, she had to take a small break from eating.
  5. She could change something in her eating environment, like get a new plate or a new placemat, or place a vase of flowers on the table. Each time she noticed the change, she would use it as a cue to slow down.
  6. She could pretend she was a food critic and that after the meal she would have to describe, in detail, the taste and texture of what she ate.

With these strategies in place, Theresa felt committed to slowing down and really savoring dinner.

In Session with Debbie: Stress Relief

This week I had a session with my client, Jennifer, with whom I only meet every few months for booster sessions.  When Jennifer came in to see me this week she told me that on the whole things have been going well but she’s been having more trouble controlling her sweets intake in the afternoons. Jennifer, who works from home, is a big baker, and through our work together had gotten to the point where she can make any type of tempting baked good and limit herself to just one per day, because she knows she would thoroughly savor and enjoy one and that eating more would make her feel off track.  Jennifer told me that there had been a few instances in the past few weeks where she baked and ate two or more of what she made – something she hadn’t done at all for months and months.

To figure out why this was happening, Jennifer and I discussed what else was going on in her life and she told me that her work life had gotten much more stressful lately and she and her husband were also contemplating a big move.  I asked Jennifer if she had incorporated stress relievers into her life to help her cope with her increased level of stress. She thought about it and said that no, she hadn’t, in part because she felt guilty about taking time during her day to listen to music or just sit with a mug of hot tea.  At this point I realized that Jennifer was falling 2675532274_09d939aa01_zinto a common Diet Trap – the Lack of Alternatives Trap. She was feeling extra stressed and wasn’t allowing herself any means of calming down except eating and so it was no wonder she was having trouble controlling her afternoon eating.

I gave Jennifer the following analogy: If she had diabetes, would she feel guilty about taking time during the day to check her blood sugar and monitor her insulin? Jennifer answered that no, of course she wouldn’t.  We discussed all the ways in which stress takes a negative toll and I pointed out to her that doing self-care activities to reduce her stress is just another way of taking care of her health – both physical and psychological.  We also discussed the consequences of not allowing herself other means of stress relief, namely that she would keep turning to food and would likely gain weight.

Jennifer and I created a list of things she could do in the afternoons when she felt stressed, along with the reminder that doing any of them would mean taking care of her health, and not something she should feel guilty about.  We also discussed that if she was tempted to take more than one baked good she would identify what was happening and label it: She was feeling stressed and her body was telling her she needed to calm down.  Jennifer would then remind herself that in that moment she wasn’t depriving herself by not having more to eat because what she didn’t need was more food, what she did need was stress relief, and that’s exactly what she would be giving herself.

In Session with Debbie: I Can Recover

This week I had a session with my client, Rob.  Rob used to struggle with the common diet trap of making an eating mistake, using that as an excuse to keep making more mistakes (“I’ve blown it for the day. I might as well just keep eating and get back on track tomorrow.”), and then taking sometimes days or weeks to really get back on track. Because of this, Rob was constantly losing and gaining the same 10 pounds. Whenever he was down in weight, at some point he would inevitably make a mistake, which would then snowball into more mistakes, and he would gain weight back.  Rob and I have worked hard on the skill of recovering right away from a mistake and fighting against the thought that since he made one mistake, he might as well keep making more. Rob has made great progress on this front and now is usually able to recover immediately following a mistake – he never waits anymore until the end of the day, or the end of the next day, or the end of the week.

When Rob came to see me this week, he told me about an experience he had over the weekend of being at a party, being tempted by the variety on the dessert table, and eating more than he had planned.  Although he got right back on track and didn’t continue to overeat (which was really great), it made me realize that Rob has had many such experiences recently.  In fact, when I thought about it, I realized that I could identify at least one time every week when Rob would get off track.  I asked Rob about this, and he acknowledged that it was true – he was having a lot of off-track moments, although the good news was that he never stayed off track.  I had a hypothesis as 2517767106_99ab6434a9_zto why this was happening.  I asked Rob if, whenever he was tempted to go off track, he had a thought along the lines of, “It’s okay to overeat because I’ll just get right back on track.” Rob thought about it and realized that the thought he was having was, “It’s okay [to overeat] because I know I can recover.”

Although it was great that Rob had confidence in his ability to recover, it wasn’t great that he was using this as an excuse to get off track.  Rob and I discussed the “I know I can recover” thought and came up with a number of reasons why it was worth it to him to overcome that thought and not give in.

1. It reinforced his giving-in muscle. Every time Rob was tempted to get off track and gave in, he made it more likely he’d give in the next time, and the time after that. Every time Rob reinforced his giving-in muscle, he made it harder to stay on track the next time.  Even though Rob was able to recover, by exercising his giving-in muscle he was just making it harder on himself to stay on track.

2. It was causing him to take in extra calories. Rob had noticed that in recent weeks his weight loss has slowed considerably, and he realized that all the extra calories he was taking in from his off-track moments was likely a huge contributor of this. Because Rob wanted to go on to lose more weight, he knew it was worth it to try to cut out the off-track moments because they were jeopardizing his weight loss.

3. There were no guarantees that he would be able to recover. Although Rob had gotten so much better about getting right back on track, there was always the possibility that he might not be able to pull himself back and would stay off track. This wasn’t a risk Rob wanted to take.

4. He felt badly about himself when he overate. Rob realized that whenever he got off track, although he recovered right away, he still got down on himself for having overeaten in the first place, and that’s not a pleasant feeling.  Rob didn’t want to have to put up with the negative self-talk that always accompanied him making a dieting mistake.

With all of these reasons in mind, Rob felt much more prepared to deal with and overcome his sabotaging thought that it was okay to get off track because he could recover right away. He was convinced that it wasn’t okay!

Read about this trap and more in our new book, The Diet Trap Solutionavailable for pre-order now.

In Session with Debbie: Dinner Decisions

In session this week, my client, Rachel, told me that over the past few weeks she has been struggling with keeping her eating under control during dinner. Rachel, who doesn’t cook very much, has too often found herself at the end of a long day stopping at a restaurant, buying something fairly unhealthy, and then eating too much of it.

Rachel and I talked about various strategies for helping her stay on track through dinner and I suggested that she could plan in advance what she would have for dinner, and how much she would have. Like most dieters, Rachel historically has had a much easier time staying on track when she has a plan (like, for example, when she goes to a party or out to eat), so I figured that having a plan would help in this situation, too.13400210473_637d10abc8_n Rachel didn’t like this idea. She told me that she never knows in advance what she’s going to want for dinner and therefore didn’t want to decide ahead of time in case it wasn’t what she was “craving” in the moment.

Once I realized that Rachel was waiting until the end of the day to make dinner decisions, I understood why she was having so much trouble. I pointed out to her that she was relying on the most unreliable Rachel to make food decisions. She was relying on end-of-the-day Rachel, who was tired, hungry, and depleted to decide what to have for dinner. We discussed the fact that beginning-of-the-day Rachel was a much better person to make food decisions. She was fresh and well-rested and entirely sure of why it was worth it to her to make healthy decisions. End-of-the-day Rachel was a different story entirely.

Once Rachel was able to view the situation from this angle, she felt more willing to at least try planning dinner in advance. She realized that losing weight was more important to her than making a spontaneous dinner decision. I asked Rachel what sabotaging thoughts she might have that would get in the way of her sticking to her plan, and these are the thoughts and responses that we came up with:
Sabotaging Thought: I don’t want to eat what’s on my plan because it’s not what I’m craving.
Response: That’s okay! I don’t always need to eat exactly what I’m most craving at any given moment. Nothing bad will happen if I can’t have exactly what I want. I can always plan to have it tomorrow. It will taste good then, too.

Sabotaging Thought: It’s okay not to stick to my plan because I’ll just be able to control myself if I get something different.
Response: Consider the evidence. When in the past few weeks have I been able to exert in-the-moment willpower after work? Morning Rachel made a very good dinner decision, and even though after-work Rachel doesn’t feel like sticking to it, I’ll be so glad I did once the night is over.

Sabotaging Thought: I won’t be satisfied if I can’t eat something big and unhealthy.
Response: Actually the opposite is true. When I eat something big and unhealthy, it makes me feel big and unhealthy. When I stay on track, it makes me feel so much better.

 

With the strategy of planning dinner in advance, and armed with Response Cards to help her stick to her plan, Rachel felt much more confident about her ability to stay on track through dinner.

 

photo credit: Waldorf salad via photopin (license)

In Session with Debbie: Off-Track Mentality

This week, I had a session with my client, Jane, who last week returned home from a vacation. Before she left on vacation, Jane was feeling very good about her eating, and while she was on vacation, she felt she did really well (and, in fact, didn’t gain any weight). However, in the six days between her return and our session, Jane hasn’t been feeling on track.  Jane and I discussed what has been going on since she got back, and Jane told me that once she arrived home, lots of things seemed to hit her all at once – she had a big work project to get done, her elderly mother was having problems with her nursing home, and there was a leak in Jane’s bathroom.  Jane said all of these things combined made her feel like she just couldn’t deal with anything else, and that being on track with her eating felt too difficult.

Jane was clearly having many thoughts typical of someone who is off-track, such as, “I can’t do this,” “This is too hard,” and “I can’t handle it.”  I discussed with Jane that these thoughts were not a true reflection of reality; this was her off-track mentality talking.  Even though she was thinking it was too hard, it didn’t mean it actually was too hard. I pointed out to Jane (who is herself a therapist) that this is similar to someone who is experiencing depression. We often say that depression lies. Depression tries to convince someone that she has always been depressed, that she’ll always be depressed, that she’s weak and that she’s not worth anything. But that, too, is not a true reflection of reality. That’s the depression talking.

Jane felt enlivened by the idea that her thinking about not being able to handle her eating was not necessarily accurate and was just her off-track mentality lying to her.  When she was able to take a step back from these thoughts and really evaluate them, Jane, too, was able to see that they weren’t true. She was able to remember other times when her life felt really stressful but she maintained control. She was also able to remember that, when she’s on track, on a day-to-day basis it really doesn’t feel overly hard because she has positive momentum built up.  Jane and I discussed that while it is true that getting back on track can be hard, it’s not true that staying on track is too hard to manage.  By the time she left session, Jane told me that she felt much stronger and willing to do what she needed to do to get back on track. She knew she could do it, and she knew that once she did, it would feel so much easier again.

In Session with Debbie: Kitchen Cleanup

In session this week, my client, Brian, told me he was having trouble getting himself to refrain from eating while he was cleaning the kitchen after dinner.  Brian explained to me that he and his wife split household duties, and while she was in charge of most of the cooking, he was in charge of the kitchen clean up.  Unfortunately, Brian really disliked kitchen cleanup duty, and he used food (eaten standing up) to procrastinate getting started.  Brian realized that he would eat more (also standing up) while he was cleaning as a means to make the task more pleasant.

To help Brian with this, I first asked him, “What goes through your mind when you think about cleaning the kitchen?” Brian told me it was something like, “I hate that I have to do this. This stinks. This is so annoying.”  Upon hearing this, it was no surprise to me that Brian had such trouble getting himself to start cleaning the kitchen; it was clear that he was making it so much harder for himself by telling himself such negative things. I asked Brian if there was a way in which he could reconceptualize kitchen duty and make it more pleasant.  Brian and I talked about this further, and Brian told me that one of his values was being a good family member and taking care of his family.  His wife does many things to take care of the family, and his cleaning the kitchen was one way in which he could do the same. We agreed that instead of viewing kitchen duty as a hated and inconvenient task, he would instead view it as an important way in which he was being a good family member.  Instead of telling himself, “I hate cleaning the kitchen, this stinks,” we decided that Brian would tell himself, “I’m being a good family member by cleaning the kitchen. It’s great that I get to take care of my family in this way.”  Brian made a Response Card with this idea and agreed to read it every night after dinner.

We then discussed what other strategies Brian could put in place to make the cleaning more pleasant.  I asked Brian how long it actually took to clean the kitchen, and Brian guessed it was about 20 minutes. “Although,” he told me, “It would probably be even less if I didn’t waste time eating while I was doing it.”  We agreed that as a first strategy, he would time how long it actually took. Brian guessed it might be only about 10 minutes.  We then decided that he would do something like put on music, or listen to a podcast on his phone, while he was cleaning.  That way, he’d have something interesting to focus on and would be less likely to turn to food to make the task more pleasant.

With these strategies in place – changing his thoughts about cleaning the kitchen and reading a Response Card before he got started, timing how long it takes, and listening to something pleasurable while he cleaned – Brian felt confident that he could get himself through kitchen cleanup without eating.

In Session with Debbie: Overeating Dinner

In session this week, my client, Emily, told me that while she has gotten much better at moderating her eating during the day, she is still having trouble sticking to reasonable portions in the evening.  Emily said that after a long day, and knowing she still had housework and papers to grade ahead of her, all she wants to do is relax and eat a lot.  Emily and I discussed what goes through her mind once she eats what she knows is a reasonable amount and is then tempted to go back for more, and Emily identified that it was something along the lines of, “This food tastes really good and I don’t want this period of eating and relaxing to end.”  In discussing this further, Emily realized that part of the reason it was so difficult for her to limit her eating in the evening is because once she’s done dinner, she then tells herself that it’s time to get started on her evening tasks and her time to relax is finished.  Once we figured this out, it was no surprise that it was so hard for Emily to stop eating because ending dinner not only signaled the end of eating but it also signaled the end of her allowing herself to relax.

Because of this, we knew it would be important for Emily to build more relaxation time right after dinner, so that stopping eating wouldn’t feel like such a big shift into the next part of her evening.  Emily decided that she would give herself an additional half an hour or so after dinner to continue relaxing and she would save one of her favorite shows to watch during this time.  In this way, she would have something to look forward to once she finished eating.

Emily also made the following Response Cards to read after dinner to help her stay on track:

I’m done eating but I’m not done relaxing.  I still have time to myself to watch my favorite show before I get started on other things.

If I continued to eat more now, it would be because I wanted to relax more, not because I’m still hungry.  But if I overeat, the only thing it will do is make me feel guilty and mad at myself, which is the opposite of relaxation. 

If you’re tempted to overeat in the evenings, ask yourself: What am I really looking for here? If you’ve eaten enough, it’s not about hunger, it’s about something else. For Emily, it was more relaxation, so we built that into her evening by having her watch a favorite show after dinner.  Once you figure out what it is you’re using food to achieve, look for other, non-food ways to fulfill it.

In Session with Debbie: Losing Weight While Traveling

My client, Deanna, just came back from a week-long trip and something great happened upon her return: She found out she lost a pound and a half.  In almost every previous trip Deanna had taken, she had gained weight, and sometimes a significant amount of weight, so this was an entirely new experience for her.  In session this week, Deanna and I talked about everything she had done that made the trip so successful so that she could remember it for next time.

  1. Deanna told me that the first thing she did was take time before she left (which she partly did in session with me) to really think through the trip and make a plan for how she would handle her eating. Never before had Deanna had a deliberate plan for what she would eat while traveling; she always just had the idea that she would “wing it” and try to make good decisions. Having a written plan of how she would handle her eating, and reviewing that plan each and every morning, really enabled Deanna to stay in control of her eating while traveling. Deanna’s written plan had the following components:
  • Bring healthy food for the airplane
  • One glass of wine every other night
  • ½ a piece of bread and half my starch at dinner
  • Ask for fruit instead of potatoes at breakfast
  • Try to have some type of salad for lunch
  • No dessert before dinner and ½ dessert after dinner, or dessert every other night
  1. Deanna told me that, since she was eating more caloric meals than she normally did (because she ate almost every meal at a restaurant), she didn’t snack during the trip.
  2. Deanna also made it a top priority to be active on this trip. She made it a goal to go to the fitness center in her hotel at least three times during her seven day trip, and made sure to take opportunities for spontaneous exercise whenever possible, like taking the stairs instead of elevators, walking around the airport instead of sitting at her gate, walking places instead of taking cabs (when possible), etc.
  3. Deanna gave herself lots of credit during the trip whenever she made a healthy decision. Instead of focusing on everything she wasn’t eating, she made sure to tell herself how great it was that she way staying on track, and how resisting food would help her reach her important goals.  In doing so, Deanna was actually able to feel good about staying on track because the focus was on what she was getting, not what she was giving up.
  4. When Deanna got home and saw that she hadn’t gained weight, hadn’t even maintained her weight, but had actually lost weight, she captured how great she felt on a Response Card to read before every trip in the future.

For the first time that I can remember, I actually lost weight while traveling. This feels SO AMAZING. Although there were times on the trip it felt difficult to make healthy decisions, now that I’m back I don’t regret a single thing that I didn’t eat or drink. I just feel so proud of myself and have such an huge sense of accomplishment. It was 1,000% worth it.

In Session with Debbie: Sleep

In session this week, my dieter, Jason, and I discussed an issue that he was having trouble with: Getting to sleep on time. This is a fairly common problem many of my clients face and it’s an important one to figure out.  Studies show that people eat more on days they are sleep deprived than on days that they aren’t, and when people stay up too late, they often want to turn to food to help them stay awake.  Both of these things were happening with Jason – he was eating too much at night to help him stay awake to watch “just one more” television show (which never turned into just one more), and he found it much harder to resist cravings and moderate his appetite following a night of missed sleep.

To help him combat his late-night ways, the first thing Jason and I did was institute a bedtime of 11:00pm. Although Jason didn’t initially love the idea of having a “bedtime,” we discussed the pros and cons of having one versus not having one, and Jason was able to see that not having some type of guideline in place for when he would get in bed was leading him to consistently stay up too late, eat too much, and sabotage his weight-loss efforts.  It wasn’t worth it.  Jason decided that he would also set an alarm on his phone to go off every night at 10:30.  That way, it would give him a half hour to wrap things up and remind him that it would soon be time to get in bed.  He also decided that he would read his Advantages List when his alarm went off to remind him of all the reasons why it worth it to him to lose weight (and, consequently, why he needed to get in bed).

Jason and I then discussed what sabotaging thoughts might get in the way of him sticking to this bedtime.  Here are his thoughts and the response that we came up with:

Sabotaging  Thought: I’ll watch just one more show.

Response: One more show is never just one more show. One more show doesn’t work! If it did, I would never stay up too late but I always stay up too late.  No more shows.

Sabotaging Thought: It’s okay just this one time to stay up later than I said I would.

Response: “Just this one time” is like “just one more show” – it doesn’t work and I need to prove to myself that I do what I say I’ll do.

Sabotaging Thought: I don’t feel like going to bed right now.

Response: I may not feel like going to bed right now, but I even more don’t feel like sabotaging my weight loss efforts and having to stay overweight. It’s worth it to get in bed.

Sabotaging Thought: It’s not really that important to go to bed on time.

Response: It really is that important.  Staying up too late makes me overeat both at night and the next day.  Besides, on the days I do go to bed, I feel so much better the next day – rested and alert.  I’ll be so happy tomorrow morning I made myself get in bed.

With these strategies in place (a set bedtime, an alarm reminding him of the impending bedtime, and reading his Advantages List and Response Cards if he was tempted to not adhere to it), Jason felt confident that he would finally be able to get himself to bed at a reasonable hour.

In Session with Debbie: Two Events

In session last week, my client, Jeremy, told me that he was feeling worried because he had two events to attend on Saturday night.  He explained to me that there would be a lot of food at each one and he was nervous about his ability to stay on track.  I reminded Jeremy that it’s never the situation in and of itself that would cause him to get off track –it wouldn’t be the fact that he was at an event surrounded by a lot of appetizing food that everyone else was eating that would cause him to overeat, it would be his thinking about the situation. So we needed to do two things: first, come up with a plan for how he would handle his eating, and second, figure out in advance what sabotaging thoughts he might have that would lead him to stray from this plan and come up with responses to them. 

Jeremy and I discussed the two events and decided that a reasonable course of action would be for him to have dinner at the first event and a reasonable portion of one dessert, or smaller portions of two desserts, at the second event.  Jeremy also decided to stick to water or club soda, knowing that he would rather spend his calories on food, and also because he would be driving. 

Next I asked Jeremy to think about what sabotaging thoughts he might have at either even that would lead him to get off track.  Here are the sabotaging thoughts that Jeremy came up with and our responses:

Sabotaging Thought: It’s okay to eat extra because I’m celebrating.

Response: My body doesn’t know or care that I’m celebrating; it processes all calories in the same way regardless.

 

Sabotaging Thought: I’ll make it for it later by eating less during the week.

Response:  “Making up for it later” just doesn’t work because there’s no guarantee that I’ll actually be able to get myself to eat less later on.  It also doesn’t work because if I overeat, I reinforce my giving-in muscle and make it more likely I’ll overeat the next time, and the time after that.  It’s important to continually reinforce the habit of eating consistently. It’s not about the calories, it’s about the habit.

 

Sabotaging Thought: I really want it.

Response:  It’s true, I do really want that food. But I EVEN MORE want all the benefits of losing weight (better health, fewer aches and pains, improved self-confidence, getting to feel like myself again).  Either way I’m missing out on something I want. If I overeat, I miss out on the advantages of losing weight. But if I miss out on extra food, then I GET all the advantages of losing weight. 

 

Sabotaging Thought: Everyone else is eating a lot, why can’t I?

Response:  My body doesn’t know or care what anybody around me is eating, it only knows what I eat. So just because everyone else is eating (and drinking) a lot, doesn’t mean that I can. My body doesn’t care what they’re doing.

 

Sabotaging Thought: My wife won’t know about it, so it’s okay.

Response: My wife won’t know about it, but I’ll know about it, and my body will know about it. If I overeat, I’ll negatively impact myself psychologically and physically. Psychologically because I’ll reinforce old, maladaptive habits and I’ll also feel badly and guilty about my eating.  Physically because I’ll likely feel overly full, take in too many calories, and possibly gain weight. 

Jeremy decided that he would review his eating plan, his Advantages List, and these Response Cards before each event (and during them if he felt vulnerable to overeating while he was there). 

When Jeremy came back to see me this week he reported that the events had been a success and that, with the strategies and tools we put in place, he was able to stay completely on track. This is a great example of how any situation can be handled, no matter how difficult it may seem initially, when dieters take time to formulate a plan, think about what sabotaging thoughts might get in the way of them sticking to their plans, and then coming up with responses so they don’t give in.