In Session with Deborah: Difficulties Going Home

This week, I had a session with my dieter, Emily. Emily told me that she and her sister are planning a trip home this weekend to celebrate their mother’s birthday, and that she thought it would be hard in a number of ways:  Emily would be off of her usual routine, she would be spending a long time in the car, she would have fewer occasions to exercise, and she would not be in control of her food.  Beyond these practical matters, Emily also told me that saying in control of her eating might be difficult because she would be experiencing more stress, which puts her in danger of engaging in emotional eating.  Although Emily loves her family, she also finds that being around them for an extended period of time can be stressful (in part because they often comment about what she does and doesn’t eat).

In session, Emily and I spent most of the time coming up with strategies for both her practical and psychological concerns.  Emily knew that one the most helpful things she can do for herself is to make a general plan for her eating and exercise over the weekend.  Emily decided that she would plan ahead and bring meals and healthy snacks in the car so that she wouldn’t have to worry about finding healthy choices on the road or being tempted by unhealthy food.  Emily also decided that she would make it priority to take at least a 20 minute walk each day that she at home, which would have the dual benefit of getting in some exercise and also being a stress-reliever.

Emily and I also discussed what sabotaging thoughts that might come up this weekend.  Emily said that her family often watches what she eats and makes comments, and although they are usually well-meaning, they cause Emily stress.   I pointed out to Emily that because she is now an adult, she doesn’t have to worry about “rebelling” against family by sneaking food or worry about what they will say about her eating because the only person she has to answer to is herself.  Emily I discussed this idea further and she made the following Response Card:

 

 

 

 

 

Emily and I also discussed the emotional eating aspects that might come into play this weekend and what strategies she can use if she’s feeling negative emotions, like taking a walk outside, working on deep breathing and relaxtion, or calling a friend.  We also discussed the fact that going home is more of an emotional experience for her, and therefore it’s normal that Emily would feel that way.  Just because she’s feeling stressed doesn’t mean anything is wrong, and just because she’s feeling stressed doesn’t mean she has to do anything about it.  It will go away on its own, as it always does.  Emily made the following Response Card:

 

 

 

 

 

 

Emily and I also discussed the fact that she should go into the weekend knowing and expecting that it will be more difficult to maintain control over her eating; this way she won’t be surprised when it happens. As long as Emily knows this ahead of time and fortifies herself, when the difficulty hits, she will be ready and prepared.

In Session with Deborah: I deserve a treat

This week, I had a session with my dieter, Rachel.  Although she very much enjoys her job as a manager in a big medical office, Rachel also finds that her days are hectic and stressful.  In session this week, Rachel and I discussed a situation in which she got off track on Friday night.

On Friday evening, Rachel had planned on going out to meet friends after work, but then felt too tired from an especially busy week.  Although she initially thought to make herself a healthy meal at home, she ended up going home and ordering “way too much” Chinese takeout – and then eating almost all of it over the course of the night.  I asked Rachel what thoughts she was having when she decided to order Chinese takeout instead of her planned healthy dinner, and what thoughts she was having that then led her overeat.  Rachel said that the main thought she was having was, “I deserve to treat myself.”  “I had such a stressful week,” she told me, “and I was already feeling somewhat sad about missing my night out. I kept thinking that I deserved to treat myself after my hard week, and because I was staying in, the thought of big cartons full of Chinese food seemed the way to do it.”

I then asked Rachel how she felt when she was going to bed that night, and she told me she felt, “sick from eating too much, guilty, and really mad at myself.”  Rachel and I discussed the fact that, although she ordered Chinese food to “treat herself,” in the end it actually did the exact opposite because she was left feeling badly, both physically and psychologically.  I pointed out to Rachel that one of the dangers of treating herself with food was that, at least in this case, it was a form of emotional eating because what Rachel was really looking for was a way to unwind and de-stress from her busy week, as well as feel better about staying in.  Emotional eating is something that Rachel has struggled with a lot in the past, and at the time Rachel hadn’t realized that this, too, was emotional eating. And just like every other time Rachel used food to treat emotions, she ended up feeling all the worse for doing so.

Rachel and I then discussed the notion of treating herself and how she might go about it in a way that actually did make her feel like she was treating herself. Rachel told me that when she did things like get a manicure or a massage, or take a long bike ride with her friends, or indulge in an afternoon sitting in a book store with a cup of tea, she felt great, and not at all like how she felt after a night overeating Chinese food.  Rachel made the following Response Card to remind herself of this idea:

In Session with Deborah: Making a Food Plan

I recently had a session with my dieter, Kara, who is a busy stay-at-home mom to her four boys. In earlier sessions, Kara and I worked on all of the foundational dieting skills and she got very adept at consistently instituting good eating habits.  Because of this, we then started talking about having Kara make a food plan in advance and stick to it.  Kara was initially resistant to this idea and stated that her lifestyle just wouldn’t work with a strict eating plan because she was always on the go and she often didn’t know ahead of time what her next meal would be.  Kara also said that she didn’t want to give up spontaneous eating and liked being able to eat something if it was offered to her unexpectedly.  I discussed with Kara the fact that making a food plan and sticking to it would likely make her life a lot easier because she wouldn’t have to rely on willpower at any one given moment to resist unplanned treats. I also pointed out that it might actually be very helpful for Kara to have a food plan, because she was often scrambling around at the last moment to make sure that she had dinner on the table for her family. 

Despite these compelling reasons for why it might be worth it to try making a plan and sticking to it, Kara still resisted the idea and so we agreed to try it her way first – she’d work on staying in control of her eating and resist cravings, but without having a formal plan.  Over that week, Kara tried hard to reign in her eating without a food plan and without violating her rule: no junk food until after dinner.  However, when Kara came in to see me the following week, she dejectedly told me that something had thrown her off almost every single day, like when she was offered licorice at the park, cookies at a PTA meeting, or a dinner out with her husband.  

Kara and I discussed what had happened over the week and she realized that, right now, she faces too many temptations each day to be able to resist all of them easily enough, and therefore making a plan and sticking might be very helpful in overcoming this obstacle.  I reminded Kara that she probably tried very hard each day to resist the temptations and to reason herself out of eating food she knew she shouldn’t, and therefore likely had a much harder week than if she had just known ahead of time whether or not she was going to have something.  Kara decided that she was willing to try and stick to a food plan for at least one week and see if it made a difference in her overall day. 

Before she set out to do this, Kara and I spent some time in session thinking about when it would be hardest for her to stick to her plan and what sabotaging thoughts might get in the way of her doing so.  Kara thought that the hardest times would be, as it had been, when she was offered or saw food she didn’t expect, and to not give in in that moment.  I asked Kara what thoughts she might have in those moments, and then she made Response Cards with responses that we formulated together.  Here are some of Kara’s sabotaging thoughts and then the responses we formulated:

Sabotaging Thought: I really want to eat that right now even though it’s not on my plan. Just this one time won’t matter.

Sabotaging Thought: It’s not fair that I can’t eat this treat right now.

Sabotaging Thought: I really don’t like having to make a food plan.

When Kara came in to see me earlier this week, she reported that she had had a much better week. As we predicted, once Kara made a food plan and worked on sticking to it, it made several aspects of her life easier. First of all, Kara struggled a lot less about whether or not to eat something that was offered to her because she knew that if it wasn’t on her plan, she shouldn’t convince herself that it was okay to eat it. Second, Kara also found that she really enjoyed having meal plans for the day (and even for the week) because it allowed her more time with her boys in the afternoon because she was spending less time trying to figure out what to prepare for dinner.  Once Kara decided to try making a food plan, she realized that it wasn’t nearly as bad as she thought it was going to be and, in many ways, it actually made her day better, not worse.

In Session with Deborah: Reviewing Response Cards

An integral part of our work with dieters is having them make and read Response Cards.  Response Cards are simply helpful ideas, messages, and responses that dieters practice reading every day and which help them respond to and overcome sabotaging thoughts.  Last week I had a session with my dieter, Marissa.  During session, Marissa told me that her stack of Response Cards was starting to become unwieldy and that it was taking a long time to read them all in the morning, so by the time she got to the last ones, she was just rushing through to accomplish the task.  Knowing that Response Cards are only truly helpful if dieters really take the time to read and process each one, I asked Marissa to bring in her stash of cards to our next session so that we could go through them and figure out if there were some she no longer needed to be reading. 

This week Marissa brought in all of her cards and we spent part of session reading and really thinking about each one.  Including cards that Marissa and I had made together in session, as well as ones that she had made on her own at home, Marissa had over 40 Response Cards; she was right – that probably is too many for someone to read through and process individually every morning.   The first thing Marissa and I did was go through each card and categorize them into one of three categories: there was a “Yes” pile for cards that Marissa still found very helpful and knew she would benefit from reading daily, a “Maybe” pile for cards that Marissa wasn’t sure would be entirely helpful, or cards that weren’t necessarily helpful every day, and a “No” pile for cards that no longer applied to what she was working on or having trouble with. 

Most of the cards that ended up in Marissa’s “No” pile had to do with skills that she was easily able to get herself to do every day:

Reading my Advantages List will take less than 1 minute.  Isn’t it worth 1 minute in the morning if it might help me reach my goals?

It’s not about the calories, it’s about the habit. It doesn’t matter if the bite of food has 20 calories or 200 calories, I need to eat everything sitting down.

It’s 100% worth it to me to take the time to pack and bring lunch every day because it will save me calories AND money.  When I don’t bring lunch and end up buying something unhealthy, I feel guilty about both what I ate and unnecessarily spending money. 

Marissa and I agreed that just because she would be putting some cards away for the moment, she wouldn’t throw any of them away.  Although these cards didn’t seem relevant to her now, they very well may be at some point again in the future.   

When Melissa and I were going through her “Maybe” pile, we realized that some of the cards in this category should be put away for now, some should be brought out only when they were applicable, and some she should keep in other places, like her car or her desk, and read them as-needed. 

Marissa decided to put away (for now) cards about special occasions and traveling:

My body doesn’t know or care that it’s my birthday, it processes calories the same 365 days a year.  However, it’s reasonable to plan in advance to eat some extra on my birthday.  Doing so will help me to enjoy what I’m eating without guilt and therefore enjoy my birthday more.

There is no such thing as “blowing it for the whole trip,” because if I make a mistake and continue to eat off track for the rest of the vacation, I will continue to gain more weight.  Get right back on track! 

Cards that have to do with things like eating out or dealing with treats in her office, Marissa decided to keep in her desk and/or in her car:

If I walk into the office kitchen and see something tempting, walk right back out! Remember – if I hadn’t seen it in the first place, I wouldn’t want it anyway, so I’m not missing out on anything.

When I eat out, remember: Just because everyone around me is eating something, doesn’t mean that I can. My body has no idea what anybody else is eating, it only knows what I eat. 

By the time Marissa and I had finished going through her “No” and “Maybe” piles, she only had about 20 cards in her “Yes” pile.  Some of them included:

If I’m feeling stressed, remember that staying in control of my eating will help me to feel more in control in general. Staying in control of my eating makes me feel less stressed, not more.

I’m entitled to do what I need to do to reach my goals, as long as I’m not purposely hurting anyone else. I’m entitled to turn down food, request that food be prepared the way that I want it, and put my own needs first.  Remember, if I’m not good to myself, I can’t be good to anyone else.

It’s not as if I can only eat everything I want or I can’t eat anything I want. I can eat reasonable portions of foods that I enjoy and still lose weight. It’s not all-or-nothing!

Even after decreasing her “Yes” pile, Marissa told me that she still felt a little burned out and didn’t necessarily want to read 20 cards each morning.  Marissa and I discussed this more, and we decided that, at least for the next week, every morning she would read the first five cards in her pile, and then put them at the bottom of the stack.  Marissa and I also decided that since she would only be reading five cards, she would take time to really process each one, and think about how it might be helpful to her that day.  By doing it this way, Marissa will still be reading all of her most important cards each week, but by limiting the number (at least temporarily) that she reads each day, she’ll have the opportunity to really evaluate each card and think about its meaning, which is much more helpful than reading a large stack of cards without really paying attention to them.

In Session with Deborah: Green Days

Two weeks ago I had a session with my dieter, Jennifer, who has devised for herself a rating system to catalog her eating days. Good eating days are green, okay eating days are yellow, and days when she gets off track are red.  At the moment Jennifer is going through a difficult dieting time and is struggling to get herself consistently back on track, and she has been having a number of yellow and yellow/red eating days.   Just a few weeks ago, and for many weeks before that, Jennifer had been doing very well and had been consistently having green days (which were still interspersed with the occasional yellow day).  Jennifer told me that she really wanted to get back to where she was before and again have consistent and consecutive green eating days, but she feels like it’s too hard and right now she can’t imagine being able to have so many perfect eating days in a row. 

The first thing I did was remind Jennifer of something very important: Just because she previously had green day after green day, doesn’t mean that all of her eating days were perfect. I reminded Jennifer of mistakes that she had made on some of those days, like giving in to a craving at her son’s school, eating a second helping at dinner, and eating standing up while she was putting away leftovers.  However, none of these mistakes meant she didn’t end up having a great day because she was able to immediately recover from them.  Jennifer and I then discussed the fact that green days don’t equal flawless days; instead, they are days in which when Jennifer made mistakes, she immediately got back on track and didn’t lose her sense of control, so the mistakes turned out to be very minor (and didn’t lead to more and more mistakes). 

Since Jennifer has been going through a harder time recently and kept finding that one mistake would snowball into more, she had started to castrophize mistakes and view them as something she would need to avoid altogether in order to return to having consistently green days.  Jennifer lost sight of the fact that just a few weeks ago, mistakes were a part of her daily life and her daily green days.  It was critical for Jennifer to remember this because it helped make the prospect of having green days again not seem so daunting.  In response to this conversation, Jennifer made the following Response Card:

 

Jennifer and I then discussed some specific strategies she could use to get through this hard time and make it pass more quickly.  Here are some of the things we did:

1. We took a look at Jennifer’s Advantages List and revitalized it so it felt fresh and resonant to her.  Since she’s going through a hard time, it’s especially important for Jennifer to read her list so that she can remember exactly why it’s worth it to her to keep going.

2. We did a visualization exercise in which Jennifer visualized exactly what a day was like a few weeks ago when she was doing really well.  We discussed how good she felt about being in control, the fact that, on the whole, it wasn’t that hard for her to stay on track, and what she was doing differently that she could start implementing again (like making her kids’ lunches the night before so that she had easier mornings, doing a weekly shopping on Sunday, planning meals for the whole week, not just day-by-day, etc.).

3. We decided that for the next week, Jennifer would spend most of her energy working on the basics of dieting, like reading her Advantages List, reading her Response Cards, eating everything sitting down, slowly, and mindfully, and giving herself credit.  In addition to the basics, Jennifer decided that the one other thing that would be extremely helpful for her to continue working on is making meal plans for her family and sticking to them.  We decided that Jennifer would focus on just these things for a week (or until she felt more in control), and after that we would discuss adding back in other skills.  This way Jennifer had very specific things to concentrate on, knew exactly what was expected of her, and also had evidence from past weeks that she is capable of doing all these things. 

When I saw Jennifer during our next session, she reported that she had just had three green days in a row, and was starting to build back up her momentum. Jennifer told me that what was most helpful for her was remembering that green days don’t have to be perfect days and that she can be totally on track while still making mistakes. Jennifer said that once she took the pressure of being perfect off of herself, she was once again able to ger herself to do what she needed to do because she didn’t live in fear of making a mistake.

In Session with Deborah: Regaining Focus

When my dieter, Janine, came in to session this week she told me that she had a hard time getting her dieting tasks done over the past week.  Her three kids had all been away at summer camp and returned home last week, and Janine suddenly found herself in a whirlwind of doctors’ appointments, preseason sports practice, and end of summer get-togethers.  Janine told me that with so much suddenly going on, she found that her dieting skills just seemed to fall by the wayside because she didn’t have enough time to get them done.

One of the first things I did with Janine was bring out the checklist she fills out every night with the dieting skills she’s working on that week.  We went through the checklist, item by item, and discussed how long, in general, each one takes.  Janine realized that nothing on her checklist takes all that much time, and, in fact, many of them take almost no time (like eating everything sitting down, giving herself credit, reading her Advantages List, limiting junk food to one time per day, etc.) In doing this, Janine was able to see that it wasn’t really a lack of time that kept her from practicing her dieting skills; rather it was a lack of focus.  With so much else going on, Janine was not able to make dieting one of her top priorities and therefore did not have the energy or focus to commit to it. Janine and I had the following conversation:

Janine: I don’t know, this week was so busy, I’m just not sure I’ll be able to find the time and energy to focus on it this coming week, too.

Debbie: If you remember, when we first starting working together it was hard for you then, too, to prioritize dieting because you had a lot going on. But we sat down and figured out how you could make it a top priority, which you then did because it was worth it to you to do so at the time. Is it worth it to you now to make this a top priority?

Janine: Yes, definitely.

Debbie: Why is it worth it?

Janine: Because I’m tired of not liking the way I look. I’m tired of not having enough energy, of not wanting to get dressed because I don’t like my clothes, of feeling heavy in my body, of worrying about my health. 

Debbie: So, with those things in mind, is it worth it to you to make a commitment to focus on your dieting skills this week?

Janine: Well, yes and no.

Debbie: What’s the “no”?

Janine: Well, I really do have a lot of other things going on that need my attention.  And I don’t always feel like working on this. And I like eating a lot of junk food.

Debbie: And what’s the “yes”?

Janine: The yes is everything I just said – wanting to look better, feel better, have better health, and so many other things.

Debbie: So this is an important question and the answer is entirely up to you:  which is more important to you – the reasons to make a commitment to focus on dieting or the reasons not to make a commitment.

Janine: Well, when you put it like that, the reasons to do it are more important. No question.  I have to do it.

Debbie: Okay, so I’m going to ask you again: Is it worth it to you to make a commitment to focus on your dieting skills this week?

Janine: Yes, it’s worth it.

Debbie: Are you sure?

Janine: Yes!

This conversation was important for us to have because when Janine’s life got busy, she lost the focus necessary to accomplish her dieting skills and she wasn’t thinking about why it was worth it to her to regain it.  I knew that in order for Janine to have a better week, she needed to be sure of her commitment to dieting, which would then make it much easier for her to focus on prioritizing and accomplishing her diet tasks and skills.  Janine made the following Response Card to read this week:

 

 

 

 

 

Similar to what I did with Janine, whenever dieters lose focus, it’s important for them to ask themselves:

  • Why do I want to regain my focus?
  •  What are the advantages and disadvantages? 
  • With the advantages and disadvantages in mind, which are more important to me?

If dieters decide that the advantages of regaining focus (and, therefore, of continuing to lose or maintain weight) outweigh the disadvantages, then it becomes easier for them to recommit to doing what they need to do because it helps them realize that the reasons not to do it are just not as important.

In Session with Deborah: Vacation Goals

My dieter, Mark, came in to see me this week.  Over the past month, Mark’s weight loss has slowed down and, in general, he and I have been working on consistently maintaining his healthy eating habits with the awareness that he may or may not continue to lose more.  This week, one of the things Mark wanted to put on the agenda was his upcoming trip with his wife and kids.  Mark and his family are driving to Maine and spending two weeks there before driving back home.  Mark told me that he wanted to discuss how he would handle both eating during the car rides and also while he was in Maine.

I first asked Mark: What is your goal for this trip? Is it to lose weight, gain a little, or stay the same?  Mark replied that since he has been in such a good eating groove lately and has been feeling good about himself, about the way his clothes fit, and about how much easier healthy eating has become now that he’s gotten in control and stayed in control, his goal for the trip is to stay the same – not lose any weight over the next two weeks, but not gain any, either.  The reason I posed this question to Mark before we talked about anything else is because defining his goals for the trip was necessary in order to figure out what his plan should be; Mark’s vacation plan would differ depending on the answer.   

With the goal in mind of maintaining his weight, Mark and I then began figuring out what a reasonable plan would be.  Mark and I first discussed the car rides to and from Maine, because in the past Mark has used being in the car for long periods of time as an excuse to continuously overeat junk food snacks and unhealthy foods he would buy when he stopped for gas.  Mark and I came up with the following plan for the car trips:

1. Make sure to eat three normal meals.  Eat breakfast before I leave and take the time to stop and eat a real lunch (getting there 45 minutes later won’t matter in the long run).  Stop for dinner on the road or wait until we get there to sit down and eat dinner. 

2. Bring all snacks with me. Continue to eat like I do on normal days: one snack between breakfast and lunch and one snack between lunch and dinner.  Bring snacks with me so I’m not tempted to buy unhealthy food when we stop for gas.

3. Respond to my Sabotaging Thoughts. Remind myself that just because I’m in the car doesn’t mean I can snack all day long. My body doesn’t know or care that I’m in the car and it, and I, will be so much happier if I eat the same way as I do on a normal day. 

Mark and I then discussed what he wanted his plan to be for while he was in Maine and he told me about a homemade ice cream store that his family frequents whenever they are in Maine.  Mark said that he would feel deprived if he couldn’t eat ice cream with his family if they went during the day, but, at the same time, he also didn’t want to give up his nightly treat.  Here is a snippet of our conversation:

Mark: I think maybe the plan should be that, while I’m on vacation, I have two treats a day.  What do you think?

Debbie: Well, do you eat two treats a day now?

Mark: No, I only eat one.

Debbie: So you only eat one treat a day now and in general have been maintaining your weight. My guess is that if you eat two treats a day while on vacation, you’ll gain some weight.  Let’s take a look at your goal again.  At the beginning of session you said that you wanted to maintain your weight on this trip, and that goal seems to be incompatible with the plan of eating two treats a day.  So – do you want to change your goal, or do you want to change your plan? The choice is entirely up to you.

Mark: No, I really don’t want to gain any weight while we’re away, especially since we take this trip every year and I don’t want to gain weight every time we’re in Maine. I guess I’ll cut it back down to one treat a day while I’m on vacation.

Debbie: Okay. And remember, it’s reasonable to have a different plan when you’re away than you do normally. I know that you follow the rule, “No dessert until after dinner,” but I’m wondering if that’s one you might want to amend while you’re in Maine. Maybe in Maine, the rule should be, “one treat a day,” but you can choose when to have it. That way, if your family goes out for ice cream during the day, you can have it then, but not have your treat at night.  What do you think of that idea?

Mark: I think that’s a good idea because I really don’t want to miss out on our favorite ice cream, but sometimes it just doesn’t work to get it after dinner.

Debbie: So what do you want to say to yourself on a night when you’ve already had ice cream during the day, but now want to eat your nightly treat?

Mark: I guess I need to remind myself that I’ve already had my treat that day, and I can always have another one tomorrow. I can’t eat two treats and maintain my weight, and not gaining weight is so much more important to me than having an extra treat.

Debbie: That’s a great response!  Do you want to make a Response Card to remind yourself of that idea?

Mark: Definitely. 

Mark and I continued to hash out his vacation plan, and I frequently asked him: What is your goal for this trip? Do you want to change it or keep it the same?  This made our planning easier because it helped Mark remember that he had the choice of changing his goal, but since he didn’t want to, he had to make a plan that would enable him to reach it.  Here are some of the items on Mark’s vacation plan:

1. Eat three meals a day – brunch just doesn’t work for me.

2. Eat one treat a day except on my daughter’s birthday, when I’ll have two.

3. Make sure to do some form of exercise every day, even if it’s just taking a short walk on the beach.

4. Limit alcohol consumption to just on the weekends – when I don’t have it, I don’t miss it anyway.

5. Go with Emily to the grocery store to ensure that I have healthy foods readily available.

6. If we’ll be out for the day, bring snacks with me whenever possible so I don’t have to rely on finding something healthy on the fly.

7. Continue to read my Advantages List and Response Cards every day and practice my healthy eating habits.

8. Continue to weigh myself everyday with the scale in Maine.

9. Remind myself that my goal for this trip is to prove to myself that I can go to Maine every year without gaining weight.

10. Remember that I will feel GREAT if I stay in control of my eating, and that it will put a huge damper on my trip if I feel out of control.

At the end of our session, Mark told me that he felt much more confident in his ability to stay in control while in Maine. He also decided that if he was tempted to eat or drink something that wasn’t on his plan, he would ask himself, “Is this going to help me reach my goals or not?”

By centering our discussion on Mark’s goal for the trip, and by reminding him that he could change his goal if he wanted to, Mark was able to come up with a plan that felt reasonable and doable, and one that he felt good about, knowing it would help get him to where he wanted to be.

In Session with Deborah: The Hangover Effect

Over the past few weeks, my dieter, Karen, and I have been working on strategies to help her stay in control when she eats out.  Meeting friends for meals is a large part of Karen’s social life, and she has found that over the years, eating out has been a contributing factor to her steady weight gain.  When Karen first came to see me, she was feeling somewhat hopeless and asked me whether or not she should just stop eating out entirely. I assured Karen that she wouldn’t need to stop eating out as long as she was able to learn and practice skills that would enable her to eat out without losing control. I also assured Karen that I felt confident that she would be able to achieve this goal, as long as she put in the time and effort, and persevered.  After some trial and error and with lots of practice, Karen and I were able to come up with an “Eating Out Protocol” which successfully enabled her to stay in control when she ate out.  Here is some of what it entails:

1. If possible, always look up the restaurant’s menu online before I go and determine ahead of time what I’m going to eat and drink. If I’m going to a friend’s house, call and ask what will be served beforehand, and plan accordingly.

2. Read my Advantages List and Response Cards before I leave the house.

3. At the restaurant, don’t tempt myself by opening the menu.

4. When I’m ordering, make sure to request for the food to be prepared in the way I want it.

5. When I get my food, immediately portion off how much I’m going to eat and either push the rest aside or get it wrapped up.

6. Make an effort to eat slowly and mindfully and really enjoy the experience.

7. If I feel tempted to eat or drink more than I had planned, go to the restroom and read my Response Cards again.

With these strategies, Karen has made great strides in staying in control at restaurants.

At our session earlier this week, Karen explained a new struggle she’s experiencing: While it’s become easier and easier for Karen to remain in control at restaurants, the moment she gets home, she tends to “lose it” and ends up overeating. This, Karen explained, has caused her distress.

I reassured Karen that what she is experiencing is normal and happens to many dieters.  We call it the “Hangover Effect,” which refers to a situation in which dieters are able to stick to their plan well and remain in control when eating out, and then, due to sabotaging thoughts that affect their eating, lose control once they get home. In order to help Karen combat the Hangover Effect, we first examined a specific situation that had occurred in the previous week: Karen had eaten out at a Mexican restaurant with two friends, stayed in control, and then came home and ended up giving in to cravings for ice cream, cereal, and crackers.

I asked Karen if she could identify what sabotaging thoughts she had that night, and Karen responded that the strongest one was, “I was so good at dinner and didn’t have any of the tortilla chips and salsa, and no dessert, so I deserve to eat extra now.”  First, I reminded Karen that her body has no idea what she didn’t eat, it only knows what she did eat.  So even though Karen passed up a lot of food at the restaurant, she still ate a reasonable portion of food. Since Karen’s goal is to lose weight and keep it off, it was then unreasonable for her to eat more, even though it might initially seem otherwise.  Karen and I discussed this idea further and she made the following Response Cards:

It’s so important and so great that I stayed in control at the restaurant, but it’s equally important that I stay in control at home, too.  It’s the only way I’ll reach my goals.

My body doesn’t know or care how much I didn’t eat when I was out, it only knows how much I did eat, so I can’t eat extra now that I’m home.

Karen and I also discussed what might be helpful for her to do and say to herself once she gets home. I asked her if she can think of anything that’s been particularly helpful, and she replied that drinking a cup of hot tea as soon as she gets home has helped her to relax and unwind.  Since having her Eating Out Protocol has been helpful for Karen, we decided to devise a “When I get Home” protocol so that she could continue her success at home.  Here is what Karen’s “When I get Home Protocol” looks like:

1. Before I go out to eat, put a tea bag in a mug and place it on my table, along with my Response Cards.

2. When I get home: Go to the kitchen and read my Response Cards while I make my tea.

3. Take my tea upstairs and don’t go back into the kitchen until morning.

I also reminded Karen that it took time and practice for her to be able to stay in control when she ate out, so it would likely be the same for this problem, too.  Karen told me that, armed with these strategies and with the mindset that she would do her best and keep practicing, she felt much better and more confident in her ability to overcome the Hangover Effect.

When a Dieter Becomes her own Diet Coach

 

Whenever I first meet with a new diet client, I always make sure to explain to them that the ultimate goal of treatment is to teach them to be their own diet coach so that they don’t need to work with me for life.  In my work with dieters, there are a few things that really mark a turning point in their progress and which signify that they are on the road to ultimate success. 

One such turning point is when dieters demonstrate that they are becoming their own diet coach.  In a recent session, my dieter, Michelle, really proved that this was starting to happen for her.  Michelle has two young daughters.  Both of their birthdays happen to fall within the same week and both of their favorite treat is Michelle’s homemade chocolate chip cookies.  The afternoon of her first daughter’s birthday, Michelle set out to bake chocolate chip cookies which would be served at her daughter’s birthday dinner that night, in addition to the cake she had bought.  Michelle told me that she made the cookies in the late afternoon (which happens to be one of her more vulnerable times for sugar cravings) and while she was making the cookie dough, she started to get a craving to eat some, despite the rules she’s set for herself: “No junk food until after dinner” and “Eat everything sitting down, slowly, and mindfully.”  Michelle ended up giving in to sabotaging thoughts and mindlessly ate a lot of cookie dough while standing at the counter. 

After this happened, Michelle felt sick from all of the cookie dough she had eaten, and she was angry with herself for giving in to a craving and breaking her rules—especially since she had previously been following them so well.  This afternoon incident continued to stay with Michelle and caused her to feel out of sorts into the evening, resulting in her again giving in to sabotaging thoughts and eating a piece of birthday cake, despite having already had more than enough sweets for the day. 

That night, Michelle realized that she had made several mistakes, and she knew it was worth it to her to figure out how she could correct them, especially since the same situation would reoccur just a few days later for her younger daughter’s birthday.  Michelle sat down and thought about what had gone wrong and why. She realized that one of her first mistakes was not reading any Response Cards or her Advantages List before she started baking, even though she knew it could be quite difficult to resist the sweets.  She also had set aside time to bake during her most vulnerable time of the day, when she is most likely to give in to sabotaging thoughts. Additionally, Michelle didn’t have a clear plan for when she was going to eat the cookies, if any, and how she would balance that with having cake, so she wasn’t able to say something to herself like, “You don’t need to eat any now, you’re going to have one soon enough after dinner.” 

Michelle realized that planning was, indeed, necessary, so she set about making a plan for her upcoming cookie-baking.  This was her plan:

1.  Bake cookies right after lunch when I’m not hungry.

2. Read my Advantages List right before I start baking.

3. Plan to have one cookie after dinner and one half-size slice of cake.  If I want more cookies, I can plan to have one the next day.

4. Remember what happened last time and how I felt.  I want this time to be different!

Michelle also took the time to really think about what sabotaging thoughts got in her way the first time and made the following Response Cards to read with her Advantages List:

 

 

 

 

 

 

 

 

 

A few days later on her younger daughter’s birthday, Michelle carried through with her plan and the day went off without a hitch.  When Michelle came into session this week, she told me this whole story and we discussed what an important milestone this was for her.  Michelle had a challenging situation, she sat down and figured out what went wrong, she made new Response Cards in response to her sabotaging thoughts, and she came up with a plan to do things differently the next time.  I reminded Michelle that if we had had a session right after her first cookie-baking experience, I would likely have done almost the exact same things she did on her own.  This really proves that Michelle is fast on her way to becoming her own diet coach.   

It’s important to keep in mind that a big marker of Michelle’s progress is not when she stops making mistakes altogether, because everyone makes mistakes from time to time. The ultimate goal is for dieters to make mistakes and then recover from them right away and figure out how to handle the situation differently in the future, which is exactly what Michelle has done

In Session with Deborah: Tempting Treats

In my last blog post, I detailed a session I had with my dieter, Amy, in which we focused on her mindset and plan for her upcoming birthday.  When Amy returned for her session this week, we first discussed how things went on her birthday.  Amy reported that it had all gone “amazingly well” and that she followed her birthday plan exactly as it was laid out. 

Debbie: Last week we discussed some of the sabotaging thoughts you’ve experienced on previous birthdays.  The thought, “I won’t be able to enjoy my birthday if I stay in control of my eating,” seemed particularly strong. Did that come up this time?

Amy: It did, actually, when I was reviewing my plan before the guests came—I was thinking, “This just doesn’t seem like enough for my birthday.”

Debbie: And were you able to respond to that thought?

Amy: Yes, I did. I reminded myself that I still get to eat two pieces of dessert. . . that I’ll be full after two pieces anyway, and that I really don’t need more food, whether or not it’s my birthday.

Debbie: That’s great! Did reminding yourself about these things help?

Amy: It did, and I also read my Response Cards which helped.

Debbie: Great.  Were there other times throughout the night when you had sabotaging thoughts?

Amy: The only other time was after I had two pieces of dessert. I was looking at this really delicious cake that my sister had made and I was thinking, “I really want to have another slice. I know that cake tastes so good.”

Debbie: What did you do when you had that thought?

Amy: I excused myself and went to the bathroom to read my cards – again.  And I kept thinking, “You won’t be happy when you go to bed tonight if you eat more cake.  You’ve done so well all evening; don’t give in now.”

Debbie:  And so you were able to resist?

Amy: I was, and once everybody left and all the leftovers had been put away, I was really happy I did. 

Debbie: So, this may seem like an obvious question, but looking back – do you regret not eating more cake that night?

Amy: No! Not at all. And it was one of the first birthdays I can remember in which I went to bed not feeling stuffed. . . and instead, feeling really good about my eating. It was great.

Amy did really well on her birthday, although, as we predicted in our previous session, she did experience sabotaging thoughts.  However, because we had taken time in advance to formulate responses to possible sabotaging thoughts and she had taken the time to prepare before her party, she was able to effectively respond to them and not give in.  And, Amy experienced what most dieters eventually find to be true: once the event was over, she didn’t regret not eating more.  In fact, instead of feeling deprived, she felt proud of herself for the things she didn’t eat because she was able to go to bed feeling good about herself and her eating.

Amy next told me about a challenging experience she had later that week.  Two evenings after her birthday, she was reading before bed and found herself thinking about (and having a craving for) the leftover cake that she had wrapped up and put in the freezer after her party.  Amy told me that she struggled for a while about whether or not to give in to her craving, but ultimately her sabotaging thoughts got the better of her; she ended up going downstairs and eating a large piece of cake. 

Amy and I discussed this situation in more depth, including the sabotaging thoughts that led her to give in to a craving that night. Amy realized that one of her strongest sabotaging thoughts was, simply: “That cake was so good.  I really want to eat some of it right now.”  I asked Amy what her plan was supposed to have been for the leftover cake and she responded, “I don’t know, I hadn’t really thought about it.”  Amy and I discussed this further and we realized that one of the reasons she was unable to effectively respond to her sabotaging thoughts that night was because she didn’t have a plan for when she was going to enjoy the rest of the cake. Because she didn’t have a plan, she was unable to say to herself (something like), “Even though I want to eat the cake right now, I’m planning on having it tomorrow, and I can definitely wait until then. Besides, if I eat it tomorrow when I’ve planned to, I will be able to enjoy it so much more because I won’t feel guilty about it.” 

Amy and I then came up with a new rule for her: whenever she has a highly tempting food in her house, she is going to make a plan for when she’s going to eat it. We agreed that this will make it so much easier to resist cravings that arise at any one given moment, because she will know exactly when she does get to eat it. 

This session with Amy is a good example of the importance of both successes and challenging “slip ups”.  Even though Amy ended up giving in to a craving, we learned something very important from her experience. And we were able to figure out an important guideline for her which will help her handle similar challenges more easily in the future.