Not enough is written about maintaining a weight loss, and this is a problem because for most dieters, that’s where the real work begins. Losing weight is unquestionably difficult but it comes with enormous positive reinforcement – watching the scale go down, fitting into clothes, getting compliments, etc. Weight maintenance has many fewer new and motivating milestones and it becomes about getting ourselves to keep doing what we’re doing, even though most of the excitement has passed. Read more
This week I had a session with my dieter, Rachel, whom I previously hadn’t seen in about eight months because she no longer needed weekly sessions. Rachel got in touch with me because she noticed that her weight had gone up a few pounds and so we agreed that we would have a session or two to help her get completely back on track.
In session, the first thing I did was give Rachel lots of credit because she was able to recognize that she was slipping in places (which was causing her to gain weight) and she faced the problem head-on, instead of waiting a few weeks or months or more (which could easily have turned a 5 pound weight gain into a 15 pound or more weight gain).
Rachel and I then discussed what things she had led slide lately and what old habits had been slowly creeping back. Here are the areas that Rachel identified as needing work:
1. Eating standing up. Instead of really being aware of everything that she was eating and making it a priority to eat sitting down, Rachel realized that she had lapsed back into eating while she was cooking, while she was clearing the dishes, and while she was making her kids’ lunches. While it wasn’t a whole lot of extra food, it certainly did start to add up at the end of the day/week.
2. Snacking with her kids. Before we began working together, Rachel would always snack with her kids and eat whatever they were having, without really thinking about it. One of the changes we had instituted was that Rachel had specific snack times during the day when she would have healthy snacks, not the crackers and snacky foods her kids ate. Rachel realized that she had slowly started getting away from deliberate snack times and had again started to eat whatever and whenever her kids did.
3. Eating whenever she felt hungry or just wanted to eat. Another change that Rachel and I had worked on was helping her overcome her fear of hunger and eat at specific times, to ensure that she didn’t overeat during the day (which was a risk because she worked from home). Rachel told me that she had started to do things like go into the kitchen whenever she felt like eating and having something, instead of waiting until her next meal or snack.
4. Keeping serving bowls on the table at dinner. Rachel had also decided a while ago that it was best to not keep big serving dishes on the table during meals because the extra food would tempt her and she would often end up having seconds, even though she didn’t need them. Removing the serving bowls enabled Rachel to just concentrate on what was on her plate and not constantly fight against the temptation to have more. Rachel realized that over the past few months, serving dishes had reappeared on the dinner table, which meant that Rachel sometimes took and ate more food than she needed.
Rachel and I then discussed exactly how she would get herself to correct these old habits and fortify her new, helpful habits. We also reviewed Rachel’s Advantages List and all of the wonderful benefits she has already experienced from losing weight, so that Rachel would remember exactly why it was worth it to her to get herself back in line and how much better she would feel as a result of doing so.
Question: I have read the book, re-read parts, and implemented the techniques but the scale is not budging. I have stayed within the same 2 pounds for at least 3 months – even with exercising 5-6 days per week and cutting my calories. I am afraid the answer may be to accept this weight and call it maintenance because I cannot see adding more exercise or decreasing calories as I am already doing what I think is the most I can. BUT- I am not totally comfortable at this weight and I only have about 10 pounds to lose to be at my ideal weight. Any feedback would be appreciated.
Answer: I first want to tell you about our concept of ‘ideal weight’ – it’s the weight that you get down to when you’re eating and exercising in a healthy way that you can maintain. Now this weight may not the weight of your thinnest friend, it may not be the weight you were at in college, and it almost definitely isn’t the weight of the celebrities we see on television. In our minds, your ideal weight is the weight that you can get down to and stay at, not the weight that you can get down to, then gain some weight back, then work on losing it again, then gaining it back again. We just don’t believe that it’s worth getting down to a weight that you ultimately can’t maintain (by either exercising or eating in a way that is not sustainable) because you’ll just gain it back and then feel very discouraged.
It’s also important to know that most people, when they lose weight, get down to what we call their lowest achievable weight. However, most people don’t stay there! They eventually end up relaxing their habits just a bit and gaining a few pounds back and end up leveling off at we call their lowest maintainable weight. Their lowest achievable weight is probably not their lowest maintainable weight because it would require intense focus on their eating and exercise.
Without knowing the specifics of your situation, it sounds like you likely are right around your ideal weight (in the way we define it), and at either your lowest achievable or lowest maintainable weight – it’s hard to tell at this point. Remember, losing weight is basically a matter of calories in and calories out. So could you lose more weight? Of course you could if you cut your calories really low and/or exercised an abnormally high amount. But those things are never maintainable, so it’s not worth it because the only thing that will happen is you’ll get down to a weight that you can’t maintain.
All this being said, it doesn’t mean you have to be at all unhappy with where you are now. In fact, you should be extremely proud of yourself for the weight you did lose and for all of the hard work and dedication you put into it. Instead of focusing on the 10 pounds you didn’t lose, think instead about all of the weight you did lose. Even if you’re not quite at the weight you wanted to get down to starting out, think about what life was like at your higher weight and before you really gained control over your eating. My guess is that life is different and better now in so many ways. Do you feel better about yourself? Are you fitting into more clothes? Are you happier with what you see in the mirror? Can you do more activities and/or do them more easily? Are you less self-conscious? Do you have fewer aches and pains? Is your health at all improved? Do you feel less at the mercy of hunger and cravings? Do you no longer fear going into situations in which there will be a lot of tempting food? Do you feel better about your ability to exercise?
Likely you’ve already experienced many benefits of losing weight, and it’s important to recognize them. You can also ask yourself: How would my life really be different if I lost another 10 pounds? Would the differences be so significant? Is it possible that I’m already experiencing many of the things I wanted to achieve, even though the number on the scale isn’t what I initially had in mind? It sounds like it may be worth working on changing your concept of your own ideal weight, feeling proud about where you are, and move forward appreciating all the wonderful changes that have come about as a result of losing weight.
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
We received the following letter a few weeks ago from Kari, a woman who read and followed The Beck Diet Solution. With Kari’s permission we are posting her story because we have found it incredibly inspirational and think others will, too. Kari’s story reminds us that, while dieting can be difficult, the payoff of doing so is amazing and absolutely, 100% worth the effort. Like many dieters, Kari has found that learning to take control of her eating has also enabled her to take control in other areas of her life, too. Congratulations on all your hard work, Kari!
(P.S. We’d love to hear your stories, too!)
October 5, 2011
Dear Dr. Beck,
I knew I had experienced transformation, but it didn’t really hit me how dramatic the change was until I saw these two pictures next to each other on my computer!
Thank you for writing your books and helping me to give myself the 40th birthday present that I really wanted. When I turned 39 on Oct. 23, 2010, I said that by the time I turned 40 I wanted to be a healthy weight. Well, I’m about to turn 40 and I am now in the “normal” weight range, thanks to using the skills I learned in your books.
I am a musician and losing weight has made performing so much easier and a lot more fun. I have so much more confidence because I feel great. But also, and perhaps more importantly, I’ve learned how to help myself stay on track with not just dieting, but practicing music, budgeting money, and other areas that I would like to improve.
The Beck Diet Solution is an incredible tool, and I am so glad that I had the good fortune to discover it! No other diet I tried could take me all the way to goal – yours was the only plan that covered every single hardship that I might face and taught me how to plan for those times. Your diet plan was the only one that taught me how to tailor the program to my own circumstances – from planning the food I liked to creating my own responses to my specific sabotaging thoughts and behaviors. Your plan was the only one who dealt with the reality of food pushers, traveling and getting off track. I liked learning how to count calories because it gave me the knowledge I needed to know to deal with meal planning, restaurants and parties. If I had times when I cheated, I knew how to analyze the situation and plan to avoid that pitfall again. The Beck Diet Solution is a sensible, comprehensive approach that really works!
I have been on the plan for a little over a year now, and I just recently made new “advantages” cards. When I looked back at the previous year and compared it to my current cards, I could see how much I’ve matured as a person because of following your plan. I really feel that your approach helped me to become more conscious of myself in so many areas of my life – not just how I look or feel physically, but how I greet life in general now on an emotional level. I now notice distorted or sabotaging thoughts about other things, not just food, and I can talk back to those as well.
Anyway, I can’t thank you enough. You’ve changed my life and I know there are positive ripple effects to the people around me. I hope everyone who has a desire to lose weight will find your books and experience the amazing transformation that I have.
Thank you again!
Q: Now that I have lost weight, I’m finding that my motivation to stick to my diet is lessened and my Advantages List and Response Cards don’t have the same strength/power to keep my motivated. Why is this? What can I do?
A: Good question. We find that this sometimes happens to dieters – they are overweight and very unhappy about it. They learn the necessary cognitive and behavioral skills and they lose weight. Their life and health gets better. They keep practicing their skills and eventually they become used to their new look and size. And, most importantly, they (for the most part) really forget the reality of their daily life before they lost weight and the countless ways that being overweight is difficult.
When this happens to dieters, especially if they tell us their Advantages List is not really helping, the first thing we have them do is sit down and do a visualization. We ask them to think back to a time before they started losing weight and see themselves going through a typical day. We ask them to think about:
• What are you wearing?
• What do you wish you could be wearing?
• How easily or not easily are you moving around?
• Are you able to exercise comfortably and without being self-conscious?
• Do you have any sharper aches and pains?
• How is your health? Are you at higher risk for any illnesses or diseases?
• What are you eating?
• Are you feeling good about what you’re eating, or does eating certain foods cause you guilt?
• Do you feel in control of your eating?
• Are you often engaging in the uncomfortable “should I/shouldn’t I” struggle about eating things?
• How do other people look at you?
• How do you feel about yourself?
• Do you have a sense of pride in your appearance?
• Do you feel comfortable interacting with other people, either professionally or personally, who are a smaller size than you are?
• Are you setting a good example for your children?
• Do you feel comfortable being intimate with your partner?
• Are there things you are doing that day that you don’t have to do now?
• Are there things you do now that you weren’t able to do that day?
If dieters are able to do this effectively, it should help remind them of all of the small and big reasons it has been worth it to keep working on implementing their skills consistently. When we ask dieters if they would rather stop implementing their skills and return to how things used to be, 100% of the time we hear a resounding “NO!”
We also discuss with dieters the fact that, in the beginning, dieting was likely very hard for them because they were learning all of these skills for the first time. Eventually it got a lot easier and they were able to implement them consistently. But the truth of the matter is, from time to time dieting gets more difficult, which then causes motivation to lag, which then causes dieting to get even harder. We remind dieters that harder periods are completely normal and they happen to everyone. The biggest shame of all would be if dieters gave into a harder time and used it as a reason to give up, telling themselves, “This is too hard, I don’t want to do it anymore.” What dieters need to know is that as long as they keep working at it, dieting will get easier again. It always does.
So what can they do in the meantime to help make this difficult period go by faster?
1. Make a new Advantages List. By this point you’ve probably stopped reading it every day, and that’s fine. But as soon as dieting gets more difficult it’s important to start reading one every day for a period of time. Likely your old Advantages List will not be as compelling anymore because you’ve been living those advantages for a while. Use the visualization technique we mentioned to think about some new advantages you haven’t been paying attention to lately (maybe you forgot how you used to hate it when people looked at what you bought at the supermarket, or how you didn’t like to eat in social situations where everyone was of a smaller size than you, or how you used to worry that you were setting a poor example for your kids).
2. Make new Response Cards. Take time to identify what sabotaging thoughts you are having in regards to continuing to practice your dieting skills and write down strong responses to them on cards. Read these cards every day until dieting gets easier again.
3. Visualize. For a few days, take a little bit of time and again think about how your life was different before you lost weight. Ask yourself how it would feel to get back there and whether or not practicing your skills, while not always fun, are actually less of a burden than being overweight.
4. Remember. There are a few things that dieters often lose sight of once dieting gets tougher. One of the biggest ones being that when they were eating whatever they wanted whenever they wanted, often they were doing so without a sense of complete control and it did not feel good. Making healthy choices and feeling control of your eating feels so much better than constantly feeling bad about what you’re eating. Remember how it used to be and then remember how it is now.
Q: How do I get myself back on track after I slipped up on my diet and not just give up? This is something I have really struggled with over the years and has stopped me from keeping off any weight that I lose.
A: You’ve hit the nail on the head because being able to recover from mistakes right away is one of the most important skills needed for permanent weight loss. Our most successful dieters are not those who never make mistakes (because, let’s be real, we’re all human and we all make mistakes), but those who can get themselves back on track right after. How do we teach our dieters to do this?
One of the first things we do is help dieters identify and respond to their sabotaging thinking about making mistakes. Usually after they slip up they are having thoughts in one of two categories. Either they’re thinking something along the lines of “Oh I’ve really screwed up this time, I guess it means I can’t do this,” and having a lot of defeatist thinking, or they’re tell themselves “Since I made a mistake today I might as well just continue eating and get started back on my diet tomorrow,” and are having a lot of ‘fooling themselves’ thinking.
For those in the first category, we remind our dieters that one mistake does not mean that they’re a total failure but it would be a failure if they used that as an excuse to give up completely. We help dieters to see that if they were learning a different skill, like how to play the piano, they would not think that hitting one wrong key meant they should give it up completely because they wouldn’t have the expectation of being perfect; rather they would most likely just take it as a sign that they need to practice the piece more to get it right and learn from their mistakes.
Often dieters have years and years of failed dieting attempts behind them so it makes sense that they would catastrophize about a mistake because in the past it might very well have derailed them. We help dieters learn to forgive themselves for making a mistake, which then allows them to be able to look at the situation more objectively so we can learn from it. Frequently dieters make mistakes because they weren’t properly prepared ahead of time and weren’t able to respond effectively enough to sabotaging thinking in the moment. We help dieters figure out how they can be more prepared for similar situations in the future and what new responses they need to formulate and practice. The truth of the matter is that mistakes can be extremely useful because we can learn invaluable things from them which helps prepare the dieter for future successes. So, no, one mistake never means total failure unless dieters allow it to become that way and they are a natural and unavoidable part of the learning process.
For dieters in the second category, we help them realize that the thought “I’ll start again tomorrow” makes no sense because it’s not like at a certain point the calories stop adding up. One mistake, like eating a piece of unplanned cake, will probably not show up on the scale at the end of the week. However, one piece of cake, a bag of chips, a donut, and a piece of pizza probably will. And one piece of cake, a bag of chips, a donut, a piece of pizza, some candy, ice cream, chocolate, etc etc definitely will so the sooner they can get themselves back under control the better. We always tell dieters that there’s no such thing as blowing it for the day because at ANY point they can decide to draw the line and get back on track.
We discuss with dieters the fact that there are very few (if any) other areas in life where people think it makes sense to compound one mistake with another. We give dieters the red light analogy: imagine you are driving in your car, run a red light, and get pulled over by a cop who then gives you a ticket. You wouldn’t think, “Well I’ve messed up today, I might as well run red lights for the rest of the day and then start driving carefully again tomorrow.” No! You would stop at the very next red light and get on with your day. Dieting is the same thing – one mistake never justifies continuing to make more. Another analogy I like is reminding dieters that if they fell down a few stairs, they wouldn’t say “screw it” and then throw themselves down the rest of the flight of stairs. Of course what they would do is pick themselves back up and walk down the rest of the way. Continuing to eat off track once dieters make a mistake is like continuing to run red lights or throwing themselves down the rest of the stairs – completely irrational.
We also help dieters realized that the thought “I’ve messed up so I might as well just give it up for the day,” is a classic example of all-or-nothing thinking. All or nothing thinkers see situations as completely one way or the other, not realizing how much middle ground there is in between. All-or-nothing dieters think that they are either completely perfect on their diet, or they are totally off of it, not realizing that dieting is never black or white because everybody makes mistakes. We examine with dieters the costs and benefits of continuing to hold onto this all or nothing thinking, and help them make cognitive shifts away from it.
Lastly, we remind dieters that thinking they’ll just start again tomorrow has NEVER helped them to lose weight in the past and keep it off. And a lot of times it doesn’t work that way and it may take dieters several days or months to get themselves back on track. The sooner they can recover from mistakes the better and they never have to wait until the next day/month/year to do it. Dieters often need many, many experiences of getting themselves right back on track to prove to themselves that they can do it effectively. And the more times they successfully get back on track, the more confident they become and the easier it is to do the next time. As I said in the beginning, ALL successful dieters and maintainers make mistakes, they just recover from them right away.
How often have you noticed that formerly normal weight people have gradually gained weight throughout the years? Or dieters who have lost a significant amount of weight and then gained it back quickly? Should people even try to lose weight at all? The answer is yes, if they are already having weight-related health problems or if they are putting on extra weight every year and so are likely to have health problems in the future. On the other hand, studies that have examined how much weight people are able to lose and how much they are able to keep off long term are fairly dismal. Most people gain weight back. Here is a sure fire formula for gaining weight:
- Lose weight quickly.
- Go back to your old way of eating when you lose weight.
- Continue to eat and exercise exactly as you have been as you get older.
- Eat in the way “everyone else” is.
- Make excuses for why it’s okay to eat when you shouldn’t.
Each of these items is explained below.
- Lose weight quickly: One of the best ways to gain weight quickly is to drastically cut your calories. Research shows that the faster people lose weight, the faster they tend to regain it.
- Go back to your old way of eating when you lose weight: It’s plain biology. If you lose weight on 1200 calories a day, for example, and then your weight plateaus, you will start to gain weight back once you go up to 1300 calories a day. That’s the equivalent of one good sized apple or four crackers. And if you return to eating 2,000 or 3,000 calories, as perhaps you did before, of course your weight will increase.
- Continue to eat and exercise exactly as you have been as you get older: It seems unfair, but it’s true. Metabolism tends to decrease with age. If you don’t start eating less and/or exercising more, you’ll gain weight. Now it’s reasonable to gain a little weight, especially if you’re eating in a healthy way, but those pounds can really add up as the decades go by.
- Eat in the same way you assume everyone else is: It’s possible that you know the rare person who can consume a great number of calories a day and not gain weight. But it’s more likely that the people you know (especially if they’re over 40), are either restricting their eating in some way or are themselves gaining weight each year. In any case, it’s irrelevant. If you don’t want to gain weight, you’ll need to figure out what’s right for you to eat—which isn’t necessarily right for another person.
- Make excuses for why it’s okay to eat when you shouldn’t: Your body processes calories in exactly the same way, regardless of circumstances. It doesn’t care if you’re stressed, tired, or celebrating; if it’s a special occasion; if no one is watching you eat; or if the food is free. It may be reasonable to plan in advance to eat a little more in some circumstances but understand that if you don’t compensate by exercising more or cutting an equivalent number of calories another time, you will gain weight.
It seems unfair. It’s so hard to lose weight and so easy to gain it back. But once you learn the cognitive (thinking) and behavioral skills you need, the process of losing and maintaining a weight loss (it’s the same process!) becomes much easier.
The Beck Diet Program was developed by Dr. Judith S. Beck with Deborah Beck Busis, LCSW.
Beck Institute for Cognitive Behavior Therapy is a leading international source for training, therapy, and resources in CBT.
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