Ask the Diet Program Coordinator

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.

Ask the Diet Program Coordinator

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

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

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

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

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

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

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

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

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

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

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

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

Each of these items is explained below.

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

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

Are You a “Normal” Eater?

People who have never been overweight and have not had significant issues with their weight eat, think, and behave differently from chronic dieters. If you’re a chronic dieter, do you have a tendency to:

  1. “Graze,” i.e., eat a larger amount of food than you intended throughout part of the day, or binge-eat
  2. Feel a lack of control over your eating
  3. Try not to notice how much you’re eating
  4. Eat until you feel uncomfortably full
  5. Overeat and stop only when the food is gone
  6. Eat alone (maybe in secret) because you’d be embarrassed by how much you’re eating
  7. Obsess (think too much) about food throughout the day or evening
  8. Feel depressed, guilty, or disgusted with yourself after overeating
  9. Eat as a primary coping strategy when you’re upset
  10. Eat when you’re bored
  11. Significantly overvalue body shape and weight
  12. Weigh yourself more than once a day
  13. Become pre-occupied with how heavy your body feels or how tight your clothes are after meals or throughout the day
  14. Plan ahead so you never have to be hungry
  15. Avoid the scale when you think you have gained weight
  16. Feel unable to control what you order to eat or what kind of food you buy
  17. Make one “mistake” (i.e., “cheat”) and then eat with abandon
  18. Feel helpless when you gain weight
  19. Continually make exceptions to your eating rules
  20. Eat whenever you feel like it, regardless of your level of hunger
  21. Try to fool yourself about the amount you consume or the consequences of your consumption
  22. Skip meals to lose weight
  23. Outlaw certain foods completely

These characteristics are generally not shared by “normal” eaters and they can make it difficult to lose weight—or to keep it off. You may be able to curb these tendencies for a period of time, especially if you’re highly motivated. But chances are you will revert to these behaviors at some point and regain weight—unless you learn a different way of thinking and eating that allows you to make permanent changes in your behavior.

Planning to Eat More and Gain Weight

Julie was feeling disgruntled. She was tired of following her eating plan. “You know, I’m still pleased when I get on the scale every day. But now I’ve been maintaining my weight for the past year and a half. It’s not a thrill like it used to be.”

I asked Julie what was the hardest part of sticking to her maintenance diet.  “I’m just tired of what I’m eating. I want to eat more. I want to eat different things for lunch and dinner. I want to have a glass of wine when I go out with friends and dessert every night. I want to have an afternoon snack, like pretzels or crackers or chips. But I know if I do,” she said glumly, “I’ll gain weight.”

Julie and I reviewed her food intake on a typical day. It looked as if she were eating about 1600 calories per day. “What would you think,” I asked her, “about making just one change for this week, instead of all the changes you want all at once. You could plan to eat 200 extra calories each day. Today, for example, you could have a higher calorie lunch. Tomorrow you might want an afternoon snack. The day after that, you might want dessert. Or maybe you want to have dessert every night and keep everything else the same.  You could try this for a week or two, and see how it goes. If it’s going well, you can keep on doing it. If you’re still unhappy, you could add another hundred or two hundred calories.

“But I’ll gain weight, won’t I?” she asked. “Yes,” I replied. You will. But it will probably only be a few pounds. And you might decide it’s absolutely worth it. I know you were proud when you lost 47 pounds. But what’s the big deal if you gain back three or four pounds and maintain there? There’s nothing magic about the number 47. And if you can feel more satisfied at a slightly higher weight, why not go for it?”

Julie decided to go for it. Over the next few months, she gradually added more calories to her daily diet. But she didn’t slip into it. She made conscious decisions to eat more and she planned in advance how she would use the extra calories. Her weight went up by 4-5 pounds and there were a few outfits that became too tight. But she recognized that it was worth the trade-off. She was happier being able to have more variety in her diet.

Regaining Weight

Many dieters and maintainers are mystified when the scale starts to go up. “But I’m doing everything the same!” they usually proclaim. That’s when I ask them a series of questions to try to figure out what has changed:

  • Are you taking any new medication?
  • Are you eating all your food sitting down, slowly, and enjoying every bite?
  • Are you eating at others’ houses or in restaurants more often—or doing take-out?
  • Have you been traveling or going to special events that involve food?
  • Have your portions slowly become larger?
  • Have you added more food to your daily intake? For example, are you having an extra snack? Have you added an extra side dish to a meal?
  • Are you drinking more alcohol or caloric beverages?
  • Are you getting less exercise?

What often happens is that dieters/maintainers either start to eat out more or get a little looser, or both. They allow themselves to make changes, such as eating grapes straight from the refrigerator or adding more ingredients to a salad, without reducing their intake elsewhere. They “get away” with these changes for a short period of time—the scale may not go up initially and they start to think, “I guess I can eat a little more.” Then they slowly increase their food intake in other ways. But biology always catches up with them. Take in more calories than you expend and you WILL gain weight. 

There is always a reason why the scale has gone up, even if we can’t figure it out. But if it goes up and stays up, dieters/maintainers need to go back to carefully monitoring everything they eat (and they need to monitor their exercise, too). They may decide that they like being able to eat a little more and are willing to maintain at a higher weight. This is a perfectly reasonable decision, if they are in good health. But they should make a conscious decision to do so, and not let a lack of vigilance lead to continuing weight gain.

BACK TO BASICS

 

Marta was dismayed. After 20 months of maintaining her weight loss with relative ease, she had gone off track and had gained back five pounds.

 

“I wouldn’t mind it so much if I had decided in advance to eat more,” she said, “but that’s not what happened. A couple of weeks ago, we had company for the weekend. I was fine at first, but then everyone else was eating and drinking so much, that I wanted to, too. I just stopped using my usual weekend plan. So by Monday morning, I had gained two pounds. I felt really bad about that, and I was okay for the next couple of days. But then, for some reason, I started snacking too much after dinner. I’d have that old sabotaging thought, ‘I’ve eaten too much. I might as well start again tomorrow.’ I didn’t go way overboard the way I used to, but I did eat more than usual for the rest of that week and this week, like larger portions at meals, bread and butter at dinner, and extra snacks at night. I keep promising myself that I’m going to get back in control but I can’t seem to do it. My weight is up and I’m afraid I’ll just keep gaining more.”

 

Marta and I talked about the two choices she could make:

 

  1. She could plan to eat extra food, including bread and butter at dinner and an extra snack at night. It would be planned eating, though, not spontaneous deviations from her plan. Depending on how many extra calories she planned to have, she might gain a little more weight, plateau at her current weight, or lose a little.
  2. She could go back to her previous plan and lose the five pounds she had gained.

 

Either plan was completely legitimate and either way, she’d need to go back to practicing her daily CT skills (e.g., reading her Advantages Deck and Response Cards right after dinner, going to her Distraction Box if she felt the urge to eat unplanned snacks).

 

Marta called me several days after our “booster” session. She was back on track, felt in control, and didn’t need another appointment. I asked her what had made the biggest difference. She said going back to the basic CT skills had done the trick.

How to Keep Your Weight Loss Resolution

 

If you want to be successful, DON’T START OUT BY DIETING! In my experience, the major reason that people have difficulty losing weight or keeping it off is that they jump right into following an eating plan before they have learned how to diet.

           

Almost anyone can lose at least a little weight; you don’t necessarily need dieting skills to do so. But you do need these skills if you want to continue to lose weight and keep weight off. You need to learn exactly what to do when dieting gets harder. And it does get harder—for everyone–sometimes within the first week or two, sometimes not for a month or two. People often give up because they don’t have the skills to push through the difficult times. Then they regain whatever weight they have lost.

           

 If you’ve only sailed a boat in calm waters, you don’t want to leave on an extended trip without knowing what to do when the going gets tough. You might be able to navigate well when the ocean is calm, but look out if the weather gets rough! You need to learn foul weather skills in advance.

 

It’s the same with dieting. You don’t want to run into a rough patch and be ill-equipped to handle it. You need to learn, before you run into a squall, how to motivate yourself when you’re feeling unmotivated, how to refocus your attention when you have a craving, how to stick to a plan when you’re eating out, and how to get back on track immediately when you make a mistake. These skills are not intuitively obvious, but they can be learned in a step-by-step program. It’s too difficult for most people to focus on changing their eating while they’re learning these skills. That’s why I recommend postponing the start of your diet until you know what to do in stormy weather.                       

Dieters Need a Complete Diet for Life

I’ve been bombarded with questions about how my new book, The Complete Beck Diet for Life, is different from my first diet book, which did not contain a diet (eating plan) but did contain a six-week program to teach people how to diet. Most obvious is that the new book has a healthy eating plan that is flexible and enjoyable so people can modify it and stay on it for life.

Why did I include a diet? After publication of the first book, I received a couple of thousand emails and read a couple of thousand postings from online support communities who were following the program. I found that a cognitive behavioral approach just wasn’t enough. Although I urged people to find a healthy, well-balanced, nutritious diet, I found that people weren’t following that advice. They were choosing fad diets, unbalanced diets, diets that didn’t include their favorite foods, diets that allowed them to skip breakfast, diets that incorporated way too many carbs (and not enough foods to satiate their hunger), diets that were unnecessarily restrictive in choices or provided too few calories. Inevitably, dieters would stray from their eating plan, gain weight, get discouraged, and give up—then, after a few days or months, would try again with another inadvisable diet, and the cycle continued.

I also found out that many dieters should ease into making changes in their food intake, for example, changing just one meal at a time. They need to be guided in modifying a basic eating plan so it suits their tastes and lifestyles. They need to learn how to handle challenging eating situations where they don’t have control over the food that’s available or where others are pushing food on them. They especially need to learn exactly what to do when it’s not time to eat but they’re experiencing hunger, cravings, or want to soothe their distress with food.

In short, to be successful, dieters needed a complete program for weight loss, that incorporates a psychological approach (e.g., what to do when you’re feeling discouraged, disappointed, or deprived), dieting skills, an enjoyable eating plan, and techniques for keeping motivated for life. Most people think that just following a diet will be enough. I had previously thought that just learning essential skills was enough. But now it’s apparent—you need both.

Why Is It So Hard to Throw Away Food?

Some dieters are so surprised when I suggest that throwing away food is an essential skill for long-term success (pages 82-83 of The Complete Beck Diet for Life). Stella told me that she usually nibbled on the food her children left on their plates and on the small amount of food left in serving dishes. “It’s only a little,” she would rationalize. “I don’t want it to go to waste.” We discussed this problem one day in session.

First, I re-introduced the notion that eating food she hadn’t planned to eat in advance was strengthening her “giving-in” muscle, which meant it was more likely that the next time she would give in and the next and the next. It wasn’t so much the calories (two fries and a bite of hamburger aren’t terribly caloric) for any one instance of eating food from their plates, it was the habit.

Second, we talked about the concept that the food was actually going to waste in her body. The only way the leftover food wouldn’t “go to waste” would be if she wrapped it up and gave it to someone who truly needed it.

Third, I asked Stella if she could think of someone who had a different view about wasting food. Stella told me that her husband who would never even think about eating from their kids’ plates as he cleared the table or taking the last two tablespoons of mashed potatoes from the serving bowl if he had already finished eating.

Fourth, we looked at the impact of her ideas about wasting food. Stella was able to see that her habit had probably added pounds to her weight in the past few years and would likely continue to do so.

Fifth, I helped Stella see that although her mother had imparted many valuable lessons to her when she was young, the idea “throwing away food is a sin,” wasn’t one of them.

Sixth, I asked Stella about her children:

Dr. Beck: Do you want your kids to grow up with the idea that throwing away food is a sin? Do you want them to feel badly if they don’t clear their plates? Do you want them to have to fight the urge to finish the family’s leftovers?

Stella: No!

Dr. Beck: What do you want them to believe?

Stella: That they should eat reasonable portions of food and stop, not eat while they’re clearing the table.

Dr. Beck: And how about you?

Stella: Okay, I see it now. I shouldn’t do it either. It’s really just an excuse, anyway. I know I should stick to my plan.

Finally, we did some problem-solving. Stella decided to have her children put their own plates in the dishwasher and take turns wrapping up leftovers. A couple of weeks later, she reported that she had completely broken herself of the habit.