Slippery Slope

I hadn’t seen Ellie for several months. At our last appointment, she had been doing quite well, having lost 30 pounds in 7 months. She called me up one Monday, several weeks ago, because she had gained weight after a weekend of eating more than usual.

When we analyzed what had happened, it became apparent that Ellie had not only overeaten over the weekend, but that she had also gradually returned to some of her previous unhelpful eating behaviors. She had been on a slippery slope for about a month. For example, she was nibbling on food leftover from her family’s dinner plates. She was eating snacks standing up at the cabinet or refrigerator, instead of setting one portion on the table and sitting down to eat it. She hadn’t read her list of reasons to lose weight for a couple of months. No wonder she was having trouble!

Together we developed a plan of action. Ellie committed to reading a new Response Card (pages 20-21 of The Complete Beck Diet for Life) every morning. It said:

“I can nibble on leftover food and eat standing up OR I can continue to lose weight. I’m much happier with myself when I don’t do those things.”

Ellie also decided to go back to filling out a Success Skills Sheet (pages 274-275) every night for two weeks.

When Ellie called me this week, she was happy to report that she was once again easily using good eating habits and following her eating plan, and that she was continuing to lose weight. Now she knows precisely what to do in the future to get back on track.

Back to Maintenance Weight

Our veteran dieter, Brian, came in for a booster session this fall. He had maintained his sizable weight loss for over a year but had recently gained back 4 pounds. Because he had developed a general plan of what to eat everyday, he was no longer writing down meal plans and so wasn’t sure where the extra weight had come from. We discussed what he had been eating and asked him if he was doing any unplanned snacking.  Brian realized that over the past few weeks he had slowly started eating more snacks.  The problem was that as he became accustomed to eating more frequently, it began to feel normal to him to eat all throughout the day.  After a little while, Brian got into the habit of eating whenever he felt a little bit hungry or just felt like eating.  At first he didn’t even realize that he had made this shift because it was a gradual but steady process. He had stopped weighing himself daily, too, and the 4 pound gain came as a surprise.

We discussed with Brian all of the skills he had initially learned that helped him stick to his food plan:  telling himself “No Choice,” reminding himself that he would be eating again soon, that hunger is never an emergency, and that he can’t have it both ways – he can’t snack whenever he feels like it and lose weight and keep it off (Days 12 and 16 of The Beck Diet Solution).  Since maintaining his weight loss was still a very important goal to Brian, he knew that it was worth it to start practicing all of his skills again, including making food plans. 

For a couple of weeks Brian wrote food plans each night and made sure to include a reasonable number of snacks (Day 15 of The Beck Diet Solution Weight Loss Workbook).  Because he had practiced it so much in the past, Brian was able to stick to his food plans and cut out the unnecessary snacking he had been doing.  Brian reported that since doing this, the 4 pounds have come off easily.  But more importantly, not only is Brian back to only eating at planned times, but he has also proven to himself that if he does in the future gain a little bit of weight again, he has all the necessary skills and techniques to get back to his maintenance weight. 

Taking the Full Dose

Our relatively new dieter, Tammy, came in this week and reported that she’s been feeling reluctant to do several of the tasks in The Beck Diet Solution program.  She said that the tasks just don’t feel relevant to her and she doesn’t see the necessity of doing them.

This is something we hear from dieters from time to time: they don’t think certain tasks are necessary, they don’t want to expend the time and energy needed to do the tasks, they don’t feel like doing them, they don’t think they need to learn those particular skills, or they are actually scared to try. We tell these dieters the same thing we told Tammy: the fact is we don’t have a crystal ball. (Then again, neither does Tammy.) And it is possible that Tammy can lose weight without doing all the tasks, but who knows what the future will bring?  It’s quite possible that a task Tammy is avoiding now will actually be something she vitally needs in five or ten years. If she doesn’t learn the skills now, we predict she may have a difficult time maintaining her weight loss. We always tell our dieters that we’re not interested in helping them lose weight—we’re only interested in helping them lose weight and keep it off!

pills.jpgWe then asked Tammy to consider what she would do if she had a bacterial infection and her doctor prescribed her a course of antibiotics.  Tammy knows that if she wants to recover, she wouldn’t only take half of the medication prescribed; she would obviously take the full dose.  It’s the same thing with The Beck Diet Solution program.  Tammy needs to do all the tasks because otherwise she’s not taking the full dose and can’t expect the program to work properly. 

Here’s another way to look at it: If Tammy had a very bad headache, she wouldn’t take a quarter of an aspirin; she would take the full pill to maximize the chance that her headache would go away.  So, too, with the BDS program – again, she needs to take the full dose if she wants to be successful. 

With these thoughts in mind, Tammy realized the importance of doing all the tasks in the program and has a new resolve to do everything she can to take the full dose, because she is absolutely determined to finally be successful in losing weight and maintaining the loss. 

Making Decisions

During this week’s phone session, our dieter Liz told us how overwhelmed, stressed, and tired she’s been lately, especially since she and family members are experiencing health problems.  And for the past three weeks, Liz hasn’t been losing weight; she’s just lost and regained the same two pounds.  So we agreed to evaluate whether it’s reasonable for her to keep trying to lose weight at this time, or whether she wants to work on maintaining her already impressive 53 pound loss. 

We asked Liz to think about the past week which she had told us was “extremely difficult.”  We asked Liz whether it was difficult for every hour of every day, or whether there were some hours or even days that were easier (Day 24 of The Beck Diet Solution). One common trap many dieters fall into is letting the memory of a few hours from a few days tinge their sense of the entire week.  Liz realized that some mornings were easier than others, and that it was really a few difficult days, off and on, not the entire week. 

Liz reported that making food plans and trying to lose weight seemed like a big burden at the moment, on top of everything else she was dealing with.  We asked Liz to think back to the time before she started working with us. She realized that while she wasn’t making food plans then, she was actually quite burdened by her weight.

We then discussed her options.  It’s very possible that right now she does have too much going on and now is not the right time to keep trying to lose weight.  In that case, Liz can simply work on maintaining her weight and she can reevaluate her situation in a couple of months.  Or Liz can decide that in spite of everything, she does want to keep working on losing more weight, but either way the choice is hers to make. 

It’s important for Liz to make this decision because for the past few weeks when she’s seen the scale continue to go up and down two pounds, she’s been beating herself up about it and feeling down.  If Liz decides to maintain her weight, then she can feel good about always being within 2 pounds of her maintenance weight, instead of feeling bad about it.  And she can decide at any point to actively try losing again. Liz has decided to take the rest of the week to think it over.

Back From Our Travels

You may have noticed that we took a hiatus from the blog for two weeks. In addition to attending Thanksgiving and a family wedding in Tampa, we gave a series of workshops in California. Altogether, we were gone for 12 days in a row. It’s difficult to maintain your weight during holidays and special events and when you’re constantly hopping on and off airplanes and staying in a different hotel every night for 7 nights. But we did.

How did we manage? We’re committed to eating pretty much the same way 365 days a year. An important study by the National Weight Control Registry showed that successful maintainers are consistent eaters. Did we want to overindulge at Thanksgiving and the wedding? You bet we did. Did we want to pick higher calorie (and sometimes less healthy) meals at airports, hotels, and restaurants? Of course. But we didn’t, because we kept reminding ourselves that we wanted to be thinner and healthier. Was the restriction worth it? Absolutely. We felt good after every single meal and we felt great when we finally got home and stepped on the scale.

Now what works for us doesn’t work for everyone. Some dieters and maintainers do better if they plan in advance (Day 32) to have 300 or so extra calories a day at these times, but not more than that. They may gain a little weight, but that’s okay, as long as they eliminate those extra daily calories as soon as they return home. They have to be careful, though, that they don’t have too many special occasions at which they consume extra calories. And they have to be careful to plan to eat more, not just slip into eating more, since the latter strengthens their giving in muscle and weakens their resistance muscle (Day 11).

Anyway, it’s good to be back and we’ll continue to blog and let you know what’s going on.

Going back to Planning: Roxanne

About five months ago, Roxanne made the decision to stop losing weight and start maintaining.  Since making that decision, Roxanne has been able to stop writing down a formal food plan each night and instead just has a general sense of what/how much she’s going to eat each day.  Like most successful maintainers, this has been fairly easy for Roxanne because she finds herself eating basically the same type of things for breakfast and lunch each day, with the only big variations being at dinner time. 

Although Roxanne is no longer trying to lose weight, she still employs many of the same techniques and strategies she did while she was on the way down.  She still consistently reads her Advantages List (discussed on Day 1 of The Beck Diet Solution) and Response Cards almost every day, and certainly whenever she’s going into a high-risk situation like a party or a reception.  She still continues to weigh herself each morning and consistently makes a conscience effort to eat everything slowly, while sitting down, and to enjoy every bite (Days 3, 5, and 21). 

scale21.jpgBecause she weighs herself every morning, Roxanne has noticed that for the past two weeks her weight has been up a little bit.  Rather than ignore the weight gain and hope that it goes away, Roxanne had decided to take steps to get herself firmly back on track so a small weight gain doesn’t turn into a thirty pound gain.  For the next couple of weeks, Roxanne is going to go back to making a written a food plan each evening for the next day, so she’ll know exactly how many calories she’s taking in.  With this strategy in hand, Roxanne is 100% confident that she will get back down to her Lowest Maintainable Weight (Chapter 11). 

This is precisely what will enable Roxanne maintain her weight loss for the rest of her life.  Whenever the scale is up by three pounds, she’ll just go back to writing down a plan and sticking to it – a skill she learned how to do well while following the Beck Diet Solution program.  Because she weighs herself each morning, Roxanne never has to worry about gaining back a lot of weight because she will always know when a small weight gain has occurred and the steps she needs to take to correct the imbalance. 

Lifestyle Changes: Roxanne

buffet22.jpgRoxanne, who was now reached maintenance, recognizes that she needs to use the skills she learned in The Beck Diet Solution for life. At our meeting yesterday, she told us about a women’s retreat she attended over the weekend in which all meals were served buffet-style.  Unlike some buffets in which the food isn’t very good and quantity is valued over quality, Roxanne reported that this retreat is known for having excellent meals.  So how did she tackle this situation?

Roxanne made it much easier by establishing certain rules for herself:

 1) She started out each meal with a salad regardless of whatever higher-calorie appetizers her companions were eating

 2) She did a complete survey of the buffet before deciding what to eat for her main course, chose whichever three things she wanted, and took one plate of food – no seconds.

3) She decided ahead of time that she would allow herself one desert one night, and the rest of the time would stick to fruit.

Following these rules made eating at the retreat a relaxing and enjoyable experience for Roxanne.  She said that she didn’t struggle at all over the things she didn’t eat, and instead felt happy and in control, knowing that she would rather be thinner than eat out of hand (Day 33).  Roxanne says that in the past, she undoubtedly would have gone for seconds at every meal and eaten desert every night just because it was there, even if it wasn’t something she particularly enjoyed.  Because Roxanne has truly made these lifelong changes, her weight is remaining stable and she is confident that it will continue to do so. 

Lemon Cake: Carolyn

Carolyn has pretty much mastered the skill of working any food into her diet.  Unlike a lot of dieters, she doesn’t have foods that are completely off-limits, and she doesn’t have certain foods that she labels either, “good” or “bad.”  Instead, she has come to realize that any food can be eaten, as long as it’s worked into a daily plan (discussed on Day 2 of The Beck Diet Solution). 

lemon-cake.jpgOne of Carolyn’s favorite desserts is a special lemon cake she only buys at one store that she doesn’t get to very often.  Carolyn had thought she would go to this store on Friday and then plan the cake into her meal plan for Saturday, as a weekend treat.  However, Carolyn instead ended up going to the store and purchasing her lemon cake on Thursday, not Friday.  When she got home with the cake, Carolyn knew both that she would be very tempted by it and that she hadn’t planned to eat it until Saturday.  That night she was having all sorts of sabotaging thoughts that were urging her to eat the cake, “It’s ok to have just a small piece; it won’t really matter; it’s so good I can hardly resist.” (Day 25) Carolyn recognized, however, that even though she was craving it, it was important to not eat the cake, and not just because it would put her over her calorie limit for the day.  If she gave in and ate the cake, she would weaken her resolve to resist cravings in the future. However, if she answered back to her sabotaging thoughts and didn’t give into her craving, she would build both her resolve to resist future cravings and the confidence to know that she can withstand them (Day 13). 

Carolyn went immediately into the kitchen and put the cake on top of the refrigerator where she wouldn’t easily see it.  She also went and read her Advantages List and reminded herself why it was so important for her to resist the cake and lose weight.  She firmly told herself, “No choice, I am not going to eat the cake,” and within in minutes, her craving diminished.  After Carolyn used these techniques to strengthen her resolve, it was no problem for her to resist the cake on Friday as well.  She ate a piece on Saturday exactly as she had planned, and felt extremely happy and proud about it.

Reaching Maintenance: Carolyn

Week 32 of our diet group and the pounds continue to come off!  Our meeting on Monday was special because we were celebrating that now two of our dieters, Roxanne and Carolyn, have reached maintenance (discussed in Chapter 11 of The Beck Diet Solution). 

Carolyn, 57, had lost 18 pounds before coming to our group.  Since the group has started, she has not only maintained that weight loss but continued on to lose another 13 pounds.  Carolyn says that the reason she has been so successful is due to the fact that she has learned to make permanent changes in her lifestyle in regards to eating and exercising.  She says she doesn’t worry about gaining weight back because she will never go back to the way that she used to be.

Carolyn says that one of the biggest changes she’s made is learning to incorporate at least some exercise into her life each by taking every opportunity to do so (Day 9 of The Beck Diet Solution).  She now always parks her car in a far spot, walks the five flights up to her office, and routinely goes on a lunchtime walk, regardless of the weather. She now also practices much better eating habits, both at home and when eating out. 

buffet.jpgCarolyn went last week to an all-you-can-eat buffet with her family to celebrate a birthday.  “In the past I would have stuffed myself silly,” she says, “but this time was much different.”  Carolyn looked at all of the food options and then picked what she considered to be the best choices based on what was available (Day 30).  She took one plate that had a reasonable amount of food and did not go back for seconds, despite her husband’s urging.  Even though her husband told her she, “wasn’t getting her money’s worth,” Carolyn knew that in fact it was worth money to her not to overeat.  Carolyn left the buffet feeling satisfied and proud, and confident that this is a situation she can repeat in the future.