A realistic strategy is the most important thing to bring on vacation. Eric lists the Sabotaging Thoughts and responses to help him stay on track.
Recently I had a session with my client, Jenny. Among others skills, Jenny and I are working on her not having dessert before dinner. In session, Jenny told me that she was distressed because although she was able to resist dessert before dinner, on many occasions she was really tempted earlier in the day and wanted to give in. “I shouldn’t be having these thoughts!” she said to me. In a previous session, Jenny had told me that she had committed to going on a run with a friend one day after work. Although she was really tempted to cancel, Jenny ended up going. I reminded Jenny of this during our session and I asked her, “Did you feel really bad about having thoughts about cancelling the run?” Jenny thought about it and said that, no, she didn’t feel bad about it. Read more
Since getting back on track, one of the hardest things for Jamie has been to try to eat things without too many distractions. She has a very busy professional life and (especially during lunch time) she does not want to take a break from what she is doing to eat and will often try to work and eat simultaneously. In session Jamie told me that the day before she was reading a research article while she was eating her prepared soup and sandwich. Since the article was somewhat hard to understand and took a lot of concentration, most of Jamie’s focus was going towards that.
After about three minutes Jamie tuned back into what she was eating and realized that she had eaten just over half her lunch and had barely noticed or tasted it at all. Jamie immediately became annoyed and chastised herself, saying “You should know better than this. I can’t believe you just ate half your lunch without paying any attention to it.” However, Jamie told me that as soon as she noticed what she was saying to herself, she thought about to things we had discussed in other sessions and reminded herself that beating herself up for mistakes will serve no positive function at all. She knew that the only thing it would do would be to make her feel worse and erode her confidence, which might then make it harder to get back and stay on track the rest of the day because it would cause her to doubt whether or not she was capable of it.
Jamie told me that she realized that what she had to do was take a moment to re-group and get over the fact that half her lunch was now gone, learn from the experience, and do things differently next time. Jamie then turned off her computer monitor and made sure that she ate the rest of her lunch slowly, while noticing and enjoying every bite. Jamie was once again reminded how crucial it is to enjoy ever y bite because she ended up feeling satisfied at the end of her lunch, but knew that she would not be feeling this way if she had continued to mindlessly eat while reading the article.
In session I gave Jamie a LOT of credit for being able to make a mistake and then recover from it right away. We discussed the fact that even successful dieters and maintainers make mistakes (because no one is perfect), but the difference is that they are able to recover from them immediately. Jamie and I also discussed how much confidence this situation gave her because she proved to herself that she could make a mistake, identify and respond to her sabotaging thinking, and get right back on track. I pointed out to Jamie that this situation is also interesting because it started out as something that could have made her feel bad and guilty – eating half her lunch without noticing or enjoying it – and because she was able to recover right away it actually ended up making her feel really good about herself.
Jamie and I also did some problem-solving and she decided that until she was able to split her focus better, for the time being she would work on not doing anything distracting while eating lunch and would instead focus on enjoying her eating. I helped Jamie formulate responses to some sabotaging thinking we predicted she might have about taking time away from work to eat so that she would be able to strongly remind herself just why it was worth it to turn off her computer monitor and take time to ensure that her lunch gave her both physical and psychological satisfaction.
Breakfast is often touted to be the most important meal of the day. Your mother may have told you that, but if you’re like many people, you skip it anyway. Recent research now backs up your mother’s advice. The conclusion of researchers at the University of Missouri who studied the topic is that people who eat a balanced breakfast, especially one high in protein, experience less hunger throughout the day.
The dieters in our cognitive behavioral program for weight loss and maintenance often come in skipping breakfast. They say they don’t have time; they aren’t hungry in the morning; they would rather save their calories for later in the day. First we provide them with psychoeducation about the importance of eating breakfast. Second, we do problem-solving to help them find the time. Third, we help them respond to sabotaging thoughts that are likely to get in the way of their adopting this new habit.
When dieters say they don’t have enough time in the morning, we discuss which a.m. tasks they can omit, postpone, do the night before, delegate to other people, or spend less time on (at least temporarily, until breakfast becomes an easy routine). Sabotaging thoughts often get in the way:
- I don’t want to get up earlier.
- I can’t leave dishes (even rinsed ones) in the sink.
- My (adolescent) kids won’t like it if I ask them to make their own lunches.
- I’d rather pick out my clothes in the morning.
- I can’t ask my husband to help out with the kids.
We help them create written responses to these kinds of thoughts that remind them that it’s unrealistic to believe that continuing to skip breakfast will lead to success—after all, it hasn’t in the past. There may, in fact, be a physiological reason why people who struggle to lose weight tend to eat too much later on in the day. And the changes they make to free
When dieters say they aren’t hungry in the morning, we try to find out what times during the day they are hungry, and what their eating patterns are like. They often have the sabotaging thought:
- I’m not hungry in the morning and I’d rather save my calories for later in the day.
Upon questioning, we invariably find that these dieters consume most of their calories in the evening, often eating right up until they go to bed. No wonder they’re not hungry in the morning. But according to research (and our own clinical experience) skipping breakfast may indeed lead to less control over eating later on. We ask them to do an experiment for at least a couple of weeks: eat a protein-rich breakfast and then monitor their day and evening eating. Almost everyone ends up with the same conclusion: eating (a balanced) breakfast really helps them eat more reasonably for the rest of the day. It turns out Mom was right after all.
Leidy, H. J., Lepping, R. J., Savage, C. R., & Harris, C. T. (5 May 2011). Neural Responses to Visual Food Stimuli After a Normal vs. Higher Protein Breakfast in Breakfast-Skipping Teens: A Pilot fMRI Study. Obesity Journal, (1-7). doi:10.1038/oby.2011.108
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.
One of our dieters, April, was having trouble this week finding time to get to all of her diet activities: sitting down to a proper breakfast, preparing lunch to take to work, cooking dinner, and going to the supermarket. April’s sabotaging thoughts kept getting in the way: “I’ll go to the supermarket tomorrow;” “I’d rather read the newspaper than fix a lunch to go,” “If I grab some fast food on the way home, I’ll have more time to email my friends tonight.” April hadn’t truly accepted the necessity of making time for dieting. We stressed the importance of prioritizing her time, of fitting the rest of her life around dieting activities (Day 8 of The Beck Diet Solution), not vice versa. We discussed doing her dieting activities first, then using reading, gardening, and watching television as rewards.
For now, April has to put all of her dieting activities at the very top of her priority list, and not do anything that’s lower on the list until she’s completed them. That means no reading the newspaper in the morning until she’s prepared her breakfast and lunch, no gardening on the weekends until she’s made her weekly trip to the supermarket, and no watching television at night until she’s completed her food plan for the next day. We also discussed that these dieting activities will soon become second nature; if April pushes herself now to respond to her sabotaging thoughts and change her habits, dieting will get easier and easier.
During our diet group this week, we wanted to have our dieters benefit from each others’ wisdom. Brenda began by talking about a sticky situation she found herself in over Mother’s Day. That morning she was extremely busy so she skipped breakfast, and by the time she got to her planned Mother’s Day brunch, she was starving. Brenda started out well, by eating the chicken and salad she had planned, but then when she was offered a hamburger, she ended up eating it – while standing up.
Maria, our champion of “putting yourself first” (discussed on Day 8 of The Beck Diet Solution), gave Brenda the following advice: she started by reminding Brenda how crucial it is to eat breakfast 365 days a year. Even when she’s busy or stressed, Maria always makes time to eat breakfast because she knows that skipping it will only set herself up to overeat later in the day (Day 2).
Maria also talked about how good she has gotten at turning down food that other people offer her. Maria, herself, went to several of her family members’ houses this Mother’s Day, and was offered food at each one. Because she had already eaten breakfast and knew what she was going to eat for lunch, Maria firmly turned down all offers of food and instead drank only coffee – and she felt great about doing so. She didn’t let herself give into the sabotaging thought, “It’s ok to eat this because it’s a celebration.” Maria reminded Brenda of how good and empowering it feels when you are strong and stick to your diet.
Lastly, Maria reminded Brenda that you can’t let yourself slip up on the basics, like eating everything slowly, while sitting down, and noticing every bite (Day 5). Chances are if Brenda had forced herself to sit down and face the hamburger, she might have been able to really notice what she was doing and talk herself out of eating unplanned food.
One skill that Maria has gotten very good at is putting herself first – making sure that she continually has the time and energy for diet and exercise (discussed on Day 8 of The Beck Diet Solution). For Maria this particularly means making sure she keeps exercise a priority. In the past, when her life got busy, exercise was always the first thing to fall off her plate.
Maria exercises on a machine at home. When her kids interrupted her exercise in the past, she would always drop what she was doing and tend to them. Now she tells them to wait until she’s done and then she helps them. After dinner, if she’s already exercised, Maria may watch television with her husband. But if she hasn’t exercised yet, she nicely refuses to join him until she has finished. Now she feels entitled to get her activities done first.
Building this sense of entitlement is crucial to lasting weight loss because life always gets busy and things always come up. If dieters don’t learn to put themselves first and ensure that they continually make diet and exercise a high priority, other factors will always get in the way of their best efforts. Maria now knows that she is entitled to exercise because she deserves to be thinner and feel good about herself, and she is a good example for all of us.
One of the topics we discussed during our group meeting is the importance of throwing out extra food. Keeping leftovers hanging around in the refrigerator and cupboards can tempt dieters and threaten to derail their good efforts. A lot of our dieters initially expressed discomfort at the idea of wasting food. However, what we like to remind our dieters is that if you eat extra food you don’t need, your body can’t use it and just turns it into fat, i.e. the food is wasted in your body. So the food is wasted in the trashcan or wasted in your body, but either way it’s wasted (discussed on Day 7 of The Beck Diet Solution).
Brenda in particular had a lot of trouble throwing out extra food. Her daughter would often cook big meals and there would be lots of leftovers that she couldn’t bring herself to toss in the trash. Brenda said the leftovers would hang out in her fridge for a couple of days until she eventually ate them, whether she really wanted to or not. She also often had half-finished boxes of snack foods in her cupboard that her grandchildren would start and not finish, and even though they were often stale and fairly unappealing, there were times when they sorely tempted Brenda.
Brenda responded really well to the notion, “In the trashcan or in your body, either way it’s wasted,” and with this new mentality it became easier for her to throw out food. Brenda slowly got in the habit of throwing out all the unwanted leftovers from the meals her daughter cooked, because she knew she’d rather the food be wasted in her trashcan than show up on the scale. Brenda also now periodically goes through her cupboards and without difficulty throws out all the unfinished, stale snack food. Learning to throw out food may seem like a simple idea, but it will continually keep Brenda from eating extra food and help her keep the weight off permanently.
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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