Angry Eating

When Jamie came in my office this week, she reported feeling disappointed.  Jamie thought she had kicked her emotional eating habits because, through lots of practice, she became adept at not eating when she was feeling sad or stressed.  This was something that Jamie had struggled with a lot at first because initially she thought she would not be able to handle feeling sad or stressed without turning to food.  Through our work together, Jamie learned that negative emotions are not going to kill her and she can do other things to comfort herself which will not have the end result of jeopardizing her diet and ultimately making her feel worse.  Jamie always gave herself a lot of credit for being able to handle these negative emotions without turning to food by using a multitude of other distracting techniques, like calling her sister or a friend, going for a walk, taking a shower, painting her nails, or listening to relaxing music. 

Yesterday evening, however, Jamie was out with a friend for dinner and midway through she got a phone call from her mother who made her angry and they ended up getting into a fight.  Jamie hung up the phone, still feeling mad.  Even though she’d almost finished the amount of food she had carefully portioned off from her plate that she would eat at dinner (and was planning to bring the rest home for lunch the next day), Jamie told me that she then proceeded to eat almost everything that was left on her plate, seemingly without noticing what she was doing.  It wasn’t until Jamie looked down at her near-empty plate that she realized she had just engaged in emotional eating, but this time it was in response to anger, not sadness or stress and felt discouraged.  I asked Jamie what she did after she realized this and Jamie reported that she left the restaurant, took a walk with her friend, and then called her mother to work the situation out.  I then asked Jamie if she had proceeded to order dessert at the restaurant or had gone home and eaten whatever was in her house.  In an almost puzzled fashion, Jamie answered, “of course not.”  I recognized what was going on here –Jamie was only focusing on the one mistake she had made that night and was not seeing all the multitude of great things she had done immediately after. 

I asked Jamie what she might have done a few years ago when she felt angry or worked up like that and she reported that she probably would have gone on to eat a lot more food to soothe herself.  I also asked Jamie what she would have done  in a situation in which she made an eating mistake and Jamie acknowledged that she probably would have gone on to eat a lot more the rest of the night, thinking she had blown it.  Jamie and I discussed how very differently she handled this situation and all of the important things that she deserved credit for.  Jamie was able to see that she deserved credit for:

  1. Once she realized she had eaten more than she planned, she did not catastrophize and continue to eat out of hand the rest of the night
  2. After dinner she took a walk to calm herself down instead of turning to more food
  3. She got problem-solving oriented and called her mom to work out the problem
  4. She was able to identify what was going on – that she was eating because she was angry – and respond to sabotaging thoughts that were urging her to keep eating
  5. She was ready to learn from the situation and would be more aware of all forms of emotional eating in the future

I pointed out to Jamie what I point out to all of my dieters: that ALL dieters and maintainers make mistakes, they are just able to recover from them right away.  Jamie and I discussed the fact that, without even realizing it, this is exactly what Jamie did because as soon as she realized she had eaten more than she planned, she put the brakes on eating right away.  We also talked about the fact that instead of feeling good about this situation and how she had proved to herself that she can recover right away, Jamie was actually making herself feel worse by only focusing on the one thing she did wrong, instead of the 20 positive things she did right after.  Jamie and I decided that as part of her homework this week, she would start focusing more on giving herself credit for all the positive things she did, both big and small.

Eating with Distractions

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.

Ice Cream and Regrets

Jamie came into session today and reported that she had a significant experience over the weekend at an ice cream parlor.  She explained to me that she had planned in advance to go and have a small size ice cream so that she could still have a drink with dinner.  However, when Jamie and her friend were waiting in line at the ice cream counter, they discussed what they were going to have and her friend said he was going to have a medium-sized cup. Immediately Jamie’s sabotaging thoughts started kicking in – “If he’s having a medium, then so can I; It’s not fair that I should have to get a smaller size; I’ll enjoy it more if I get the bigger size; I know I planned to have a small but it won’t really matter if I get a medium” and so on and so on. 

Jamie reported that she did not at that moment take the time to identify what thoughts she was having and come up with responses to them, and so she ended up ordering a medium despite her initial plan to get a small. I asked Jamie how she felt after finishing her ice cream and she said that she felt bad about herself and guilty because she went off plan.  Jamie also believes she would have actually been happier ordering the smaller size because then she would have been able to enjoy each bite knowing she had planned for it, instead of feeling guilty about the extra ice cream she was consuming.  And because Jamie continued to feel bad about the situation and let her sabotaging thoughts go unchecked, she also ended up eating more at dinner than she had planned.

Jamie and I discussed this situation in depth during her session to see what we could learn from it.  First I asked Jamie if she had done any preparing before she went out for ice cream, such as reading her Advantages List or Response Cards which would remind her how and why to not give in to cravings.  Jamie told me that she thought about the ideas but didn’t actually read the cards, assuming the messages were well-enough engrained.  I explained to Jamie we’ve found this to be true for the majority of the dieters we work with – that just thinking about the response cards is not good enough; something about actually reading them seems to enter the brain in a different and more substantial way. 

Jamie and I also discussed the paradox that she thought she would be happier with the larger size, and then ended up enjoying it less because she felt guilty about going off her plan.  I reminded Jamie of her previous experience with the french fries and how good it felt to eat a smaller, planned portion, and how much she enjoyed each one.  I asked Jamie if she regretted not eating more fries on that day and Jamie realized that while she did not regret not eating more fries, she did regret eating more ice cream.

Lastly, Jamie and talked about how this one experience of giving in to sabotaging thinking led her then to give in to more sabotaging thoughts later in the day.  I reminded Jamie that this experience wasn’t only significant because she took in extra ice cream calories, it was also important because this one time of giving in led her to give in again later that day.  Jamie agreed, saying that if she had stuck with the small ice cream, she thinks it would have been easier for her to stay on plan the rest of the day because she would be feeling good about herself and her eating and would already have experiences from that day of not giving in.

I asked Jamie to think about what she would away from this discussion and she listed:

1. It’s important to actually READ her Advantages List and Response Cards before going into a challenging situation

2. Make a new Response Card reminding her that when she sticks to her planned portion of food, she feels much better about it, is able to enjoy it more, and absolutely does not regret not eating more

3. Remember that every time does matter, and going off her plan earlier in the day strengthened her giving-in muscle and triggered her to eat off track later in the day.

I ended by giving Jamie a whole lot of credit for not allowing herself to continue eating out of hand the next day and for getting back on track.  I reminded her that even experiences where she doesn’t do as well are extremely important because we can learn as much from them (and sometimes more) as from successful ones.

Out to Dinner

Jamie came into session today and told me about a great experience she had with eating out the night before.  She reported that she deliberately did several important things in preparation of going out to eat, which greatly contributed to her feeling of success.  First, Jamie asked her friend if they could pick the restaurant ahead of time so that she would be able to look at the menu online and make preemptive food decisions.  While she was looking at the menu earlier in the day, Jamie knew that she wanted to incorporate a reasonable portion french fries into her dinner because she loved them at this particular restaurant.  Because of this choice, Jamie also definitively decided not to take anything from the bread basket when it was served although she knew that, in the moment, this wouldn’t be easy.  Another thing Jamie did was make sure she got to the restaurant a few minutes early and used that time to read her Advantages List and also a response card that she had made about saying no to the bread basket.  By doing this, Jamie ensured that  it would be front and center in her mind why it was worth it to her to stay on track during dinner.

Jamie told me that at the restaurant she didn’t even bother looking at the menu because she didn’t want to be tempted into ording something she hadn’t planned for. Jamie ordered what she had previously decided to, and then when the bread basket came out she was able to remind herself of why she wasn’t going to have any.  Jamie told me that she was surprised to find it wasn’t very difficult for her to stay away from the bread, but that she thought deciding ahead of time not to have any really did make it easier.  Not so easy was when Jamie’s food came and she looked at the huge pile of french fries on her plate, knowing that she could not stick to her diet and eat them all.  Jamie  said that her sabotaging thoughts immediately began popping up urging her to jump in and eat them [this one time won’t matter; I’m having dinner out, I can treat myself; I did so well turning down the bread that I deserve more fries; I won’t be able to enjoy myself unless I eat all of them].  Jamie reminded herself strongly that it was worth it to her to not eat the whole portion because not only would she feel sick and mad at herself after, but she would also be giving into her resistance muscle and making it more likely that she would do the same thing in the future.  Jamie also told herself that it was imperative that she prove to herself that she could eat fries and stay in control and she had NO CHOICE about not eating them all.

Throughout dinner Jamie was careful to divide her attention between talking with her friend and eating her food. Jamie knew that if she did not pay attention to her food she would wind up eating more than she had planned and she wouldn’t be able to enjoy what she did eat nearly as much.  Jamie was also cognizant of the condiments she used with dinner and did not fool herself into thinking that these things did not contribute to the calorie count of her meal. 

Because Jamie had thoroughly prepared herself ahead of time, she was able to stick to a very reasonable portion of fries and she was able to notice and enjoy every single one that she did eat, which enabled her to not feel deprived.  Jamie and I discussed this situation in session and listed all of the many things that she deserved credit for.  I asked Jamie if, looking back, she regretted not eating all of her fries or not taking from the bread basket and Jamie answered that she absolutely did not regret it; rather she felt incredibly proud of herself that she was able to stay in control and enjoy everything she ate.  Jamie and I discussed this paradox – that dieters think they’ll be happy if they can eat any food they want in whatever quantity they want, when in reality most find that the exact opposite is true. This certainly was true for Jamie because actually restricting her bread and french fry intake allowed her to enjoy her meal more, knowing that she was staying in control and would still feel good about it later.

Holding Out

After dinner and evenings have always been the hardest times for Jamie to maintain her control.  She finds that she has the urge to snack all evening long and often struggles very hard to not overeat after dinner. For Jamie, it wasn’t that she kept getting hungry over and over after dinner; rather she had a very strong and compelling urge to eat at those times which didn’t seem to have much to do with hunger.  Jamie finally sat down to try to figure out what was going on in the evenings so that she could get her eating under control during that time. 

Jamie thought about the rest of the day and realized that it was much easier for her to maintain her control up to and during dinner, and that she was often pretty easily able to stick to her planned meals and snacks.  Upon further reflection, Jamie began to formulate the hypothesis that the reason the day was so much easier for her than the night is because during the day she always knows when her next meal or snack is coming, and therefore she is able to “hold out” until then.  Jamie knows that food tastes better when she is hungry and she enjoys sitting down to meals and snacks with a reasonable degree of hunger.  Jamie realized that her biggest pitfall was not planning her evening snack or snacks well enough (because she would often just have a general plan of having some snack sometime) so therefore she wasn’t able to tell herself to just hold out until the next planned time to eat, because there wasn’t necessarily a next planned time to eat. 

This concept of “holding out” was very important for Jamie because it shows that she clearly has the ability to exert control over herself and her actions.  Jamie realized that it wasn’t that something suddenly overtook her in the evenings which made her want to eat constantly, it was just that subconsciously she didn’t know when her next meal or snack was coming so she wasn’t able to respond effectively enough to the sabotaging thoughts that were urging her to eat.

Once Jamie figured out what was going on, it made figuring out a way to solve the problem pretty easy, and she gave herself a lot of credit for being able to do this. Jamie decided that it would probably work best for her to plan two evening snacks – one a little while after dinner and one right before bed so that she would always have a next snack for  hold out for during the evening and night.

Sue: Part 11

Sue has been weighing herself daily and graphing her weight loss. She has now proven to herself several times that the number on the scale goes down some days, stays the same some days, and goes up some days—even when her energy input and output is the same! Nevertheless, she continues to be disappointed, and a little worried, when her weight is up, even by only a pound. I had her compose two Response Cards. She’ll choose which one to read before her daily weigh-in.

If I’ve Been Following My Plan

  • It will be nice if my weight is down today but it’s fine if it’s up.
  • Look where I am today compared to where I started!
  • If it’s up, it doesn’t necessarily mean I did anything wrong and if I keep following my plan, it will come down again, until I hit maintenance.
  • History has shown me that the number definitely goes up and down.
  • I don’t need to worry unless my weight goes up and continues to go up for several days in a row.
If I Haven’t Been Following My Plan

  • Okay, my weight will probably be up today and I will probably feel disappointed.
  • I need to make this an “Oh, well,” experience. “Oh, well, I don’t like the fact that my weight is up but I need to accept it—without criticizing myself—and get problem-solving oriented.”
  • It’s impossible to lose weight without making some mistakes along the way.
  • Let me figure out what led to my going off plan—especially the sabotaging thoughts that got in the way—so I can avoid the situation in the future.
  • If I get right back on track now, following my eating plan and using all my Beck Diet Solution skills, I’ll lose weight again.
  • If I use this weight gain as an excuse to give up, I may never achieve the advantages of weight loss—feeling better, being healthier, etc.
  • (Now go read my list of reasons to lose weight and ask myself how important each one is to me.)

Sue: Part 10, The Tyranny of the Scale

Sue has been weighing herself once a week. She was confused and disheartened that her weight had gone up a little this week. After all, she told me, she had stuck to her plan and, on top of that, had done considerably more exercise than usual.

I asked Sue if this was a typical reaction for her—feeling disappointed when the scale didn’t go down as expected. She acknowledged that yes, this was a long-term problem. She also told me that in the past, if she expected the scale to show a higher weight (because she had eaten more than planned), she often avoided the scale altogether. The scale avoidance had often led to her gaining a LOT of weight because she didn’t have to face the consequences of abandoning her eating plan.

I told Sue that I thought she suffered from “tyranny of the scale,” that is, her mood was way too dependent on the number it registered. I told her it was difficult to get over the problem unless she started weighing herself every day. In fact, I told her, I not only wanted her to weigh herself, but I also wanted her to start graphing her weight.

Sue needs to see, over and over and over again, that daily fluctuations in weight are NORMAL. She had thought that the scale should go down every day or every week as long as she was sticking to her plan. She didn’t know that the scale is supposed to register a higher weight some days. It doesn’t mean she’s become fatter. If she’s stuck to her diet and exercise programs, it means she retained water, had some hormonal changes, ate saltier foods, ate later than  usual the evening  before, or experienced some other normal physiological change that we couldn’t identify. In fact, I told her, “Don’t look for why your weight is higher on any given day—unless you didn’t stick to your eating plan. Just assume it’s a normal fluctuation and that the scale will come down again within a few days.”

I told Sue that if she’s only weighing herself, without making a graph, it’s more difficult to prove to herself that daily fluctuations are normal—and that if the scale goes up or stays the same, it will come down soon. But this is crucial! It’s also hard to prove to yourself if you’re only weighing and graphing once a week. That’s why it’s worth the effort to weigh yourself daily. After 15 or 20 episodes of seeing the fluctuations, you won’t worry any more. You’ll know the ups and downs are normal and you’ll get over your fear of the scale.

Sue: Part 9, Self-Criticism

Today Sue and I touched on the topic of self-criticism again. She was able to see how “beating herself up” every time she made a mistake undercut her motivation and her sense of self-efficacy. We reiterated how important it is to become problem-solving oriented, instead. “Okay, I made a mistake. What can I learn from this for next time?” Unfortunately, Sue is not only critical of her eating, she’s generally highly critical of herself, in her work, at home, socially, and so on. Her standards for herself are just too high. Fortunately, though,  she doesn’t have the idea, “I have to be self-critical or I’ll let myself go.” (If she did, we’d have her try some experiments to see if that belief were true.)

For this week, Sue’s going to make a concerted effort to note her self-critical thoughts about her eating, her body, and exercise. That’s the first step. The next step will be learning how to respond to herself in a compassionate, problem-solving way. And we’ll continue to work together so she can learn how to set reasonable standards for herself.

Sue: Part 8

Sue is doing so well, but I wanted to prepare her for making mistakes.  We reviewed the concept that mistakes are normal, and that everyone makes mistakes from time to time.  While it’s impossible to avoid mistakes altogether, I explained to Sue that what she tells herself about her mistakes is crucial to success.

I explained to Sue that if she says to herself, “This is terrible. I can’t believe I ate that. I’m so weak. I thought I could do this [stick to a diet] but I can’t,”  she’ll feel demoralized and helpless and she’ll  be likely to abandon  her efforts. But if  she says, “Big deal, I’m human, I made a mistake, I’m going to get back on track this minute, and I’m going to give myself a LOT of credit for getting back on track,” she’ll  quickly recover and it will be NO BIG DEAL. Everyone makes mistakes, whether it’s ruining a nail you’re polishing or deviating from your eating plan. I helped Sue develop the attitude:  “I can recover from mistakes—AND LEARN FROM THEM.”

Sue: Part 7, Fear of Losing Control

Sue is still afraid that if she eats something wrong, she’ll lose control and not be able to get back in control. We had the following discussion:

Sue: I’m just afraid that one false step will be the beginning of the end.

Dr. Beck: How many times in the past few months have you taken a false step?

Sue: A fair number, I guess.

Dr. Beck: And how many times did you start on the path of serious weight gain?

Sue: Never.

Dr. Beck: And why is that?

Sue: Well, it’s because I’m learning to see something as an isolated mistake. I’m learning how to get back on track right away. I’m still motivating myself by reading my list of reasons to lose weight. And other stuff.

Dr. Beck: That’s exactly right. It’s because you now know exactly what to do when you stray, and you know how to get yourself to do it.

Sue and I agreed that she needed to keep track of all the instances in which making one mistake did NOT lead to her losing control. We also agreed that this month, Sue would reread The Beck Diet Solution. She plans to take notes in the margins about what she can do if there ever does come a time when she starts to gain weight back.

This exercise will serve as a good reminder for Sue that all the skills she needs to stay on track are there in black and white, for her whole life. I think this will also provide her with a good measure of relief.