A client I worked with a few years ago recently had her second baby and was having trouble getting her eating back under control. Lara told me that during her pregnancy, she let herself eat whatever she wanted and ended up gaining more weight than was healthy. Now at six months postpartum, she’s still struggling to put the skills that we had worked on back in place.
If you’ve gotten off track with your New Year’s resolution, this is exactly what you need to do, too! Stop expecting yourself to do everything and instead figure out what feels completely doable this week. Recommit to it, do it (and give yourself so much credit for doing so!), and then add one or more things next week.
Not having a strong plan can exponentially increase the chances of getting off track because of how many spontaneous decisions you’ll have to make all day.
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.
In session this week, my dieter, Jason, and I discussed an issue that he was having trouble with: Getting to sleep on time. This is a fairly common problem many of my clients face and it’s an important one to figure out. Studies show that people eat more on days they are sleep deprived than on days that they aren’t, and when people stay up too late, they often want to turn to food to help them stay awake. Both of these things were happening with Jason – he was eating too much at night to help him stay awake to watch “just one more” television show (which never turned into just one more), and he found it much harder to resist cravings and moderate his appetite following a night of missed sleep.
To help him combat his late-night ways, the first thing Jason and I did was institute a bedtime of 11:00pm. Although Jason didn’t initially love the idea of having a “bedtime,” we discussed the pros and cons of having one versus not having one, and Jason was able to see that not having some type of guideline in place for when he would get in bed was leading him to consistently stay up too late, eat too much, and sabotage his weight-loss efforts. It wasn’t worth it. Jason decided that he would also set an alarm on his phone to go off every night at 10:30. That way, it would give him a half hour to wrap things up and remind him that it would soon be time to get in bed. He also decided that he would read his Advantages List when his alarm went off to remind him of all the reasons why it worth it to him to lose weight (and, consequently, why he needed to get in bed).
Jason and I then discussed what sabotaging thoughts might get in the way of him sticking to this bedtime. Here are his thoughts and the response that we came up with:
Sabotaging Thought: I’ll watch just one more show.
Response: One more show is never just one more show. One more show doesn’t work! If it did, I would never stay up too late but I always stay up too late. No more shows.
Sabotaging Thought: It’s okay just this one time to stay up later than I said I would.
Response: “Just this one time” is like “just one more show” – it doesn’t work and I need to prove to myself that I do what I say I’ll do.
Sabotaging Thought: I don’t feel like going to bed right now.
Response: I may not feel like going to bed right now, but I even more don’t feel like sabotaging my weight loss efforts and having to stay overweight. It’s worth it to get in bed.
Sabotaging Thought: It’s not really that important to go to bed on time.
Response: It really is that important. Staying up too late makes me overeat both at night and the next day. Besides, on the days I do go to bed, I feel so much better the next day – rested and alert. I’ll be so happy tomorrow morning I made myself get in bed.
With these strategies in place (a set bedtime, an alarm reminding him of the impending bedtime, and reading his Advantages List and Response Cards if he was tempted to not adhere to it), Jason felt confident that he would finally be able to get himself to bed at a reasonable hour.
My client, Jason, works long hours and isn’t much of a cook. When he gets off work and wants dinner, his options are usually pretty limited. Jason often winds up going to a drive-through restaurant, and he doesn’t usually make the healthiest choices. Jason told me that while there are healthy (or, at least, healthier) options available, he has a hard time sticking to them when the time comes to place his order.
In previous sessions, Jason and I had spent a lot of time talking about how he can stay in control when he eats out with friends. Although Jason used to have very big and very caloric meals every time he went to a restaurant, in the past few months he has made a lot of progress in making healthier choices and not finishing everything on his plate.
In session, Jason and I discussed what strategies he has been using to stay on track at restaurants to see if any of them would translate to the drive-through. Jason told me that the most effective strategy for him has been to look at the menu ahead of time and decide what he’ll have, and then not even look at the menu once he gets to the restaurant. He also has a Response Card that he reads before he goes out to eat:
Every time I stick to my healthy choice I feel great after eating. Every time I veer off track and order something else, I feel guilty after eating. Sticking to my healthy choice not only enables me to lose weight, but it makes me feel so much better.
Jason and I discussed this further and realized that this same exact strategy would be very helpful for him when going through drive-thoughs, too. Jason decided that he would make it a policy to look at the drive-through menu online before he left work at night and decide in advance what to have. When he got to the drive-through window, he would then place his order without looking at the posted menu, just as he does in restaurants.
Jason also came up with an additional strategy: Since he tends to frequent the same drive-throughs, he decided that for each one he would come up with a few different meal combinations and record them in his phone. That way, if he was in a rush to leave work, he wouldn’t have to spend time looking up the menu, he could just pick something from his phone. Jason also made the following Response Card to keep in his car and read when he was waiting in line to place his order:
I’ve already decided what to order so I don’t even need to look at the menu or consider what else I might want. The decision has been made, and sticking to this decision will make me feel so much better. It’s worth it.
With these strategies in place, Jason was finally able to stay in control both when eating out in restaurants and when going through the drive-through.
A few months ago my client, Susan, went on vacation with her friend, Caroline, and Caroline’s two kids. After the trip, Susan and I spent some time in session discussing what had gone well and what could have gone better. This was especially important because we knew that Susan was again going away with Caroline and her children in a few weeks.
Susan told me that the major area that needed improvement was dessert. While it was great that she and Caroline took a walk every morning, they also stopped at a local donut and bagel shop on the way home so that Caroline could get breakfast for her kids. Susan told me that more often than not, she would go inside with Caroline, be tempted by everything she saw and smelled, and would end up buying and eating at least one donut before she walked out the door. Not only was this problematic from a calorie perspective, but Susan told me that it also threw off her eating for the rest of the day, because when she got home she wasn’t hungry for her usual healthy and satisfying breakfast, but then got very hungry an hour or two later, and would eat something which would throw off her lunch, and so on.
Susan also struggled with treats when she, Caroline, and the kids would take their after dinner boardwalk stroll during which everyone picked out a treat for dessert. This was difficult for Susan because not only would she eat what she bought, but she would also end up eating some of Caroline’s dessert, too (because Caroline, lacking a big sweet tooth, always had extra and Susan always developed a craving for it).
In session Susan and I first talked about how she would handle the stop at the donut and bagel shop. Since Susan knew she’d prefer to have dessert at night when everyone else was eating it (and since she also knew that she couldn’t eat two desserts a day and not gain weight) and because donuts were always gone very quickly and then negatively impacted her eating the rest of the day, Susan decided that she would rather just not have any donuts in the morning. To help her follow through with this, we came up with a two part strategy.
1. Susan wouldn’t even go into the donut shop with Caroline, thus limiting her exposure to temptations, and would wait outside to do stretching or check her email on her phone.
2. While Caroline was in the shop, Susan would read the following Response Card:
I have a healthy, satisfying, and delicious breakfast waiting for me at home. I’m not having a donut because it will be gone too quickly, negatively impact my eating, and make me feel guilty. It’s worth it to wait!
Susan and I then discussed how she would handle dessert at night. Since Susan knew that she was highly susceptible to craving what everyone else was eating, and since she was in the habit of sharing some of Caroline’s desserts, she decided that the best course of action would simply be to order whatever Caroline ordered. Having just been on vacation with Caroline, Susan knew that she, too, would enjoy whatever Caroline decided to have, and if they both had the same thing, then Susan didn’t have to worry about going overboard eating two desserts. To help her stick to this plan, Susan made the following Response Card:
Whatever Caroline gets for dessert, I’m sure to like. If I get something different, the whole time I am eating my dessert I will be craving whatever Caroline has, thus diminishing my enjoyment in my own dessert and causing me to eat Caroline’s extras. Just order what Caroline orders.
In session with Susan last week, she told me that she had just gotten back from her second beach trip with Caroline and her kids – and it was a huge success. Susan said that these strategies, along with the Response Cards that helped her implement them, took her from overindulging and feeling guilty, to enjoying her food and feeling great.
I described in Part I how I helped Angie make her Advantages List. This was only half the battle, however, and our next job was figuring out how she could get herself to read it every morning. I told Angie that it would be best for her to read her Advantages List first thing in the morning, before she ate anything for the day, and asked her when, during her morning routine, she might be able to incorporate this. Angie decided that it would be best if she kept it on her bedside table and read it first thing in the morning before other people (like her husband and kids) started asking her to do things. I asked Angie if she would mind if her husband saw her list, and she told me that while he was very supportive, her list was private and she preferred that no one else in the family read it. Because of this, Angie decided that she would keep the list in the drawer of her bedside table.
With the list out of sight, I was concerned that Angie might forget to read it, and asked her if she had any ideas on how to solve this potential problem. Angie said that another thing she does every morning before she gets out of bed is take her medication, and so we decide that she would put a sticky note on her medicine bottle, which would cue her to read her list.
After figuring out these logistical issues, Angie and I then discussed what thoughts might get in the way of her reading her list every morning. Angie told me it was possible she might think something like, “I’m too busy/rushed to read my list this morning.” To help combat this thought, I asked Angie to read her list aloud to me in session, and Angie was surprised to hear that it only took her 35 seconds to read the entire list. “Isn’t it worth 35 seconds in the morning if it will help you lose weight and keep it off?” I asked her. Angie agreed that it certainly was worth 35 seconds, and to help her remember that it would only take this short amount of time, Angie decided that she would write the number “35” on the sticky note she was attaching to her medicine bottle.
Angie also identified that the thought, “It’s okay if I skip reading my list this morning, I know what it says,” might get in the way of her reading her list this week. Angie and I discussed this thought and I let her know that, at least for right now, it was not good enough to just think about the items on her Advantages List, she actually has to read it, not only because reading it helps enter it in the brain more firmly but also because Angie needs to prove to herself that she can do it, whether or not she feels like it. With these ideas in mind, Angie made the following Response Card:
“Whether or not I feel like reading my list, do it anyway! It’s an important step in helping me lose weight and besides, it will only take 35 seconds.”
Although Angie didn’t feel comfortable having her list out in the open, she didn’t mind having this Response Card on her bedside table, so she decided to keep it right next to her medicine bottle so she would see it and read it first thing every morning.
With these strategies in place, Angie felt confident that she was off to a good start and would be able to read her list every morning.
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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