In Session with Deborah: The French Fry Plan

This week I had a session with my dieter, Sarah.  Although in recent weeks Sarah has been doing well with her dieting skills, she told me that one food in particular keeps tripping her up: french fries.  Sarah has two young children and she and her family often go out to eat. Sarah told me that she usually goes into meals with the plan of not having any french fries, but more often than not ends up eating some off of her kids’ plates.  Sarah told me that most children’s meals in restaurants come with french fries, and since her kids never finish what’s on their plates, the fries call out to Sarah until she eventually gives in and eats some.

When Sarah came to see me she was feeling distressed because, although she knew continually overeating fries was a problem, she didn’t know how to control herself around them.  The first thing I discussed with Sarah is that she needs a French Fry Plan – she needs to plan in advance whether or not she’s going to have fries each time she eats out.  I reminded Sarah that since she really likes fries, it’s not reasonable to expect that she’ll never eat any.  The goal isn’t to never eat fries; rather it’s to plan in advance when she’s going to have them and when she’s not so she’s able to stay in control. This way, she doesn’t have to sit through meals looking at fries and struggling about whether or not to give in and have some, because the decision will already be made.

I also discussed with Sarah that during the meals when she plans to have fries, it’s crucial to order her own fries separately. Even if the meal she orders doesn’t come with fries and her kids’ meals do, she still needs to get her own side order. The reason for this is so that Sarah can start sending herself the message that it’s never okay to eat fries off her kids’ plates. If she’s going to eat fries, it means that she eats her own fries.  This is important because if Sarah some of the time allows herself to eat her kids’ fries (and there leaves the possibility of doing so open), then they will continue to call out to her, even during meals when she’s planned to not have any.  If Sarah has the rule, “I never eat fries off my kids’ plates,” then it will be much easier to resist every time they eat out because she won’t have to even consider (and therefore struggle about) whether or not to have some of theirs.  Sarah and I discussed the fact that, while this may end up costing her a few extra dollars, it’s 100% worth it because it will drastically reduce her french fry struggle (not to mention helping Sarah reach her enormously important weight loss goals).

I then asked Sarah what sabotaging thoughts she is likely to have during the meals when she hasn’t planned to have fries but is tempted to do so. Sarah said that some of the thoughts she may have are, “I’ll just have one. One won’t matter,” and “I really like fries and I just want to eat them.”

In response to these sabotaging thoughts, Sarah made the following Response Cards:

French Fry 1RC french fries 2

By the end of session, Sarah had a very clear plan of how to deal with her french fry troubles.  Here are the steps of her plan:

1.  Always plan in advance whether or not to eat fries at any given meal.

2. When I am going to have fries, make sure to order my own.

3. Remember – the fries on my kids’ plates are completely off limits. I just never eat them.

4. Read my French Fry Response Cards before meals when I haven’t planned to have fries.

5. Enjoy meals out even more because I’ll no longer be struggling about whether or not to eat the fries on my kids’ plates.

In Session with Deborah: Difficulties Going Home

This week, I had a session with my dieter, Emily. Emily told me that she and her sister are planning a trip home this weekend to celebrate their mother’s birthday, and that she thought it would be hard in a number of ways:  Emily would be off of her usual routine, she would be spending a long time in the car, she would have fewer occasions to exercise, and she would not be in control of her food.  Beyond these practical matters, Emily also told me that saying in control of her eating might be difficult because she would be experiencing more stress, which puts her in danger of engaging in emotional eating.  Although Emily loves her family, she also finds that being around them for an extended period of time can be stressful (in part because they often comment about what she does and doesn’t eat).

In session, Emily and I spent most of the time coming up with strategies for both her practical and psychological concerns.  Emily knew that one the most helpful things she can do for herself is to make a general plan for her eating and exercise over the weekend.  Emily decided that she would plan ahead and bring meals and healthy snacks in the car so that she wouldn’t have to worry about finding healthy choices on the road or being tempted by unhealthy food.  Emily also decided that she would make it priority to take at least a 20 minute walk each day that she at home, which would have the dual benefit of getting in some exercise and also being a stress-reliever.

Emily and I also discussed what sabotaging thoughts that might come up this weekend.  Emily said that her family often watches what she eats and makes comments, and although they are usually well-meaning, they cause Emily stress.   I pointed out to Emily that because she is now an adult, she doesn’t have to worry about “rebelling” against family by sneaking food or worry about what they will say about her eating because the only person she has to answer to is herself.  Emily I discussed this idea further and she made the following Response Card:

 

 

 

 

 

Emily and I also discussed the emotional eating aspects that might come into play this weekend and what strategies she can use if she’s feeling negative emotions, like taking a walk outside, working on deep breathing and relaxtion, or calling a friend.  We also discussed the fact that going home is more of an emotional experience for her, and therefore it’s normal that Emily would feel that way.  Just because she’s feeling stressed doesn’t mean anything is wrong, and just because she’s feeling stressed doesn’t mean she has to do anything about it.  It will go away on its own, as it always does.  Emily made the following Response Card:

 

 

 

 

 

 

Emily and I also discussed the fact that she should go into the weekend knowing and expecting that it will be more difficult to maintain control over her eating; this way she won’t be surprised when it happens. As long as Emily knows this ahead of time and fortifies herself, when the difficulty hits, she will be ready and prepared.

Bariatric Surgery Sabotaging Thoughts

Last week, Dr. Judith Beck and I presented at a Bariatric Surgery conference and we spoke about helping bariatric surgery patients change their thinking to help them better adjust to their new lifestyles and stick with their new way of eating.  Here are some sabotaging thoughts and responses that are particularly relevant for people who have had (or are thinking about having) some type of bariatric surgery.

Sabotaging Thought: Now that I’ve had the surgery, it’s not fair that I can’t eat normally.

Response: I need to change my definition of ‘normal’ eating.  I actually am eating 100% normally for someone who has had bariatric surgery. The way I used to eat is no longer normal (and remember – it was likely never really “normal” in the first place because it caused me to be overweight). My new normal is following my diet.

 

Sabotaging Thought: I won’t be able to take part in big celebratory meals anymore

Response: I can still celebrate occasions without overeating or overdrinking. I don’t have to make toasts with alcohol in my glass, I can celebrate a birthday even though I’m only eating a little (or no) cake, and I can still take part in the social aspects of special events regardless of what I eat.  What I’m eating or not eating does not have to determine how much enjoyment I get.  Besides, once I lose weight, I’ll get to enjoy looking and feeling great – which will be so much more pleasurable.

 

Sabotaging Thought: I’m afraid I won’t know who I am after losing so much weight.

Response: It’s true, things will look and feel very differently. It may require some renegotiation on my part to figure out where I fit in, and renegotiations with others to figure out our relationships, but that doesn’t mean it can’t be done.  It’s better than the alternative of staying overweight, feeling miserable, and continuing to be stuck in an unhappy and unhealthy place. 

 

Sabotaging Thought: I’m sad I won’t be able to binge anymore.

Response: By having this surgery done, I am giving some things up and there are definitely disadvantages. It’s okay to be sad about what I’m losing, but it’s also important to think about how much I’m gaining, and how all-encompassingly great those things are, like better health, self-pride, and confidence.   I’ll be giving some things up, but in many ways, I’ll be getting my life back in return.

 

Sabotaging Thought: I’m afraid that I won’t be able to handle so much change.

Response: Thank goodness things will change! I need change to keep moving forward and to improve my life. Change can initially be scary, but that doesn’t mean I can’t handle it, and that doesn’t mean it won’t be 100% worth it.

In Session with Deborah: Making a Food Plan

I recently had a session with my dieter, Kara, who is a busy stay-at-home mom to her four boys. In earlier sessions, Kara and I worked on all of the foundational dieting skills and she got very adept at consistently instituting good eating habits.  Because of this, we then started talking about having Kara make a food plan in advance and stick to it.  Kara was initially resistant to this idea and stated that her lifestyle just wouldn’t work with a strict eating plan because she was always on the go and she often didn’t know ahead of time what her next meal would be.  Kara also said that she didn’t want to give up spontaneous eating and liked being able to eat something if it was offered to her unexpectedly.  I discussed with Kara the fact that making a food plan and sticking to it would likely make her life a lot easier because she wouldn’t have to rely on willpower at any one given moment to resist unplanned treats. I also pointed out that it might actually be very helpful for Kara to have a food plan, because she was often scrambling around at the last moment to make sure that she had dinner on the table for her family. 

Despite these compelling reasons for why it might be worth it to try making a plan and sticking to it, Kara still resisted the idea and so we agreed to try it her way first – she’d work on staying in control of her eating and resist cravings, but without having a formal plan.  Over that week, Kara tried hard to reign in her eating without a food plan and without violating her rule: no junk food until after dinner.  However, when Kara came in to see me the following week, she dejectedly told me that something had thrown her off almost every single day, like when she was offered licorice at the park, cookies at a PTA meeting, or a dinner out with her husband.  

Kara and I discussed what had happened over the week and she realized that, right now, she faces too many temptations each day to be able to resist all of them easily enough, and therefore making a plan and sticking might be very helpful in overcoming this obstacle.  I reminded Kara that she probably tried very hard each day to resist the temptations and to reason herself out of eating food she knew she shouldn’t, and therefore likely had a much harder week than if she had just known ahead of time whether or not she was going to have something.  Kara decided that she was willing to try and stick to a food plan for at least one week and see if it made a difference in her overall day. 

Before she set out to do this, Kara and I spent some time in session thinking about when it would be hardest for her to stick to her plan and what sabotaging thoughts might get in the way of her doing so.  Kara thought that the hardest times would be, as it had been, when she was offered or saw food she didn’t expect, and to not give in in that moment.  I asked Kara what thoughts she might have in those moments, and then she made Response Cards with responses that we formulated together.  Here are some of Kara’s sabotaging thoughts and then the responses we formulated:

Sabotaging Thought: I really want to eat that right now even though it’s not on my plan. Just this one time won’t matter.

Sabotaging Thought: It’s not fair that I can’t eat this treat right now.

Sabotaging Thought: I really don’t like having to make a food plan.

When Kara came in to see me earlier this week, she reported that she had had a much better week. As we predicted, once Kara made a food plan and worked on sticking to it, it made several aspects of her life easier. First of all, Kara struggled a lot less about whether or not to eat something that was offered to her because she knew that if it wasn’t on her plan, she shouldn’t convince herself that it was okay to eat it. Second, Kara also found that she really enjoyed having meal plans for the day (and even for the week) because it allowed her more time with her boys in the afternoon because she was spending less time trying to figure out what to prepare for dinner.  Once Kara decided to try making a food plan, she realized that it wasn’t nearly as bad as she thought it was going to be and, in many ways, it actually made her day better, not worse.

In Session with Deborah: Reviewing Response Cards

An integral part of our work with dieters is having them make and read Response Cards.  Response Cards are simply helpful ideas, messages, and responses that dieters practice reading every day and which help them respond to and overcome sabotaging thoughts.  Last week I had a session with my dieter, Marissa.  During session, Marissa told me that her stack of Response Cards was starting to become unwieldy and that it was taking a long time to read them all in the morning, so by the time she got to the last ones, she was just rushing through to accomplish the task.  Knowing that Response Cards are only truly helpful if dieters really take the time to read and process each one, I asked Marissa to bring in her stash of cards to our next session so that we could go through them and figure out if there were some she no longer needed to be reading. 

This week Marissa brought in all of her cards and we spent part of session reading and really thinking about each one.  Including cards that Marissa and I had made together in session, as well as ones that she had made on her own at home, Marissa had over 40 Response Cards; she was right – that probably is too many for someone to read through and process individually every morning.   The first thing Marissa and I did was go through each card and categorize them into one of three categories: there was a “Yes” pile for cards that Marissa still found very helpful and knew she would benefit from reading daily, a “Maybe” pile for cards that Marissa wasn’t sure would be entirely helpful, or cards that weren’t necessarily helpful every day, and a “No” pile for cards that no longer applied to what she was working on or having trouble with. 

Most of the cards that ended up in Marissa’s “No” pile had to do with skills that she was easily able to get herself to do every day:

Reading my Advantages List will take less than 1 minute.  Isn’t it worth 1 minute in the morning if it might help me reach my goals?

It’s not about the calories, it’s about the habit. It doesn’t matter if the bite of food has 20 calories or 200 calories, I need to eat everything sitting down.

It’s 100% worth it to me to take the time to pack and bring lunch every day because it will save me calories AND money.  When I don’t bring lunch and end up buying something unhealthy, I feel guilty about both what I ate and unnecessarily spending money. 

Marissa and I agreed that just because she would be putting some cards away for the moment, she wouldn’t throw any of them away.  Although these cards didn’t seem relevant to her now, they very well may be at some point again in the future.   

When Melissa and I were going through her “Maybe” pile, we realized that some of the cards in this category should be put away for now, some should be brought out only when they were applicable, and some she should keep in other places, like her car or her desk, and read them as-needed. 

Marissa decided to put away (for now) cards about special occasions and traveling:

My body doesn’t know or care that it’s my birthday, it processes calories the same 365 days a year.  However, it’s reasonable to plan in advance to eat some extra on my birthday.  Doing so will help me to enjoy what I’m eating without guilt and therefore enjoy my birthday more.

There is no such thing as “blowing it for the whole trip,” because if I make a mistake and continue to eat off track for the rest of the vacation, I will continue to gain more weight.  Get right back on track! 

Cards that have to do with things like eating out or dealing with treats in her office, Marissa decided to keep in her desk and/or in her car:

If I walk into the office kitchen and see something tempting, walk right back out! Remember – if I hadn’t seen it in the first place, I wouldn’t want it anyway, so I’m not missing out on anything.

When I eat out, remember: Just because everyone around me is eating something, doesn’t mean that I can. My body has no idea what anybody else is eating, it only knows what I eat. 

By the time Marissa and I had finished going through her “No” and “Maybe” piles, she only had about 20 cards in her “Yes” pile.  Some of them included:

If I’m feeling stressed, remember that staying in control of my eating will help me to feel more in control in general. Staying in control of my eating makes me feel less stressed, not more.

I’m entitled to do what I need to do to reach my goals, as long as I’m not purposely hurting anyone else. I’m entitled to turn down food, request that food be prepared the way that I want it, and put my own needs first.  Remember, if I’m not good to myself, I can’t be good to anyone else.

It’s not as if I can only eat everything I want or I can’t eat anything I want. I can eat reasonable portions of foods that I enjoy and still lose weight. It’s not all-or-nothing!

Even after decreasing her “Yes” pile, Marissa told me that she still felt a little burned out and didn’t necessarily want to read 20 cards each morning.  Marissa and I discussed this more, and we decided that, at least for the next week, every morning she would read the first five cards in her pile, and then put them at the bottom of the stack.  Marissa and I also decided that since she would only be reading five cards, she would take time to really process each one, and think about how it might be helpful to her that day.  By doing it this way, Marissa will still be reading all of her most important cards each week, but by limiting the number (at least temporarily) that she reads each day, she’ll have the opportunity to really evaluate each card and think about its meaning, which is much more helpful than reading a large stack of cards without really paying attention to them.

In Session with Deborah: Green Days

Two weeks ago I had a session with my dieter, Jennifer, who has devised for herself a rating system to catalog her eating days. Good eating days are green, okay eating days are yellow, and days when she gets off track are red.  At the moment Jennifer is going through a difficult dieting time and is struggling to get herself consistently back on track, and she has been having a number of yellow and yellow/red eating days.   Just a few weeks ago, and for many weeks before that, Jennifer had been doing very well and had been consistently having green days (which were still interspersed with the occasional yellow day).  Jennifer told me that she really wanted to get back to where she was before and again have consistent and consecutive green eating days, but she feels like it’s too hard and right now she can’t imagine being able to have so many perfect eating days in a row. 

The first thing I did was remind Jennifer of something very important: Just because she previously had green day after green day, doesn’t mean that all of her eating days were perfect. I reminded Jennifer of mistakes that she had made on some of those days, like giving in to a craving at her son’s school, eating a second helping at dinner, and eating standing up while she was putting away leftovers.  However, none of these mistakes meant she didn’t end up having a great day because she was able to immediately recover from them.  Jennifer and I then discussed the fact that green days don’t equal flawless days; instead, they are days in which when Jennifer made mistakes, she immediately got back on track and didn’t lose her sense of control, so the mistakes turned out to be very minor (and didn’t lead to more and more mistakes). 

Since Jennifer has been going through a harder time recently and kept finding that one mistake would snowball into more, she had started to castrophize mistakes and view them as something she would need to avoid altogether in order to return to having consistently green days.  Jennifer lost sight of the fact that just a few weeks ago, mistakes were a part of her daily life and her daily green days.  It was critical for Jennifer to remember this because it helped make the prospect of having green days again not seem so daunting.  In response to this conversation, Jennifer made the following Response Card:

 

Jennifer and I then discussed some specific strategies she could use to get through this hard time and make it pass more quickly.  Here are some of the things we did:

1. We took a look at Jennifer’s Advantages List and revitalized it so it felt fresh and resonant to her.  Since she’s going through a hard time, it’s especially important for Jennifer to read her list so that she can remember exactly why it’s worth it to her to keep going.

2. We did a visualization exercise in which Jennifer visualized exactly what a day was like a few weeks ago when she was doing really well.  We discussed how good she felt about being in control, the fact that, on the whole, it wasn’t that hard for her to stay on track, and what she was doing differently that she could start implementing again (like making her kids’ lunches the night before so that she had easier mornings, doing a weekly shopping on Sunday, planning meals for the whole week, not just day-by-day, etc.).

3. We decided that for the next week, Jennifer would spend most of her energy working on the basics of dieting, like reading her Advantages List, reading her Response Cards, eating everything sitting down, slowly, and mindfully, and giving herself credit.  In addition to the basics, Jennifer decided that the one other thing that would be extremely helpful for her to continue working on is making meal plans for her family and sticking to them.  We decided that Jennifer would focus on just these things for a week (or until she felt more in control), and after that we would discuss adding back in other skills.  This way Jennifer had very specific things to concentrate on, knew exactly what was expected of her, and also had evidence from past weeks that she is capable of doing all these things. 

When I saw Jennifer during our next session, she reported that she had just had three green days in a row, and was starting to build back up her momentum. Jennifer told me that what was most helpful for her was remembering that green days don’t have to be perfect days and that she can be totally on track while still making mistakes. Jennifer said that once she took the pressure of being perfect off of herself, she was once again able to ger herself to do what she needed to do because she didn’t live in fear of making a mistake.

5 Strategies to Get Through Hard Times

In our work with dieters, one of the first things we let them know is this: When they start out, dieting may be fairly easy because they are highly motivated, and then as they practice their skills more and more, dieting gets easier. But at some point, dieting will get more difficult.  This is normal and inevitable and it happens to everyone.  We also let dieters know that when this happens, it doesn’t mean that they are doing anything wrong, and if they keep pushing through dieting will get easier again, 100% of the time.  The problem is that most dieters don’t know that dieting is supposed to get hard at some point and when this happens they panic, thinking that something has gone wrong, it will continue to be this hard, and it’s just not worth it.  And then what happens? They give up.  But this giving up is entirely unnecessary because dieting will get easier again if they keep doing what they’re doing.

What dieters can do when the dieting gets hard:

1. Make sure that their Advantages Lists are not feeling stale.   During hard times it’s usually more difficult for dieters to remember just why it’s worth it to them to put in the necessary time and energy, so it’s important that they frequently remind themselves by reading their Advantages List However, not only is it important for dieters to read their list, it is also important for these lists to resonate with them and to feel fresh and inspiring.  If dieters have been reading the same list over and over again, it may start to feel rote.  To help with this, dieters try strategies like reword their list, add new items, read just the top three each day, take a few minute to really visualize some of the items, etc. 

2. Think about past experiences. When dieters are going through a harder time, they often forget how good it feels when they’re in control of their eating. If dieters take time to really think about a recent experience when they stayed in control and remember not only how good it felt, but also simply the fact that they were able to do it in the first place, it can help remind them that dieting is not always so difficult and that, most of the time, it feels worth it.

3. Focus on the basics. When dieting gets rough, it can be helpful for dieters to take a few steps back and concentrate just on some of the most essential dieting skills, like reading their Advantages List, reading Response Cards, eating everything sitting down, slowly, and mindfully, and giving themselves credit. Doing so can help dieters regain their focus and also feel more confident about what they’re doing because they already know they can do these things.

4. Respond to Sabotaging Thinking.  Often when dieters are going through a hard time, they have lots of sabotaging thoughts like, “This is so hard, I just can’t do it,” and, “It’s not worth it to me to continue trying to lose weight.”  If left unanswered, these thoughts can lead dieters to give up so it’s critical that they take time to identify what sabotaging thoughts they are having, make Response Cards, and practice reading them every day.    For example, dieters can remind themselves:

The things on my Advantages List are worth fighting for so just because it’s hard doesn’t mean I should give up. I’ve worked hard and accomplished other things in my life that weren’t immediately easy, and I can do this, too.

Hard times always pass. This is temporary and as long as I keep doing what I’m doing, it will get easier again.  Just keep working!

5. Make sure they are giving themselves credit.  Sometimes when dieting gets difficult dieters forget to give themselves credit for all of the good things they are still doing.  This is particularly likely to happen if they are only focusing on how hard or bad things feel.  When going through a hard time, it’s critically important for dieters to give themselves credit because they often begin to lose their confidence and sense of self-efficacy and question whether or not they can really do everything.  By recognizing the things that they are still doing, and doing well, they can fight against this and regain (or maintain) a sense of pride and achievement.

When a Dieter Becomes her own Diet Coach

 

Whenever I first meet with a new diet client, I always make sure to explain to them that the ultimate goal of treatment is to teach them to be their own diet coach so that they don’t need to work with me for life.  In my work with dieters, there are a few things that really mark a turning point in their progress and which signify that they are on the road to ultimate success. 

One such turning point is when dieters demonstrate that they are becoming their own diet coach.  In a recent session, my dieter, Michelle, really proved that this was starting to happen for her.  Michelle has two young daughters.  Both of their birthdays happen to fall within the same week and both of their favorite treat is Michelle’s homemade chocolate chip cookies.  The afternoon of her first daughter’s birthday, Michelle set out to bake chocolate chip cookies which would be served at her daughter’s birthday dinner that night, in addition to the cake she had bought.  Michelle told me that she made the cookies in the late afternoon (which happens to be one of her more vulnerable times for sugar cravings) and while she was making the cookie dough, she started to get a craving to eat some, despite the rules she’s set for herself: “No junk food until after dinner” and “Eat everything sitting down, slowly, and mindfully.”  Michelle ended up giving in to sabotaging thoughts and mindlessly ate a lot of cookie dough while standing at the counter. 

After this happened, Michelle felt sick from all of the cookie dough she had eaten, and she was angry with herself for giving in to a craving and breaking her rules—especially since she had previously been following them so well.  This afternoon incident continued to stay with Michelle and caused her to feel out of sorts into the evening, resulting in her again giving in to sabotaging thoughts and eating a piece of birthday cake, despite having already had more than enough sweets for the day. 

That night, Michelle realized that she had made several mistakes, and she knew it was worth it to her to figure out how she could correct them, especially since the same situation would reoccur just a few days later for her younger daughter’s birthday.  Michelle sat down and thought about what had gone wrong and why. She realized that one of her first mistakes was not reading any Response Cards or her Advantages List before she started baking, even though she knew it could be quite difficult to resist the sweets.  She also had set aside time to bake during her most vulnerable time of the day, when she is most likely to give in to sabotaging thoughts. Additionally, Michelle didn’t have a clear plan for when she was going to eat the cookies, if any, and how she would balance that with having cake, so she wasn’t able to say something to herself like, “You don’t need to eat any now, you’re going to have one soon enough after dinner.” 

Michelle realized that planning was, indeed, necessary, so she set about making a plan for her upcoming cookie-baking.  This was her plan:

1.  Bake cookies right after lunch when I’m not hungry.

2. Read my Advantages List right before I start baking.

3. Plan to have one cookie after dinner and one half-size slice of cake.  If I want more cookies, I can plan to have one the next day.

4. Remember what happened last time and how I felt.  I want this time to be different!

Michelle also took the time to really think about what sabotaging thoughts got in her way the first time and made the following Response Cards to read with her Advantages List:

 

 

 

 

 

 

 

 

 

A few days later on her younger daughter’s birthday, Michelle carried through with her plan and the day went off without a hitch.  When Michelle came into session this week, she told me this whole story and we discussed what an important milestone this was for her.  Michelle had a challenging situation, she sat down and figured out what went wrong, she made new Response Cards in response to her sabotaging thoughts, and she came up with a plan to do things differently the next time.  I reminded Michelle that if we had had a session right after her first cookie-baking experience, I would likely have done almost the exact same things she did on her own.  This really proves that Michelle is fast on her way to becoming her own diet coach.   

It’s important to keep in mind that a big marker of Michelle’s progress is not when she stops making mistakes altogether, because everyone makes mistakes from time to time. The ultimate goal is for dieters to make mistakes and then recover from them right away and figure out how to handle the situation differently in the future, which is exactly what Michelle has done

In Session with Deborah: Birthday Plan

Earlier this week I had a session with my dieter, Amy, whose birthday is coming up this weekend.  Amy and I discussed her plans for her birthday — she explained that she and her husband will host a dinner party at their house for a few close friends and family.  Amy told me that she was feeling somewhat anxious about this because, in the past, she has used her birthday as an excuse to overeat. She’s told herself things like, “Since it’s my birthday, it’s okay to eat whatever I want,” and, “I’ll have a bad birthday if I don’t eat everything I want,” which often led her to overeat on her birthday AND to continue to overeat  for days, even weeks, later.  Amy and I first discussed what we thought her mindset should be going into her birthday.  We had the following conversation:

Debbie: Let’s talk about your birthday last year, if that’s okay with you.

Amy: Sure.

Debbie: Okay, so what happened last year? Did you end up feeling good about your eating? 

Amy: Oh no.  I remember I was out to dinner with my husband and I was definitely thinking something like, “It’s my birthday, so I should order whatever I want,” and, “I won’t be able to have any fun at dinner or on my birthday if I restrict myself.”  I ended up eating way too much at dinner.  Then my husband had the waiter bring over a slice of carrot cake, my favorite dessert, with a candle in it—and I ended up eating all of that, too. By the time I got home, I was feeling out of control and ate lots more from the kitchen, even though I was really full by then and already feeling badly. 

Debbie: And so was your thought true? Did you end up having fun because you didn’t restrict your eating at all?

Amy: No, it was just the opposite. I ended up feeling physically sick, and I was so mad at myself for my eating. It wasn’t a good night.  I also ended up staying off track for at least a week afterward, which made the whole thing even worse.  It’s definitely my destructive pattern.

Debbie: So in terms of this year, what do you think now about the thought, “I won’t have any fun on my birthday unless I eat everything I want?”

Amy: Well, I guess I’ve proven to myself that that’s just not true.  When I ate that way last year, it made me not have any fun at all because I felt sick and guilty. I want this year to be different.

Debbie: So what do you think you could do to make this year different?

Amy: Well, first of all, I want to stay in control of my eating. I guess I should make a plan for what I’m going to eat, and remind myself that I’ll feel better if I follow it, even though it’s my birthday.

Debbie: I think that’s a great idea.  It’s so important to remind yourself that even though it’s your birthday, it’s not worth eating out of control because doing so will still ruin your night by making you feel sick and guilty. The same things that make you feel badly on a normal day, like overeating, will still make you feel badly on your birthday.  And, the same things that make you feel great on a normal day, like having a plan and staying in control, will still make you feel great on your birthday. In fact, it will probably help you to have an even better birthday night, too, and better days following your birthday.

Amy: You’re right. I want this year to be different and I want to go to bed that night feeling good about my eating, not regretting what I’ve eaten.

With this mindset in place, Amy and I began to construct her birthday eating plan.  We discussed the fact that it’s perfectly reasonable for Amy to eat some extra food on her birthday, as long as she does so in a planned manner.  Eating a little extra in a planned manner will enable Amy to retain a sense of control over her eating, which will mean that she’ll actually get to enjoy what she’s eating.  As Amy has proven to herself in the past, the moment she starts to feel like she’s out of control is the moment she stops really enjoying what she’s eating. 

Amy’s birthday plan looked like this:

Drink between 0-2 glasses of wine

One piece of bread

One serving of the main course and starch, and two servings of vegetables

Reasonable portion of two desserts (birthday cake and something else)

Amy also made the following Response Cards to read on the morning of her birthday and again right before dinner:

 

 

 

 

 

 

 

 

 

 

Armed with a plan and Response Cards, Amy told me that she felt much more confident going in to her birthday this year than she ever has in previous years.  She felt determined to avoid repeating mistakes from her past and to set a new precedent on her birthday so that she can go to bed feeling happy this year and for years to come.

In Session with Deborah: Memorial Day Weekend

This week I had a session with my dieter, Amy.  Amy told me that while she is excited for the long weekend, she’s also nervous because she has a lot of events over the weekend and she’s worried about how she will handle her eating.

The first thing I did was reassure Amy that she had nothing to do be nervous about. I reminded her that if she makes a mistake over the weekend, it’s not the end of the world, and she has already become adept at the skill of making a mistake and getting herself right back on track.  In the event that she did get off track, I asked Amy to tell me exactly what she would do.  She replied that she would:

1. Label it a “mistake” and not castrophize.

2. Read her Advantages List and some Response Cards and remind herself that she will feel so much better if she gets right back on track that minute.

3. Think about other times when she’s made mistakes and how proud and great she felt when she got right back on track.

4. Think about what sabotaging thoughts led her astray and what responses might be helpful in the future.

5. Resume normal eating for the rest of the day and give herself lots and lots of credit.

Amy and I then discussed what events she had this weekend so that we could come up with a plan.  Amy reported that she is going to the beach Friday through Monday morning and will likely eat out for dinner all three nights, and then she will be attending a barbeque on Monday afternoon.

Amy and I first tackled how she will handle eating out three nights in a row while she’s at the beach. As a lover of bread, wine, and dessert, I reminded Amy that she probably couldn’t have all three at all three meals.  Amy and I talked this over and we realized that it is unhelpful to think of each meal out as a separate event, because if she did, then she might feel deprived not having bread, wine, or dessert at any of one of them.  Instead, we decided to conceptualize the three meals as one package deal, and figure out during which of the three Amy would have these treats.  In doing so, Amy is much less likely to feel deprived at any one meal because she can say to herself, “I don’t need to have bread tonight, I’m going to have it tomorrow. And besides, tonight I’m having wine.” 

Next, Amy and I talked about her strategy for the barbeque.  We came up with the following guidelines:

  • Look at all the food before deciding what to have.
  • No nibbling and no eating standing up! Make a plate of food and deliberately sit down to eat it so I can see how much I’m having and be visually and physically satisfied.
  • If we’re there for a long time, have a snack if I’m hungry but make sure to sit down and eat it mindfully.
  • No dessert at the barbeque – if I really want something, I can bring it home and have it after dinner.
  • No more than two drinks.  Remember, I’ve already had a big weekend and I don’t need more alcohol.
  • Spend time talking to people. I’m there for the social aspect, not for the food!
  • Bring and read the following Response Cards:

 

 

 

 

 

 

 

 

 

 

 

Armed with these plans and strategies, and a renewed confidence in her ability to handle mistakes in the event that she makes any, Amy reported that she was feeling a lot less nervous and a lot more excited about the weekend to come.  I reminded Amy that she has the ability to handle any eating event, especially when she has a strong plan and a firm belief in why it’s worth it to her to follow it.