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.

Sue: Part 6, Perseverance

Sue and I were talking about times in the past when she had started to gain weight. It appeared as though each time started with a small weight gain; then she started thinking that dieting was too hard, then she abandoned her plan.

I wanted to prepare Sue in case this same kind of thing happens in the future. I asked her whether there was anything else in her life that had been very difficult, but that she had managed to push through anyway. She gave me a perfect analogy:

Sue explained that several years ago she was headed toward being a professional singer. But she had a teacher who taught her incorrectly, and Sue actually damaged her vocal cords. Singing became very difficult and she thought about abandoning it. But she didn’t. She persevered. Eventually she found a really good teacher, who taught her very important lessons. Sue returned to practicing very hard, and was able to achieve a good measure of success as a singer.

Now Sue is going to create a Response Card to remind herself that she had the necessary perseverance and the right tools to reach her goal of becoming a singer—and this same perseverance, coupled with the tools she was learning from The Beck Diet Solution, will allow her to reach her goal of maintaining her weight loss.

Sue: Part 5

I told Sue that it was great that she has become so much more aware of when she’s tempted to eat standing up. For example, this past week, unprompted by me, Sue made the decision not to eat at her kitchen counter. She has decided for this coming week to eat everything sitting down this week. I offered to have her email me if she does eat standing up, because this may help motivate her: “I don’t feel like sitting down but I’m going to because I don’t want to have to email Judy and tell her I ate standing up”. We decided the one exception will be this weekend when she’s making (healthy) pizza with a friend. But if she finds she’s not enjoying every bite, she’ll sit down. If she makes a mistake, she’ll tell herself, “Okay, I’m just learning this. I forgot this time; it’s okay.”

Sue: Part 4

Sue is getting good at giving herself credit—saying “That’s good!” every time she reads her list of advantages of weight loss, every time she stops herself from eating while standing, every time she chooses healthy food to eat, every time she packs food to go (as a backup), and every time she withstands temptation. She especially gave herself credit for ordering a very healthy vegetarian meal which she said she would have “gagged on” a year ago, once for ordering the dish and once for successfully changing her tastes!

Sue: Part 3

Sue did a great job of reading her list of reasons to lose weight twice a day, every day this week. Doing so really prepared her for the tempting French fries on a communal serving plate at lunch with her coworkers. When everyone but her temporarily left the table, Sue said to herself, “I want to have thinner legs!” and she covered the fries with a napkin, so she wouldn’t have to look at them. Had she not been reading the advantages of losing weight regularly, she may not have been motivated to forego the fries.

Sue: Part 2

Sue has a very demanding job. She can’t predict when she’ll have time to eat or what food will be served. We talked about the necessity of always bringing a back-up meal with her on workdays, something that won’t spoil. If it turns out that the food that’s served is healthy, she can save the back-up food for another day.

I later emailed the following message to Sue: If packing food ever seems like a burden, realize that you’re not alone. Some people with metabolic problems have to do exactly the same thing because they have to eat certain categories of food and they have to eat regularly.

I also wrote: Do you think you could put packing a back-up meal in the same habit category as brushing your teeth or taking a shower? They are things you do daily, whether you feel like it or not. You don’t struggle with doing them because you’ve decided these habits are essential. You just do them. The sooner you put “packing a meal” in a “no choice” category, the less you’ll struggle and the more successful you’ll be.

Sue: Part 1

I started working with a new dieter today. Sue has already lost 50 pounds on her own. In fact, she has lost 50 pounds several times in her life—and always gained it back. She doesn’t want that to happen this time. She’s committed to learning the lifetime skills she’ll need so that this time, she can be successful.

Sue would like to lose more weight but understands that we won’t know what a reasonable maintenance weight will be until she gets there; that is, the weight she is when she’s eating a healthy diet she can sustain for life.

We haven’t talked much about what and when Sue eats. I don’t want to focus much on food until she’s learned the essential preliminary skills. It would be too hard to focus on learning these skills and changing what she eats at the same time.

Today we concentrated on the reasons Sue wants to lose weight. She’ll copy some reasons from The Beck Diet Solution and add as many more as she can think of. (She’s going to put the list in her iPhone.) I urged Sue  to turn a general reason such as “I’ll have more energy” into several specific reasons:

  • “I’ll have more energy on the job”
  • “I’ll have more energy to see my friends at night”
  • “I’ll have more energy to enjoy bicycling on the weekend”

Since she’s already achieved a fantastic weight loss, she’ll also add to the list positive experiences she’s having day to day that relate to losing weight. For example, she told me she cried (for joy!) in the dressing room the other day when she was able to fit into size 10 pants. She’ll add every compliment she gets to the list, too.

We also developed a system for Sue to remember to read this list every morning and at her most difficult part of the day: 3 pm. Sue decided to set the alarm on her phone to alert her when it’s time to read the list. She said she was 100% sure she would follow through with these assignments—she didn’t think any “sabotaging thoughts” would get in the way (e.g., “I don’t have to read the list—I know what’s on it.”). Sue “gets” it. She may not need to constantly remind herself now why it’s so worth it to stick to her eating plan but she has to have these reasons firmly entrenched in her mind for the times when temptation is great.

I’m looking forward to more sessions with Sue!

Recapturing Confidence: Rose

Rose has returned to diet counseling after having been away for two and a half months, dealing with a family crisis. She regained 5 of the 21 pounds she originally lost. She can’t wait to lose the 5 pounds again, predicting that she won’t feel good about herself until she does. We discussed with Rose that what shows up on the scale is just a number and that part of her feeling so good before was not only feeling thinner but also feeling confident and in control. We decided that it would be good for Rose to immediately recapture the confidence she had three months ago. We made a list of all the things she had been doing but is no longer doing, or no longer consistently doing.  In this spirit, Rose is going back to the basics. She has committed to reading her Advantages List and other response cards at least twice a day every day and she’s also going to go back and reread measuring1.jpgsections from The Beck Diet Solution.  Although she has returned to making food plans, this week she’s going to start measuring her food again to ensure that her portion size hasn’t crept up and she’s committed to at least a five minute walk every day.  Finally, Rose is going to try to give herself credit for all the dozens of small things she’s doing right every day to raise her awareness of how well she is doing. 

With these strategies in place, Rose is already feeling more confident and in control, even though she’s five pounds heavier. 

Thanksgiving Plan: Rose

thanksgiving.jpgWe’ve talked before in this blog about the importance of always having a plan, but we think it bears repeating, especially with Thanksgiving just around the corner.  We were reminded of this during a session with our dieter Rose last week.  We asked Rose, who is having Thanksgiving with relatives a couple of hours away from her house, what her food plan was for that day.  She responded that she didn’t really have a formal plan but was sure she’d just stay within her normal 1,500 calorie diet that day. 

We asked Rose what would be the disadvantages of making a written plan for Thanksgiving Day (it’s important to make a plan for the whole day, not just Thanksgiving dinner).  Rose admitted that one of the downsides would be that she wouldn’t feel as free to try different foods.  We discussed with Rose the fact that she can’t have it both ways – she can’t eat whatever she wants when she wants it if she wants to lose weight and keep it off.  We asked her if she thought she’d be more likely to stay within her calorie limit if she had a written plan and Rose answered yes, it was much more likely if she had a plan.  Because Rose reaffirmed that her goal is to lose weight and keep it off, she decided she wanted to do everything she can to reach that goal – including making a Thanksgiving plan.  As part of her plan, Rose decided that for this one day she would plan to eat an extra 300 calories, which would allow her to eat a little bit of everything she wants and not feel deprived.  Rose recognized that if she didn’t plan to eat this extra 300 calories, she might not stick to her plan and could end up eating hundreds more than she had planned. 

We also asked Rose to imagine stepping on the scale the day after Thanksgiving.  If she didn’t make a plan, it is likely that she could have gone over her limit by a couple hundred calories (if not a couple of thousand).  Rose envisioned that in this scenario she would feel guilty and weak, and angry with herself for overeating.  If Rose did make a plan, she was likely to stick with it and not over eat. Then Rose saw herself stepping on the scale and feeling proud and happy – and incredibly glad that she hadn’t overeaten. 

With these powerful images in mind, and also with the resolve that she would do whatever it takes to reach her goal, Rose made a written plan for Thanksgiving Day and feels confident that now she will handle the situation with ease.