How Full Do I Want to Feel?

While my client April was out running errands last week, she realized that it was past lunch and she was really hungry. April was right near her favorite pizza shop, which had recently reopened, and the idea of getting pizza seemed hugely appealing. When April got to the restaurant, she knew that getting one slice of pizza and a salad would be the smart choice. She ended up ordering two pieces of pizza, a salad, and she threw in a black and white cookie for good measure. After eating both pieces of pizza and the cookie, she ended up feeling very overly stuffed.Pizza

We discussed this situation in session, and April realized a few things that she could have done to have a different outcome. First, we recognized the importance of prioritizing eating on a regular schedule and not allowing herself to get caught up in errands, even if she was being productive. It is unquestionably harder to make a decision that’s in line with your goals when you’re very hungry and have no clear plan in place.

I said to April, “At least you had the thought that getting one piece of pizza and a salad would be smart. What were the thoughts that led you to get a second piece and a cookie?” April thought about it and realized that she must have said something to herself along the lines of, “I’m starving. I just want to eat something that will really satisfy me.” I asked, “If you had gotten one piece and a salad, how do you think you would have felt when you finished eating? Would you be satiated? Would you still be hungry?” April told me that she definitely would have been full, because one piece of pizza and a salad is a satisfying meal.

In talking it through more, April realized that either way she would have ended up full. If she ordered one piece of pizza and a salad, she would be pleasantly full and would have the satisfaction of knowing she made a good choice that was in line with her goals. If she veered from that and ordered two pieces and a cookie (plus a salad that she never ended up eating), she would wind up overly full and regretful.

To help her remember this idea the next time she was faced with an eating decision and was having the sabotaging thought, “I’m starving. I need something extra and really satisfying,” she’ll ask herself this question: Do I want to feel one piece of pizza and salad full, or do I want to feel two pieces of pizza and a cookie full? This will help remind her that either way she’ll be satiated, but if she sticks with the first choice, she’ll be full and proud of herself.

Fantasy vs. Reality

My client Jeff was in the habit of eating a whole pizza several nights per week. While he knew this was sabotaging his health and weight loss goals, he found that he kept giving in to the lure of the pizza. In session, I asked, “What’s so great about eating a whole pizza?” Jeff thought about it and said, “I don’t know. It’s just so great. There’s so much sauce and cheese, and it’s so filling and satisfying.” I said, “Let’s look at this objectively. How do you feel psychologically when you finish eating a whole pizza? Are you thinking, ‘That was a great decision?’” Jeff answered that he often felt pretty regretful. I responded, “How do you feel physically when you finish a whole pizza? Do you feel pleasantly full?” Jeff responded that he often felt stuffed and somewhat uncomfortable.Pizza

This was very interesting to me: when asked what eating a whole pizza was like, Jeff said it was great and satisfying. When asked how he specifically felt psychologically and physically after eating a whole pizza, the answer was very different. No wonder Jeff kept eating a whole pizza! He kept buying into the fantasy of what eating a whole pizza would be like: satisfying and great. He would either not recognize or not pay attention to what the reality of eating a whole pizza was like: full of feelings of regret and being overly stuffed. Jeff made the following Response Card:

It’s true the idea of eating a whole pizza is great, but the reality is not great at all. I end up uncomfortably stuffed and mad at myself. In giving up eating a whole pizza, I’m really not giving up anything that actually feels good. It’s worth it to stop at a reasonable amount.

I’ve seen this fantasy vs. reality concept play out in many other ways in my clients throughout the years. When we first started working together, my client Jen would overeat ice cream every time she got very upset. We worked hard on building up alternate coping mechanisms for Jen to employ when she got upset that helped her feel better and continue to feel in control of her eating. In time, she saw that eating to soothe her upset feelings ultimately caused more upset: she ended up mad at the situation and mad at herself.

There was one instance a few weeks ago when Jen had a really bad day at work and fell back into her old pattern. She stopped at a convenience store on the way home from work, bought a pint of ice cream, and ate the whole thing. In session, I asked, “What were the thoughts at play?” Jen said she was thinking, “I don’t care. I had such a bad day, and I just want to feel better.” I asked, “And did you feel better? How did you feel when you finished the ice cream?” Jen answered that she actually didn’t feel better. She felt mad at herself for reengaging in old, sabotaging habits. But the reason she lapsed back into it was because she was thinking about how overeating ice cream used to make her feel, and not how it makes her feel now. Jen made the following Response Card:

It’s true that overeating ice cream used to make me feel better when I was upset, but it no longer does. Now that I know how great being in control of my eating feels, letting go of that control makes everything feel worse. Overeating ice cream no longer provides me the relief it once did.

Think about your own thoughts. Might there be times when you think something will be better than it actually is? If so, make a Response Card and start reminding yourself of the reality, not the fantasy!

All About Response Cards

Response Cards are helpful phrases written down on 3×5 cards or kept somewhere on your phone. They are one of the most powerful tools in the journey towards gaining control over your thinking, which will ultimately help you gain control over your eating.

CBT for weight loss and maintenance teaches us that it’s never the situation or the trigger that automatically leads someone to eat something, it’s their thinking about the situation. For example, my client Rachel got in a big fight with her sister and ended up going to the kitchen to eat a lot of cookies. It wasn’t the fact that Rachel got in a fight that automatically led to her eating cookies, it was her thinking about the situation. When she gets really upset, Rachel has the thought, “I’m so upset, I deserve to eat to help myself feel better.” Once she has that thought, of course she then goes and eats cookies.

In other applications of CBT, we call these “automatic thoughts” because they’re thoughts our brains make without deliberate effort on our part. In CBT for weight loss and maintenance, we call them “sabotaging thoughts” – thoughts that sabotage one’s overall eating, health, and weight goals.

While we can’t stop anyone from having these sabotaging thoughts (after all, they’re automatic), we can teach people to respond to them effectively so that they have a different outcome. This is where Response Cards come in. Whenever someone has a sabotaging thought, we ask them, “what would you like to say to yourself the next time you have thought? What might be helpful to hear?” Then, we have them write it down and read it every single day. Coming up with a great response to a sabotaging thought is wonderful, but it won’t do much unless you read it over and over and over again. The repetition of reading it is what will help it start to make new inroads into your brain.

In response to her sabotaging thought, “I’m so upset, I deserve to eat to help myself feel better,” Rachel made the following Response Card:

If I’m upset, I do deserve to feel better, but I also deserve to achieve my health goals. Instead of using food as a means to feel better, I can go call my mom, take a walk, do a mindfulness meditation or some yoga stretches, or listen to some music. These activities will help me feel better without sabotaging any other goals. Woman writing a Response Card

When I first started working with him, my client Mark was often going to a friend’s house and overeating pizza. He told me that his friends were all eating many slices of pizza, so it felt normal for him to do it, too. We discussed that Mark had to make choices that worked for him, based on his goals, not choices based on what other people were doing. Mark made the following Response Card:

My body doesn’t know or care what anyone around me is eating, it only knows what I’m eating. Just because other people are eating something, doesn’t necessarily mean it’ll work for me. I have to make choices based on my goals and what will work for me.

Read every day, these Response Cards are a powerful tool in helping you to shift your thinking and response to triggers in a different way. There are no right or wrong answers about what Response Cards should say; it’s only important to figure out what responses are persuasive and resonant to you. Any time you catch a sabotaging thought, make sure you think about what you’d like to say to yourself the next time you have that thought (because if you’ve had it once, chances are very high you’ll have it again), and write it down. Read it every day! That’s what will enable you to have a different outcome the next time the sabotaging thought pops up.

Let It Slide?

My client Tara helps run conferences (which are currently all virtual), and she is in the thick of a busy time at work. In session this week, she told me that she’s been having trouble prioritizing healthy eating and exercise because she has so much work to do. She keeps having though sabotaging thought, “It’s okay, just let it slide until the conference is over next week.”

I asked Tara to think about the pros and cons of “letting it slide” until the conference is over. Here is her list:Woman working on a laptop

Pros:

  • I won’t have to take time away from work to exercise.
  • I’ll be able to justify eating whatever I want.
  • I won’t have the added burden of trying to make healthy choices.

Cons:

  • Exercise is a huge stress reliever. When I don’t exercise during busy work times, I end up overeating every evening to help me calm down.
  • “Eating whatever I want” doesn’t actually make me feel good. It makes me feel overly stuffed and bloated, which impacts my sleep and concentration.
  • While trying to make healthy choices IS a burden, feeling out of control of my eating is a much greater burden.
  • Going into full “work mode” and not taking time for myself isn’t good for my mental health.
  • There is always another conference coming. If I reinforce that it’s okay to “let it slide” during this one, I’ll continue to do it for the next one. This will completely sabotage my ability to achieve the things on my Advantages List, which are really, really important to me!

When Tara took a more objective view of what “letting it slide” actually meant, she realized that it was not something she was willing to do! Her health and mental health were at stake here, and she couldn’t sacrifice them. Plus, when Tara really thought about it, she realized that she always got her work done, regardless of whether she took time to exercise and be mindful of her eating choices.

If you are tempted to “let it slide” during a stressful work or life phase, think objectively about what that means. Does feeling out of control of your eating make you feel less chaotic? Does not exercising help you feel better, or does it make things worse? Would gaining weight every time things got busy help you achieve your goals or sabotage them? Even though working on healthy eating and exercise can be harder during stressful periods, it’s ALWAYS worth it!

Evening Treats

In session this week, my client Lisa told me she was struggling in the evenings. While she found it fairly easy to stick to her plan of healthy meals and snacks during the day, in the late evening (usually around 9pm) she was going into the kitchen and eating treats, telling herself, “It doesn’t matter.”

The first thing I asked Lisa was, “What’s in your kitchen? Do you have a lot of treats in the house right now?” Lisa said that she did. She had a lot of leftover holiday desserts, plus she loads up on groceries (including junk food) when she grocery shops, since she now goes less than usual. I told Lisa that having a house full of a variety of desserts would be hard for anyone, no matter how long they’ve been working on these things. The greater variety of treats there are, the more it tricks people into thinking they should eat.

Lisa said, “That’s true. When I think about having the ginger snaps I have planned, that doesn’t sound as appealing as all that other stuff.” I responded, “Exactly! But if ginger snaps were the only dessert you had in the house, chances are they would sound more appealing. You would eat them and feel satisfied.”People eating and drinking outside

Another reason having so many treats in the house was sabotaging Lisa was because whether or not she was fully aware of it, she was probably actively resisting eating them all day. The more times in a day she tells herself, “No, you can’t have that,” the more decision fatigue starts to set in, in addition to real fatigue in the evening! Saying “yes” starts to feel more reasonable.

I told Lisa, “It’s not as if your body tells you, ‘You said no ten times, so the eleventh time you can say yes and I won’t process the calories.’ Unfortunately, it doesn’t work that way. Saying ‘no’ ten times doesn’t necessarily mean it’s okay to say ‘yes’ the eleventh time, especially if it’s not on your plan.”

Lisa and I discussed her thought, “It doesn’t matter.” I said to her, “Actually, I’m wondering if it’s just the opposite. I’m wondering if those late night decisions actually matter the most because by giving in in the evening and taking in too many calories, it’s stopping you from being able to lose weight. So, it does matter; it matters the most.” Lisa and I discussed that by staying on track all day but giving in late in the evening, it’s like she’s run 24 miles of a 26.2 marathon. It’s still a huge achievement, but she won’t get the finisher’s medal without the last 2.2 miles.

Lisa and I made some Response Cards for her to read in the evening, and we agreed on a three-part plan: First, she’ll get rid of most the treats in her house. Second, she’ll make a strong plan for what she’ll eat in the evening, and third, she’ll read Response Cards to remind herself exactly why it does matter.

The Holidays

While some aspects of the holiday season are easier to manage this year (no office kitchens stocked to the brim with holiday goodies, no parties or get-togethers, no out-of-town trips), there are still very difficult challenges. I’ve been discussing some of them with my clients over the past few weeks.

My client Rachel found that she was overbuying holiday treats for her kids in an effort to make the holidays feel special. Even though she didn’t have to contend with an office breakroom full of temptations, however, she just moved that hot zone into her own house and sabotaged herself. When we looked at the situation objectively, Rachel was able to realize that loading up on sugary treats wasn’t good for anyone in her household – not her kids, not her husband, and certainly not herself. Rachel and I made a list of new holiday traditions she and her family could institute this year that had nothing to do with eating and would enable them to celebrate safely.Vacation Plan 2

My client Lisa got off track during the beginning of the pandemic and ended up gaining about 20 pounds back from the 60 she had lost. Lisa doesn’t live close to her parents or her sister, and she said that not seeing them this holiday season made it harder for her to get back on track and lose the weight she had gained. In the past, knowing they were going to see that she had gained weight back would have been a huge incentive for her to get refocused. Lisa and I discussed that, at some point, she will be able to safely travel again. Lisa made the following Response Card to help her get back on track:

Even though I’m not seeing my family this year, at some point I will see them again. If I keep going down this off-track path, I’ll gain even more weight than I have now. Getting back on track right now is worth it because not only will it help me lose the weight I’ve regained, but I’ll feel better about myself and more in control. I need to do this for myself, not for them.

My client Jason was feeling disappointed that the holidays weren’t going to look “normal” this year, and he was overeating to help him cope. With many feeling deprived of many of their usual pleasures (dinners out, movies, museums, trips, coffee dates, etc.), it makes sense that these feelings would be more acute during the holidays. Jason and I discussed that since he wasn’t going to get joy from many typical holiday sources – most notably time with family and friends – he had to be very deliberate about finding joy in other ways to avoid turning to food to fill that need. Jason made a Response Card to help remind him of that:

Even though the holidays will look different this year, there are still things that bring me joy. I have to be intentional about filling that need, or it will come out through overeating. Overeating to bring myself joy is a trick, not a treat, because it makes me feel out of control and jeopardizes my hugely important weight loss goals.

Flareups

I’ve been working with my client Jeremy for about six months. While it took him a few weeks to learn how to tune into his thinking and get better at identifying his sabotaging thoughts, Jeremy has been doing well recently. He’s feeling very in control, he’s eating and exercising in a reasonable and healthy way, and he’s seeing the scale come down.

In session this week, Jeremy described an experience in which he was tempted to order a big takeout meal after a hard day, but he reminded himself that it ultimately wouldn’t get him to where he wants to be. He said something I’ve heard other clients say in the past: “I’ve really got this figured out. Now, I know I can do this.” While this is not a sabotaging thought in theory, I knew it was important to discuss it with Jeremy because, surprisingly, it could get him into trouble in the future.

The growing understanding of obesity is that it’s a chronic problem that requires lifetime care. And, like most other chronic problems, it’s not under control 100 percent of the time for most people. Other clients I’ve worked with have been in Jeremy’s shoes: they learn the necessary skills to gain control over their eating, and they lose weight. They feel great, and they realize that, finally, they’ve got this problem that has plagued them for years – sometimes decades – figured out.

Then, they get off track. Maybe it’s a stressor at home or work, maybe it’s a vacation, maybe it’s a global pandemic. Regardless of the cause, they find themselves reverting to old, unhealthy habits, which causes panic. They think, “I thought I could do this, but I guess I can’t. I thought I had it figured out, but I actually don’t.” Having these thoughts makes them feel demoralized. They lose hope, get very off track, and often gain back some or all of the weight they had lost.

The heartbreaking thing is that they did have it figured out. They can do it. But what they don’t realize is that just because they finally have it figured out, it doesn’t mean they’re going to be able to stay on track 24 hours a day, every day. Like most chronic problems, it doesn’t work that way. There will always be flareups from time to time. The mistake that people make is thinking that once they know what to do, they’ll be able to do it flawlessly, forever. When they inevitably stumble, they take it as a sign that they can’t do it.

I explained this to Jeremy and reinforced that he does have it figured out. He knows what to do and how to do it. Even so, he’s going to make mistakes in the future, and that’s okay. In fact, it’s unavoidable because he’s dealing with a chronic problem. As long as he has realistic expectations and knows that flareups are a part of the process, he’ll be much better equipped to deal with them. Instead of thinking, “This is terrible. I thought I could do it, but I guess I can’t,” he’ll be able to think, “I knew this would happen. Flareups are a part of the process, but I need to get refocused, recommitted, and I’ll be just fine.”

Trick, Not Treat

This week, my client Julie told me that she had gotten a little off track the previous night and had eaten too many cookies. Julie had been working on one planned dessert every night, which wasn’t always easy for her to stick to. She had previously been eating dessert throughout the day, but she had made big progress. We talked through what happened the night before, and she realized she had the sabotaging thought, “I’ve been so good at just having one dessert recently, so it’s okay to have a little extra tonight.” This type of thinking is very common: often, my clients feel justified in having extra, unplanned food as a reward for having done so well.cookies in a bowl

I reminded Julie that by having extra dessert, what she was doing in that moment was rewarding her hard work by undoing her hard work. She was rewarding great, on-track behavior by exercising her giving-in muscle, strengthening unhealthy habits (using food as a reward, eating beyond fullness, not sticking to her plan), and jeopardizing her weight loss. We discussed how, in virtually no other area of life, we would think it made sense to reward progress by undoing it. For example, when Julie was learning to drive and had months of accident-free driving, would she “reward” herself by purposely getting in an accident? Of course not!

Julie and I discussed that when she’s doing well and consistently making on-track food decisions, she absolutely does deserve a reward. She doesn’t, however, deserve a reward that ultimately sabotages her, like extra, unplanned food. Julie made the following Response Card to help her remember these ideas:

When I’m doing really well, I do deserve a treat. I don’t deserve to use extra, unplanned food as a treat because that’s really a trick, not a treat. I can’t reward hard work by undoing it!

Julie and I made a list of some other things she could try that would really be a treat, and not a trick: getting a new candle, buying a new book, scheduling a massage, or picking out a fun, new recipe to try that week. All of these things will help reward Julie for her hard work without undoing any of her progress!

I Want More

This week, I had a session with my client Sonia, a 45-year-old mother of four boys. Sonia told me the sabotaging thought that kept popping up over the past week: “I want more.” When she’s eating something that tastes good, she keeps thinking she wants more even when she knows it’s enough. Often, she feels deprived if she doesn’t have more.cinnamon bun on plate

I discussed with Sonia that when she’s eating something – assuming she’s already eaten a reasonable amount – and she chooses to continue, she’ll get more food but feel less in control and make less progress towards her goals. When she stops eating after a reasonable amount, she’s getting less food (not no food!), but she’ll feel more in control, make more progress towards good health, and reinforce healthy habits. In either scenario, she’s getting less of one thing and more of another.

Another way to look at this is that either way she’s going to feel deprived. Either she’s going to feel deprived of some food, some of the time (but not all food all of the time), or she’s going to feel deprived of achieving everything on her Advantages List. For Sonia, and many others, the unfortunate truth is that eating every bite of food she wants, losing weight, and keeping it off are mutually exclusive goals.

Sonia and I discussed that she has a bit of a hair-trigger deprivation meter. Every time she tells herself, “No, you can’t eat that,” she immediately feels very deprived. This is likely because in past weight loss phases, she actually has deprived herself. In the past, she would allow herself no carbs, no sugar, or too few calories each day. We discussed that this time is different. This time, she is eating carbs, she is eating sugar, and she is taking in a reasonable amount of calories each day. Although she’s not necessarily eating as many of these things as she would like each day, she is still eating a reasonable amount.

I told Sonia that we have to work on reprogramming her brain to understand that “No” doesn’t mean “I can’t ever have this food” (as it did in the past). Now, “no” just means, “I’m not having any more right now. But I can still plan to have more another time.”

Halloween Survival Guide

Halloween is just around the corner! It’s important to start thinking about what plans and Response Cards you need to navigate it successfully!