Reworking the Plan

Melanie, a dieter who consulted me a few months ago, recently contacted me for a “booster” session. She was doing great, still losing about 3 pounds a month. She was no longer writing down her food plan in advance, nor did she need to. Instead, she was able to decide at each meal and snack what she wanted to have and to eyeball her portions instead of measuring her food. She made sure to have plenty of (usually) lean protein and vegetables for lunch and dinner (along with a portion of healthy fat and a grain or starch). She mostly ate fruit or nuts for snacks. And she continued to eat whatever junk food she wanted (about 200-250 calories) at night. Melanie wanted to branch out in her selection of dinner entrees. Her husband wanted her to start cooking some old favorites such as lasagna and corned beef brisket. We had the following conversation:

Melanie: I’m afraid if I start to eat foods like that, I’ll gain weight.

Dr. Beck: Not if you keep your portion small.

Melanie: I’m afraid if I have less protein, I’ll be hungry.

Dr. Beck: And what are you afraid will happen if you’re hungry?

Melanie: I don’t know. I guess I just don’t like the thought of it.

Dr. Beck: Do you remember when you did the hunger experiment? (pages 121-125) What did you find out?

Melanie: I know, I know. Hunger is never an emergency. I do remind myself of that some times. But, I don’t know, it seems worse at night.

Dr. Beck: Well, do you want to do some experiments? For example, you could use your protein calories for corned beef. It will be a smaller portion than chicken. But here’s what I want you to do. Don’t linger at the table when you’re finished. Plan an activity beforehand to do right after dinner. And set a timer for 20 minutes. When the timer goes off, check your hunger level. If you’re still hungry, just tolerate it—leave the house if you think you need to. And the next day, do a similar experiment. But this time, skip your morning snack and have it sometime after dinner (immediately if you want to or later on). Plus you’ll still have your regular evening snack. What do you think?

Melanie tried the experiment with various dinner entrees, and to her relief, found that she wasn’t overcome with hunger. But she really liked the idea of eliminating her morning snack so she could have two evening snacks. She’s been sticking with her new plan for a couple of weeks now and is glad to be able to branch out and eat more in the evening.

Rules for Traveling

When traveling and staying in a hotel, dieters may be tempted by the treats in their hotel rooms. Hotels are smart – they often leave a basket of snacks in full view so they can tempt people to spend money (Day 32 of The Beck Diet Solution). But dieters can take the basket and put it in a closet or cover it with a towel and develop a rule to always carry their own treats with them instead of eating anything from a minibar, basket, or snack machine. If they’re hungry, it’s important for dieters to remember that they’ll have their next planned meal/snack within a few hours or have breakfast the next morning (Day 16 of The Beck Diet Solution).  We ask dieters to imagine if this were thirty years ago when there was no food in hotel rooms.  What would they have done then? 

Our dieter, Jason, had to apply this rule in a different way.  He travels for business once or twice a month and there is always an abundance of snack food at the back of the meeting room. He often feels either bored or somewhat stressed during meetings and it is particularly difficult for him to resist the high fat, high sugar foods. Jasonknows that eating these snacks is contrary to his plan, that he will soon feel weak and guilty, and that he could gain weight, he still has a hard time resisting in the moment.  Jason needs to read the advantages of losing weight just before each meeting. He’s also decided to make a rule for himself that he will not eat any snack food provided at meetings. It’s helpful for him to realize that he’s not alone—not everyone at the meeting eats these snacks between meals. Just like the minibar, he can’t give himself a choice about this or he will struggle every single time.  As soon as Jason makes this rule and practices following it ten times in a row, it will become so much easier for him to resist and stick to his plan.

Back to Maintenance Weight

Our veteran dieter, Brian, came in for a booster session this fall. He had maintained his sizable weight loss for over a year but had recently gained back 4 pounds. Because he had developed a general plan of what to eat everyday, he was no longer writing down meal plans and so wasn’t sure where the extra weight had come from. We discussed what he had been eating and asked him if he was doing any unplanned snacking.  Brian realized that over the past few weeks he had slowly started eating more snacks.  The problem was that as he became accustomed to eating more frequently, it began to feel normal to him to eat all throughout the day.  After a little while, Brian got into the habit of eating whenever he felt a little bit hungry or just felt like eating.  At first he didn’t even realize that he had made this shift because it was a gradual but steady process. He had stopped weighing himself daily, too, and the 4 pound gain came as a surprise.

We discussed with Brian all of the skills he had initially learned that helped him stick to his food plan:  telling himself “No Choice,” reminding himself that he would be eating again soon, that hunger is never an emergency, and that he can’t have it both ways – he can’t snack whenever he feels like it and lose weight and keep it off (Days 12 and 16 of The Beck Diet Solution).  Since maintaining his weight loss was still a very important goal to Brian, he knew that it was worth it to start practicing all of his skills again, including making food plans. 

For a couple of weeks Brian wrote food plans each night and made sure to include a reasonable number of snacks (Day 15 of The Beck Diet Solution Weight Loss Workbook).  Because he had practiced it so much in the past, Brian was able to stick to his food plans and cut out the unnecessary snacking he had been doing.  Brian reported that since doing this, the 4 pounds have come off easily.  But more importantly, not only is Brian back to only eating at planned times, but he has also proven to himself that if he does in the future gain a little bit of weight again, he has all the necessary skills and techniques to get back to his maintenance weight. 

Feeling Hungry: Evan

Before he started working with us, our dieter Evan had lost a significant amount of weight following an all liquid diet (which we don’t endorse but understand can be useful for some people).  When Evan came to see us, he wanted help transitioning to regular food and maintaining his weight loss.  One of the first roadblocks Evan encountered during his transition phase was that he began to feel an increased level of hunger. While he was on the liquid diet, although he was taking in a very limited number of calories every day, he very rarely felt hungry.  Once he began eating solid foods, his hunger returned.

We discussed with Evan the fact that experiencing some degree of hunger is a normal part of life. Most successful maintainers, for example, report feeling hungry before meals. People who have never struggled with weight or dieting know that they can tolerate hunger, that it’s never an emergency, and that if they distract themselves it will go away more quickly.  Evan realized there was a trade-off. Although he now has to deal with the (relatively minor) discomfort of hunger from time to time, in exchange he gets to experience all the pleasures from the rich variety of foods he can now eat.  And, Evan decided, the tradeoff wasn’t even close. 

Dealing with Hunger

Mark, a dieter that we recently began working with, reported that during the past week he’s been feeling extra hungry, which is making it more difficult for him to stay within his calorie limit for the day.  The first thing we discussed with Mark is the fact that this is completely normal.  All of our dieters have periods of time when they are hungrier than others. Although they often say, “I had such a hard week; I was hungry all the time,” it usually turns out they were only hungry for a couple of hours during a few days that week, but let the memory of that hunger color the entire week.

We told Mark that if it’s not time for one of his preplanned snacks or meals and he’s feeling hungry, there are lots of things he can say to himself.  First he can remind himself that hunger is never an emergency – it can be somewhat uncomfortable but he’s lived through much worse physical discomfort in the past (a badly broken arm, a root canal, and a popped kneecap).  Mark can also remind himself that there’s always another meal coming and that he’s going to be eating again fairly soon. Last, Mark can tell himself that just because he’s hungry doesn’t mean he should eat – if he wants to get and stay thinner, he simply can’t eat every time he feels like it. 

We also asked Mark if what he’s been feeling lately is always hunger, or whether he might be confusing it with a craving or a desire to eat (Day 11 of The Beck Diet Solution).  We urged Mark to pay attention to the physical sensations attached to his “hunger” and try to discern whether it really is true hunger.  Mark related that he had been working fewer hours this week, and it’s possible that he felt at loose ends and therefore felt like eating, as opposed to being hungry.   

We proposed an experiment for Mark to try: for one or two days this week, he’s going to spend almost all of his calories on protein and vegetables and limit carbohydrates and starches.  Many of our dieters have tried this experiment and were surprised to see how much more full and satisfied they felt when they varied their diet in this way.  We told Mark to give it a try, and if the same is true for him then at least for now, when he’s feeling more hungry, it’s probably worth his while to incorporate more protein into his diet.