BACK TO BASICS

 

Marta was dismayed. After 20 months of maintaining her weight loss with relative ease, she had gone off track and had gained back five pounds.

 

“I wouldn’t mind it so much if I had decided in advance to eat more,” she said, “but that’s not what happened. A couple of weeks ago, we had company for the weekend. I was fine at first, but then everyone else was eating and drinking so much, that I wanted to, too. I just stopped using my usual weekend plan. So by Monday morning, I had gained two pounds. I felt really bad about that, and I was okay for the next couple of days. But then, for some reason, I started snacking too much after dinner. I’d have that old sabotaging thought, ‘I’ve eaten too much. I might as well start again tomorrow.’ I didn’t go way overboard the way I used to, but I did eat more than usual for the rest of that week and this week, like larger portions at meals, bread and butter at dinner, and extra snacks at night. I keep promising myself that I’m going to get back in control but I can’t seem to do it. My weight is up and I’m afraid I’ll just keep gaining more.”

 

Marta and I talked about the two choices she could make:

 

1. She could plan to eat extra food, including bread and butter at dinner and an extra snack at night. It would be planned eating, though, not spontaneous deviations from her plan. Depending on how many extra calories she planned to have, she might gain a little more weight, plateau at her current weight, or lose a little.
2. She could go back to her previous plan and lose the five pounds she had gained.

 

Either plan was completely legitimate and either way, she’d need to go back to practicing her daily CT skills (e.g., reading her Advantages Deck and Response Cards right after dinner, going to her Distraction Box if she felt the urge to eat unplanned snacks).

 

Marta called me several days after our “booster” session. She was back on track, felt in control, and didn’t need another appointment. I asked her what had made the biggest difference. She said going back to the basic CT skills had done the trick.

How to Keep Your Weight Loss Resolution

 

If you want to be successful, DON’T START OUT BY DIETING! In my experience, the major reason that people have difficulty losing weight or keeping it off is that they jump right into following an eating plan before they have learned how to diet.

           

Almost anyone can lose at least a little weight; you don’t necessarily need dieting skills to do so. But you do need these skills if you want to continue to lose weight and keep weight off. You need to learn exactly what to do when dieting gets harder. And it does get harder—for everyone–sometimes within the first week or two, sometimes not for a month or two. People often give up because they don’t have the skills to push through the difficult times. Then they regain whatever weight they have lost.

           

 If you’ve only sailed a boat in calm waters, you don’t want to leave on an extended trip without knowing what to do when the going gets tough. You might be able to navigate well when the ocean is calm, but look out if the weather gets rough! You need to learn foul weather skills in advance.

 

It’s the same with dieting. You don’t want to run into a rough patch and be ill-equipped to handle it. You need to learn, before you run into a squall, how to motivate yourself when you’re feeling unmotivated, how to refocus your attention when you have a craving, how to stick to a plan when you’re eating out, and how to get back on track immediately when you make a mistake. These skills are not intuitively obvious, but they can be learned in a step-by-step program. It’s too difficult for most people to focus on changing their eating while they’re learning these skills. That’s why I recommend postponing the start of your diet until you know what to do in stormy weather.                       

Dieters Need a Complete Diet for Life

I’ve been bombarded with questions about how my new book, The Complete Beck Diet for Life, is different from my first diet book, which did not contain a diet (eating plan) but did contain a six-week program to teach people how to diet. Most obvious is that the new book has a healthy eating plan that is flexible and enjoyable so people can modify it and stay on it for life.

Why did I include a diet? After publication of the first book, I received a couple of thousand emails and read a couple of thousand postings from online support communities who were following the program. I found that a cognitive behavioral approach just wasn’t enough. Although I urged people to find a healthy, well-balanced, nutritious diet, I found that people weren’t following that advice. They were choosing fad diets, unbalanced diets, diets that didn’t include their favorite foods, diets that allowed them to skip breakfast, diets that incorporated way too many carbs (and not enough foods to satiate their hunger), diets that were unnecessarily restrictive in choices or provided too few calories. Inevitably, dieters would stray from their eating plan, gain weight, get discouraged, and give up—then, after a few days or months, would try again with another inadvisable diet, and the cycle continued.

I also found out that many dieters should ease into making changes in their food intake, for example, changing just one meal at a time. They need to be guided in modifying a basic eating plan so it suits their tastes and lifestyles. They need to learn how to handle challenging eating situations where they don’t have control over the food that’s available or where others are pushing food on them. They especially need to learn exactly what to do when it’s not time to eat but they’re experiencing hunger, cravings, or want to soothe their distress with food.

In short, to be successful, dieters needed a complete program for weight loss, that incorporates a psychological approach (e.g., what to do when you’re feeling discouraged, disappointed, or deprived), dieting skills, an enjoyable eating plan, and techniques for keeping motivated for life. Most people think that just following a diet will be enough. I had previously thought that just learning essential skills was enough. But now it’s apparent—you need both.

Why Is It So Hard to Throw Away Food?

Some dieters are so surprised when I suggest that throwing away food is an essential skill for long-term success (pages 82-83 of The Complete Beck Diet for Life). Stella told me that she usually nibbled on the food her children left on their plates and on the small amount of food left in serving dishes. “It’s only a little,” she would rationalize. “I don’t want it to go to waste.” We discussed this problem one day in session.

First, I re-introduced the notion that eating food she hadn’t planned to eat in advance was strengthening her “giving-in” muscle, which meant it was more likely that the next time she would give in and the next and the next. It wasn’t so much the calories (two fries and a bite of hamburger aren’t terribly caloric) for any one instance of eating food from their plates, it was the habit.

Second, we talked about the concept that the food was actually going to waste in her body. The only way the leftover food wouldn’t “go to waste” would be if she wrapped it up and gave it to someone who truly needed it.

Third, I asked Stella if she could think of someone who had a different view about wasting food. Stella told me that her husband who would never even think about eating from their kids’ plates as he cleared the table or taking the last two tablespoons of mashed potatoes from the serving bowl if he had already finished eating.

Fourth, we looked at the impact of her ideas about wasting food. Stella was able to see that her habit had probably added pounds to her weight in the past few years and would likely continue to do so.

Fifth, I helped Stella see that although her mother had imparted many valuable lessons to her when she was young, the idea “throwing away food is a sin,” wasn’t one of them.

Sixth, I asked Stella about her children:

Dr. Beck: Do you want your kids to grow up with the idea that throwing away food is a sin? Do you want them to feel badly if they don’t clear their plates? Do you want them to have to fight the urge to finish the family’s leftovers?

Stella: No!

Dr. Beck: What do you want them to believe?

Stella: That they should eat reasonable portions of food and stop, not eat while they’re clearing the table.

Dr. Beck: And how about you?

Stella: Okay, I see it now. I shouldn’t do it either. It’s really just an excuse, anyway. I know I should stick to my plan.

Finally, we did some problem-solving. Stella decided to have her children put their own plates in the dishwasher and take turns wrapping up leftovers. A couple of weeks later, she reported that she had completely broken herself of the habit.

Slippery Slope

I hadn’t seen Ellie for several months. At our last appointment, she had been doing quite well, having lost 30 pounds in 7 months. She called me up one Monday, several weeks ago, because she had gained weight after a weekend of eating more than usual.

When we analyzed what had happened, it became apparent that Ellie had not only overeaten over the weekend, but that she had also gradually returned to some of her previous unhelpful eating behaviors. She had been on a slippery slope for about a month. For example, she was nibbling on food leftover from her family’s dinner plates. She was eating snacks standing up at the cabinet or refrigerator, instead of setting one portion on the table and sitting down to eat it. She hadn’t read her list of reasons to lose weight for a couple of months. No wonder she was having trouble!

Together we developed a plan of action. Ellie committed to reading a new Response Card (pages 20-21 of The Complete Beck Diet for Life) every morning. It said:

“I can nibble on leftover food and eat standing up OR I can continue to lose weight. I’m much happier with myself when I don’t do those things.”

Ellie also decided to go back to filling out a Success Skills Sheet (pages 274-275) every night for two weeks.

When Ellie called me this week, she was happy to report that she was once again easily using good eating habits and following her eating plan, and that she was continuing to lose weight. Now she knows precisely what to do in the future to get back on track.

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. 

Taking the Full Dose

Our relatively new dieter, Tammy, came in this week and reported that she’s been feeling reluctant to do several of the tasks in The Beck Diet Solution program.  She said that the tasks just don’t feel relevant to her and she doesn’t see the necessity of doing them.

This is something we hear from dieters from time to time: they don’t think certain tasks are necessary, they don’t want to expend the time and energy needed to do the tasks, they don’t feel like doing them, they don’t think they need to learn those particular skills, or they are actually scared to try. We tell these dieters the same thing we told Tammy: the fact is we don’t have a crystal ball. (Then again, neither does Tammy.) And it is possible that Tammy can lose weight without doing all the tasks, but who knows what the future will bring?  It’s quite possible that a task Tammy is avoiding now will actually be something she vitally needs in five or ten years. If she doesn’t learn the skills now, we predict she may have a difficult time maintaining her weight loss. We always tell our dieters that we’re not interested in helping them lose weight—we’re only interested in helping them lose weight and keep it off!

We then asked Tammy to consider what she would do if she had a bacterial infection and her doctor prescribed her a course of antibiotics.  Tammy knows that if she wants to recover, she wouldn’t only take half of the medication prescribed; she would obviously take the full dose.  It’s the same thing with The Beck Diet Solution program.  Tammy needs to do all the tasks because otherwise she’s not taking the full dose and can’t expect the program to work properly. 

Here’s another way to look at it: If Tammy had a very bad headache, she wouldn’t take a quarter of an aspirin; she would take the full pill to maximize the chance that her headache would go away.  So, too, with the BDS program – again, she needs to take the full dose if she wants to be successful. 

With these thoughts in mind, Tammy realized the importance of doing all the tasks in the program and has a new resolve to do everything she can to take the full dose, because she is absolutely determined to finally be successful in losing weight and maintaining the loss. 

Making Decisions

During this week’s phone session, our dieter Liz told us how overwhelmed, stressed, and tired she’s been lately, especially since she and family members are experiencing health problems.  And for the past three weeks, Liz hasn’t been losing weight; she’s just lost and regained the same two pounds.  So we agreed to evaluate whether it’s reasonable for her to keep trying to lose weight at this time, or whether she wants to work on maintaining her already impressive 53 pound loss. 

We asked Liz to think about the past week which she had told us was “extremely difficult.”  We asked Liz whether it was difficult for every hour of every day, or whether there were some hours or even days that were easier (Day 24 of The Beck Diet Solution). One common trap many dieters fall into is letting the memory of a few hours from a few days tinge their sense of the entire week.  Liz realized that some mornings were easier than others, and that it was really a few difficult days, off and on, not the entire week. 

Liz reported that making food plans and trying to lose weight seemed like a big burden at the moment, on top of everything else she was dealing with.  We asked Liz to think back to the time before she started working with us. She realized that while she wasn’t making food plans then, she was actually quite burdened by her weight.

We then discussed her options.  It’s very possible that right now she does have too much going on and now is not the right time to keep trying to lose weight.  In that case, Liz can simply work on maintaining her weight and she can reevaluate her situation in a couple of months.  Or Liz can decide that in spite of everything, she does want to keep working on losing more weight, but either way the choice is hers to make. 

It’s important for Liz to make this decision because for the past few weeks when she’s seen the scale continue to go up and down two pounds, she’s been beating herself up about it and feeling down.  If Liz decides to maintain her weight, then she can feel good about always being within 2 pounds of her maintenance weight, instead of feeling bad about it.  And she can decide at any point to actively try losing again. Liz has decided to take the rest of the week to think it over.

Back From Our Travels

You may have noticed that we took a hiatus from the blog for two weeks. In addition to attending Thanksgiving and a family wedding in Tampa, we gave a series of workshops in California. Altogether, we were gone for 12 days in a row. It’s difficult to maintain your weight during holidays and special events and when you’re constantly hopping on and off airplanes and staying in a different hotel every night for 7 nights. But we did.

How did we manage? We’re committed to eating pretty much the same way 365 days a year. An important study by the National Weight Control Registry showed that successful maintainers are consistent eaters. Did we want to overindulge at Thanksgiving and the wedding? You bet we did. Did we want to pick higher calorie (and sometimes less healthy) meals at airports, hotels, and restaurants? Of course. But we didn’t, because we kept reminding ourselves that we wanted to be thinner and healthier. Was the restriction worth it? Absolutely. We felt good after every single meal and we felt great when we finally got home and stepped on the scale.

Now what works for us doesn’t work for everyone. Some dieters and maintainers do better if they plan in advance (Day 32) to have 300 or so extra calories a day at these times, but not more than that. They may gain a little weight, but that’s okay, as long as they eliminate those extra daily calories as soon as they return home. They have to be careful, though, that they don’t have too many special occasions at which they consume extra calories. And they have to be careful to plan to eat more, not just slip into eating more, since the latter strengthens their giving in muscle and weakens their resistance muscle (Day 11).

Anyway, it’s good to be back and we’ll continue to blog and let you know what’s going on.

Going back to Planning: Roxanne

About five months ago, Roxanne made the decision to stop losing weight and start maintaining.  Since making that decision, Roxanne has been able to stop writing down a formal food plan each night and instead just has a general sense of what/how much she’s going to eat each day.  Like most successful maintainers, this has been fairly easy for Roxanne because she finds herself eating basically the same type of things for breakfast and lunch each day, with the only big variations being at dinner time. 

Although Roxanne is no longer trying to lose weight, she still employs many of the same techniques and strategies she did while she was on the way down.  She still consistently reads her Advantages List (discussed on Day 1 of The Beck Diet Solution) and Response Cards almost every day, and certainly whenever she’s going into a high-risk situation like a party or a reception.  She still continues to weigh herself each morning and consistently makes a conscience effort to eat everything slowly, while sitting down, and to enjoy every bite (Days 3, 5, and 21). 

Because she weighs herself every morning, Roxanne has noticed that for the past two weeks her weight has been up a little bit.  Rather than ignore the weight gain and hope that it goes away, Roxanne had decided to take steps to get herself firmly back on track so a small weight gain doesn’t turn into a thirty pound gain.  For the next couple of weeks, Roxanne is going to go back to making a written a food plan each evening for the next day, so she’ll know exactly how many calories she’s taking in.  With this strategy in hand, Roxanne is 100% confident that she will get back down to her Lowest Maintainable Weight (Chapter 11). 

This is precisely what will enable Roxanne maintain her weight loss for the rest of her life.  Whenever the scale is up by three pounds, she’ll just go back to writing down a plan and sticking to it – a skill she learned how to do well while following the Beck Diet Solution program.  Because she weighs herself each morning, Roxanne never has to worry about gaining back a lot of weight because she will always know when a small weight gain has occurred and the steps she needs to take to correct the imbalance.