cognitive behavioral therapy for weight management

In my last post I mentioned Judith Beck. I recently spent too much money on a seminar she put on CD only to find that her program did not exactly float my boat. Too much structure, complete with eating plans and eating schedules: yikes! Yet, it was not a total waste. She is a Cognitive Behavioral Therapist, and she does have some points that I found useful, so I'm going to share those, along with some of my own editorializing, so we can all get my money's worth out of that seminar.

In my last post, I talked a little about emotional eating, but Beck barely mentions this, focusing more on the automatic thought (cognition rather than emotion) that precedes the behavior of eating. For example, if you reach for a bag of chips when you are not hungry, there must be a thought involved in that decision, whether or not you are aware of it. So you would be thinking, "It is okay to eat this even though my body doesn't need it because______."

We each have a million ways to fill in that blank, like "because I had a hard day," or "because he worked so hard to make this for me" or, well, you get the idea. If you can hear the self talk that precedes the decision to eat more than you need, you will learn something about your relationship with food. (She doesn't go into your "relationship with food," that's way too touchy-feely for a Cognitive Behavioral Therapist--or CBT: those are my words, and Geneen Roth's.)

I'm going to be self indulgent for a moment and use myself as an example. If we eat for something other than hunger, we are responding either to an internal trigger (eg, I'm bored and lonely) or an external trigger (eg, someone brought donuts into the office this morning). I respond to external triggers, and when someone brings donuts into the office, not only will I eat one even if I'm not hungry, I will eat three! Now it would NEVER even cross my mind to stop by a donut shop and buy a donut, so when there's a boxful in front of me, I'd better eat as many as I possibly can, because who knows when I will have another chance? Besides, I need to try every flavor. I don't want to miss anything.

I am an opportunistic eater, or what my husband would call an "opportunivore." I hate to miss an opportunity. If I'm at a potluck, I have to try every single dish. Have any of you ever been to Fresh Choice with me? It's a scary thing.

Now what is that about? I'm actually a little stuck here. It's almost a hoarding behavior. It's like I grew up in the depression. But I have never known any real scarcity. There MUST be an underlying emotion about not having enough...of something. So maybe I am an emotional eater after all...

Beck and CBT in general don't go there (to the emotion behind the cognition behind the behavior), but can you see how identifying that automatic thought can be helpful? It is okay for me to eat this third donut because.... How you fill in the blank will tell you a lot about what you believe about yourself and food and maybe life in general. Then you have to ask yourself: Is it true? Is that statement true?

Where Beck does go is to a very task-focused program, and one of her many, many tasks is writing reminder cards or response cards with statements that will ultimately (hopefully) replace your automatic thoughts. Two of her examples are, "I can eat whatever I want whenever I want, or I can be thinner: I can't have both," and "It's more of a waste to keep eating than it is to throw this food away." (This is my other issue: I am fanatical about not wasting anything--clearly related to that hoarding impulse!)

I guess the idea is when you are considering that third donut, you pull out one of your handy cards which calls your automatic thought out onto the table. Personally, I can't see myself carrying around little cards, but carrying those two statements in my head might turn out to be pretty handy.

One of the main tasks in her program is to motivate yourself every day. She tells you to write a list of all the many specific reasons why you want to lose weight and read your list at least 2x a day (every day for the rest of your life), in the morning and whenever your "weakest point" is during the day. Even better, you can write all your countless reasons on little cards so you have a whole deck to work with. Each morning you can pick out the three that feel most relevant to you that day and carry them around with you and pull them out of your pocket to contemplate throughout the day, maybe even visualize them. If one of your reasons for wanting to lose weight is to fit more comfortably (or at all) into an airplane seat, picture yourself doing just that. (That is her example, not mine.)

I'm all for visualization, and I'll talk more about that later, and maybe Beck's approach would be great for some people, but I think she takes it a little too far for me. Still, I did say at the very beginning that you need to know what your motivation is, and reminding yourself of that whenever you need to can only be helpful. So next time I'm reaching for that donut, instead of saying "This is okay because I rarely have the opportunity to eat donuts," I will say, "Wait a minute, do I really want this donut more than I want to fit into an airplane seat?"