Healthy Weight, Healthy Mind: Writing It Down Can Help Improve Your Progress

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

As you work on changing your thoughts and “friending” yourself, creating a Thought Log with the ABCDE format will help you analyze events in your life and track progress. You might dedicate a special journal just for this exercise.

  1. When something upsets you, jot down the activating event (A), dysfunctional beliefs (B), and emotional consequences (C) of your thoughts.
  2. Consider what thinking category causes you to feel bad (all or nothing thinking, emotional reasoning, etc.).
  3. Now you can dispute (D) the thought and replace it with a kinder, factual, probable, and useful perspective.
  4. Finally, you can evaluate (E) how strongly you felt the initial emotion. Perhaps in the beginning you felt frustrated at an intensity of 90 on a scale of 1 to 100.
  5. Record the new rating of frustration (1 to 100) after you begin thinking differently.

You may not like keeping a journal with this much structure, and that’s okay. But I do recommend you take time to evaluate how this information affects your life.

Sit down with paper and pen, or at your computer, and write about which fallacies of thought have kept you from losing weight and sustaining that weight loss. You don’t need to write a novel. Don’t worry about spelling or grammar and feel free to use bullet points instead of sentences.

I suggest you start with writing how the environment and your thinking influenced you to regain weight in the past. Suppose you gained weight after a combination of events — you hurt your foot in October, followed by the stress and social events of the holidays, and then you felt discouraged and gave up. What if you changed your interpretation of those events — your thoughts and beliefs? Would the story have a different ending?

Write about how you could have changed the environment to ensure better success. Then try writing how you could change your thoughts if you couldn’t change the environment. How could this situation end with a better outcome? While you’re at it, write about several of those possible good outcomes. This will show you how changing your thoughts could lead to much better results.

This writing exercise will be like a dress rehearsal for similar challenges in the future. Instead of falling into the same traps as before, you’ve prepared yourself to respond in a healthier way. As with anything you practice the right way, you’ll soon develop thinking skills and new confidence to overcome future challenges to maintaining a healthy weight.

Healthy Weight, Healthy Mind: Disputing Your Dysfunctional Beliefs

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

I hope you agree that it’s a good idea to change thoughts and beliefs that stand between us and weight management. But how can we do it?

The first thing to remember is that thinking is automated. If we do nothing, we continue to think and behave the same way. Changing our thoughts requires practice and persistence. Earlier you read about the ABCs — activating events that lead to beliefs, followed by a consequence, such as an emotion.

One way to practice changing thoughts is to add a D to our ABCs. The D stands for dispute. What are we disputing? We are disputing beliefs that lead to undesirable reactions to situations. Here’s an example:

Activating Event:

Joanie vowed to begin eating better but a co-worker brought her wonderful lemon bars to work on Friday. Joanie ate four of them.

Belief:

I totally blew it today — I have absolutely no self-control! Since today was a disaster, it doesn’t really matter what we eat for dinner. We might as well order a pizza with extra cheese tonight — and go ahead and add those dessert bread stick thingies too. I can always get back on track at the beginning of next week.

Consequence: Frustrated with herself for not handling the lemon bar situation well, Joanie feels hopeless about managing day-to-day food choices. She loses focus on her goals and overeats for the rest of the weekend.

Dispute:

Let’s look at Joanie’s dysfunctional beliefs and how we can dispute them. Thinking she’d already blown it for the day and had absolutely no self-control are perfect examples of all-or-nothing thoughts that have a tone of failure and hopelessness. The idea that she should go ahead and eat more because she ate too much earlier is emotional reasoning. After having her wallet stolen, would Joanie withdraw money from the bank and set the money on fire? If she accidentally dropped a glass and it broke on her kitchen floor would she break more dishes, because ten broken glasses are the same as one? When a patient describes it-doesn’t-matter feelings, I’m often reminded of the lyrics from my favorite Kenny Wayne Shepherd song. It’s like:

…blue on black, tears on a river, push on a shove, it don’t mean much… whisper on a scream — doesn’t change a thing.

That’s how we feel when emotions run high. But feelings are not reality. The extra calories we eat after a snacking mishap aren’t the same as a whisper on a scream. They matter. More importantly, these beliefs interfere with your ability to handle slips. Thinking this way ultimately continues the diet-relapse cycle. Just as setting money on fire after getting your wallet stolen is illogical, so is continuing to make poor food choices just because you made one poor choice.

The belief I can always get back on track at the beginning of next week is a classic procrastination strategy that gives Joanie permission to think and act irrationally because she’ll start fresh at some time in the future. The procrastination thought helps her feel a little better because she has an obscure plan to get back on track. Procrastinating gives Joanie a little psychological space to forget about messing up earlier, so she can eat the pizza and dessert breadsticks without overwhelming guilt. But if Joanie took time to think rationally about her situation, she’d realize that going off the rails for the entire weekend leads to feelings of regret. So how could Joanie think about the lemon bar incident? Consider these ideas:

Disputing “I’ve already blown it for the today.”

Although I’m not happy about eating the lemon bars, I haven’t ruined my day. That extra 600 calories is a minor contributor to my weight, especially if I eat reasonably the rest of the evening.

Disputing “I have absolutely no self-control.”

That’s not true. I have a lot of self-control in many areas of my life. I often refuse buying things to stay within our budget. I don’t tell people off every time I have a negative thought about them, and when it comes to food, I’ve been making good choices more than not-so-good ones for weeks.

Disputing “It doesn’t matter what I eat for dinner, we might as well order a pizza.”

In actuality what I eat the rest of the evening does matt it only feels like it doesn’t. Making better choices the rest of the day will help me recover from slips more easily in the future. Possibly, Joanie really wants the pizza and dessert breadsticks for dinner. If that is the case, fine, but let that decision arise from rational thoughts that allow her to fully consider the pros and cons. The pizza meal should be her conscious choice, not an emotional reaction.

Disputing “I can always get back on track at the beginning of next week.”

Hold on, that isn’t a recovery plan — it’s a sneaky way of giving myself permission to stay on a path I’ll regret later. What can I do right now to get back on track? I’ll take a five-minute walk and think about the best way to handle food choices for the rest of the day.

The last part of the ABCs (and now D), is to add E. E reminds us to evaluate. At this stage, we examine how facing dysfunctional beliefs about weight management will change our emotions, and then alter our behavior in a positive way.

Did thinking different about a situation help calm your feelings?

Did you behave in a different way, with less drama and a better outcome?

If you’ve already begun reacting to situations in a more sensible, thoughtful way, then the thought changing exercises are working. If not, don’t feel discouraged. Take time to examine which thoughts are still holding you back. Remember that emotions are not a switch we turn on and off. Even if we begin thinking differently, our emotions can linger awhile. Just because you recognize something isn’t true doesn’t mean you immediately stop reacting emotionally to the initial thought. Combining the thought restructuring exercises above with deep breathing or moderate exercise may help settle your emotions.

Healthy Weight, Healthy Mind: Why Making Demands on Yourself Won’t Help You Reach Your Goals

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

In the last few posts we’ve been reviewing thoughts that might interfere with achieving health goals. This week we will explore why making demands on yourself won’t help you reach your goals.

The psychologist Albert Ellis is famous for telling people to “stop shoulding on yourself.” I can’t think of an area in life where the word “should” is used more often than with diet, exercise, and weight management.

Why do we use this word? In some situations, the word should may bring good results by reminding us of things that are right and most consistent with our beliefs. I should study for my test instead of going out with my friends. Once you say this you know you’ll feel guilty if you go out. Since you don’t like feeling guilty, you stay home even though you don’t want to. Doing well on the test reinforces your strategy to use the word should.

But sometimes, should is a way we superficially deal with a situation to make us feel a little bit better. If I am talking to my dentist and say, “I know I should floss more often,” this statement probably won’t lead to action. It’s used to relieve the embarrassment I feel for all the problems with my teeth. This type of should makes me feel like I’m doing something, even when I’m not and have no intention to. In a situation like this, using should takes the pressure off, but may actually make it less likely that I’ll change my behavior.

If you want to manage your weight long-term, shoulding yourself is not the best strategy. As in the dentist example above, it may actually prevent us from doing what’s important. Even if you have short-term success guilting yourself into action, this won’t be effective in the long run. Even if it worked, who wants to feel guilty or pressured all the time? Telling yourself you have to do something strips away your perception of freedom and can lead to feeling disgruntled and even angry.

Imagine if the Christmas-time bell ringer for the Salvation Army stopped you at the grocery store, shook his fist at you, and said, “I know you have enough money to contribute to help us. You should stop thinking so much about yourself and your family and give to those who barely have enough to eat or don’t have a home to live in.”

Telling yourself you have to do something strips away your perception of freedom and can lead to feeling disgruntled and even angry.

How would you respond? I suspect you’d react in one of two ways: Either you’d walk on by (even if you were considering a donation before he started his diatribe), or you’d feel guilty enough to reluctantly throw some cash into the red container. No matter what you decided to do, you wouldn’t feel good about the bell ringer—and next time you’d probably use a different entrance to avoid the red kettle.

No one likes being strong-armed, so why do it to yourself? Telling yourself you should eat and exercise in a certain way will make those activities less desirable. You’re almost certain to (1) rebel against yourself, or (2) engage in exercise and dieting with a chip on your shoulder. Either way, you won’t be able to keep this going very long.

In a way, you’re telling yourself you aren’t smart enough, good enough, or disciplined enough to make choices based on what you truly want.

If I tell myself, “I should have an apple, not the cake,” I end up losing no matter which food I choose. If I eat the apple I feel deprived. If I eat the cake I feel guilty. If I eat both of them I feel even worse.

Maybe you substitute a different word for should:

I have to

I need to

I ought to

I’m supposed to

These phrases yield the same results. If we want to make lasting behavior changes and feel good about it, we need to stop talking to ourselves that way. Be nice to yourself. A simple change in words can make all the difference. Instead of using those demanding should words, try something like this:

I could have the apple or I could have the cake.

I could go to the gym or I could stay home.

I can take the elevator or walk up the stairs.

I could order dessert or wait until later.

You are giving yourself a choice — not a command. With this approach you can weigh the options, looking at the pros, cons, and consequence of each decision. Sometimes you might decide on the cake, but you needn’t feel guilty if you figured out how it could work within your larger goal of being healthy. If you decide on the apple you don’t need to feel deprived, because you decided it was the best decision.

As you go through the day, watch for the times you “should” yourself and try viewing these situations as a choice.

Healthy Weight, Healthy Mind: 5 Ways to Resist Snacking After Dinner

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

Reader Question: No matter how hard I try, I just can’t seem to resist snacking after dinner. A handful of chips turns into a bag, or a piece of chocolate turns into 10 pieces. What are some strategies I can use to control my evening binging?

This is a great question about a common challenge. There is no best approach for everyone, but here are five possible ways to curb your late-night eating. You may choose to combine several of these strategies to make them work for you.

  1. Keep unhealthy foods out of the house. I know this sounds simple, but it almost always works. In the evening, we are looking for something tasty and convenient. We are unlikely to leave the comfort of our home for a snack. This out-of-sight-out-of-mind approach also helps avoid feeling deprived. Not eating tempting foods that are in front of us often requires a lot of restraint and mental energy. So don’t make it so hard — save your energy for times when you have less control of the food that is within arm’s reach.
  2. Enlist support from other family members. If other household members resist this idea of keeping trigger foods out of the house, talk to them about it. At a minimum you can usually convince them to store things out of sight. On more than one occasion, patients have told me that their spouse stores trigger foods in their car, the garage, or an out-of-reach cabinet.
  3. Plan your snacks and enjoy them — in moderation. Most of the time we want to focus on eating something that is healthy and tasty -— fruit, vegetables with dip, etc. Make these foods extra appealing with their presentation. Place them on a plate, in bite-size portions, and focus only on eating (sort of like snack-time for young children). To be more intentional with this approach, try eating only at the table rather than in front of the TV or other electronic device.
  4. Practice eating not-so-healthy foods. I realize this doesn’t work for everyone. But in my experience, all-or-nothing approaches are usually unsustainable when it comes to snacking on foods you have determined you don’t want to live without. Although keeping tempting unhealthy foods out of the house is a good idea, this doesn’t mean you can never have a pleasurable indulgence. I have actually asked patients to bring chocolate or other snacks to our sessions. During our meeting I guide them through a mindful eating practice where they eat a small amount slowly, savoring each bite. I ask them to let go of guilt and simply enjoy the food. Learning to eat highly pleasurable foods in this way can build confidence to occasionally consume a favorite snack in moderation. It can also make foods less appealing when we remove the “forbidden” label.
  5. Determine the function of food and find an alternative. Late night eating can be related to boredom, stress, or simply habit. If you are eating out of boredom, what else could you do? I would encourage you to literally make a list and plan to do something from your list each evening. It should usually be something fairly simple. Food is easily accessible and highly pleasurable, and so your alternative should be, too. Is there a book you’ve been wanting to read or an instrument you want to learn to play? Is there a trip you would enjoy planning or some music you could listen to while knitting, crafting, or working on a home-improvement project? If you are eating to deal with the stress of your day, consider calling a friend, writing in a journal, or walking the dog.

 

Healthy Weight, Healthy Mind: Catastrophic Predictions and Labeling Won’t Help You Lose Weight

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

In the last few posts we’ve been reviewing thoughts that might interfere with achieving health goals, including all-or-nothing thinking, mind reading, and filter focus. This week we will explore catastrophic predictions and labeling.

Catastrophic Predictions

“If I don’t lose weight now, I never will.”

“Really? Why do you say that? I asked.”

“My doctor told me I’m no longer pre-diabetic; I actually have diabetes. My knees hurt and I take six different medications every day. If that isn’t enough motivation, nothing will ever get my butt in gear.”

An assumption means you don’t have proof to support a belief. You are guessing. Is it really worth it to get worked up over a guess?

The idea that you’ll never lose weight if you don’t do it now is a good example of a catastrophic prediction. This way of thinking creates enormous pressure to change. Although this pressure can yield results in the short run, it doesn’t work well as a long-term perspective. A now-or-never mindset builds resentment and is emotionally exhausting. You may believe that putting intense pressure on yourself to change NOW will eventually lead to healthy habits. But our minds don’t work that way. Think about anything you were pressured to do as a child (play a sport, take piano lessons). If you didn’t begin enjoying yourself or grasp its value early in the process, you probably fizzled out before long. As we will discuss later, choice is much easier to sustain than pressure.

Catastrophic predictions in other areas of our lives also create anxiety. The single mom in the inner city may believe that if her child doesn’t do his homework every single night he’ll end up on drugs or in prison. This thought process causes her to feel anxious, and as a result of her fear, she pressures her son over doing homework. Her approach is not calm and supportive, but instead demanding and authoritarian. Unfortunately, this method probably won’t yield a happy homework time or a love of academic pursuits for her son — unless she can also instill in him the value of an education.

Labeling

“So Bob, tell me why you’ve had trouble getting into a regular exercise routine.”

“That’s an easy question. I’m just lazy.”

Lightheartedly, I responded, “Well, I have to be honest with you — I can’t fix lazy! Let me ask you a few other questions. You have a job, right?”

Bob nods his head. “Yep, two more years ‘til I can retire.”

“Kids?”

“Three of them, and all out of the house. I’ve got two grandkids thanks to my oldest son and his wife.”

“Do you get to spend much time with your grandkids?”

Bob leaned back in his chair and chuckled. “They live nearby and it’s one of the greatest pleasures in my life. I take my 7-year-old grandson fishing almost every weekend in the summer. My 4-year-old granddaughter — now she’s a piece of work — she likes to come over and ride on the tractor with me.”

“So they love spending time with their grandpa!”

“Oh, you betcha.” He leaned forward as though telling me a secret. “Last time after they were over they asked their mom if they could move in with us.” Bob sat back and pushed his glasses back towards his face. “I guess we’d have room. Heck we have ten acres, we could build on if we wanted!”

“It sounds like there’s a lot to take care of at home. Do you mow most of the land?”

“I mow about two acres, the rest is just woods — my granddaughter would tell you she mows the yard.”

“What do you do in your free time?”

“I don’t have much of it, but I like to tinker with my motorcycle.”

“So you don’t just sit around with your feet up and have people wait on you?”

Bob started laughing, “No, no. I see where you’re going.”

“Okay, so we’ve established you are not lazy, so let’s talk about the real reasons you struggle with exercising regularly.”

In situations like Bob’s, the reason he doesn’t exercise may be related to some combination of not enjoying it, lacking time, not knowing what to do, not having a past history of exercising, or not seeing the benefits. Labeling himself “lazy” is inaccurate and does nothing to solve the problem.

Likewise, labeling someone a “jerk” does nothing to define problems with the relationship. Therefore, the relationship probably won’t improve. Saying you failed a test because you’re stupid prevents you from looking at the real reason you didn’t perform well.

In most instances, labeling is a poor way of explaining our behavior. We are unintentionally reasoning our way out of a solution. In other situations, using labels can be a copout. When you label yourself stupid, lazy, disorganized, or lacking willpower, you’re saying you can’t change — and that lets you off the hook for managing your weight. Labeling other people as jerks means you can’t fix the relationship, so why bother trying?

Healthy Weight, Healthy Mind: Stop Trying to Be a Mind Reader

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

Assuming we know what other people are thinking can get us into big trouble. This fallacy of thought can fuel racism, perpetuate neighborhood feuds, lead to social anxiety, result in road rage, and contribute to disintegrating marriages. When we try to read another person’s mind we’re often wrong—but we act on those beliefs anyway. If my wife lets me oversleep because she knows I’m extra tired, I might “read her mind” and decide she let me oversleep to prove a point about my inability to set an alarm. This could lead to an argument over nothing.

The hard part about mind reading is sometimes we get it right, which reminds us to keep doing it. We remember the times we assumed correctly and tend to forget the times we guessed wrong.

Mind reading can obstruct weight management by causing anxiety and concern over what others think about us. Thinking this way can result in self-imposed pressure to prove something to a boss, sibling, spouse, or co-worker. As a result, we may eat to help relieve the stress caused by these feelings — or we may lose focus on weight-related goals.

Mind reading can directly impact health behavior if we make assumptions about what others think about our size, what we eat, or our competence using exercise equipment at the gym.

At our initial session I had asked Tara if she’d be willing to keep a food journal so we could review it a week later. As we began our second session, I asked how things had gone the previous week. Tara was polite but a bit jittery as we sat three feet apart with a round table between us. Every minute or so she pulled at the front of her shirt to prevent it from conforming to the body she’d grown to hate. She had kept a food and activity journal using an app on her phone, but it remained tucked in her purse, which was on the floor near her feet. As I began to ask specific questions about eating and exercise, she again picked at her shirt.

“I know you’re going to think this is just an excuse but we had out-of-town guests this week and I didn’t follow the plan very well.”

As I tried to reassure her that my role was to help, not judge, I asked if I could take a look at her food journal. She leaned over, picked up her large purse, and began to rifle through it.

“You must think I’m really disorganized. I know my phone is in here,” she said. Finally, she pulled out the phone and a crumpled tissue fell on the table. “I’m sorry, that’s embarrassing.”

“It’s okay, really — if I had a purse I can only imagine what might fall out of it,” I said, hoping to help her feel at ease.

She quickly stuffed the tissue back in her purse and set the phone near her body at the edge of the table. She looked down at her phone, rubbing her thumb back and forth on the screen trying to clean it.

“Before you look at this, I just want you to know that I’m not lazy and I know I shouldn’t eat this way. I’m sure all of you guys eat well and exercise — but I’m just not there yet. You probably think I’m not going to do well because I’ve already messed up and it’s only the first week of the program.”

“Tara, I honestly haven’t made any assumptions about you and how you’re going to do in the program.” I paused, hoping she would look up from her phone. When she didn’t, I gently placed my hand flat on the table only inches from her. I leaned forward and tilted my head to the side in hopes of lifting her gaze toward me. She looked up. “I’m just glad you’re here and willing to allow me to work with you on some of the things you’re struggling with. I assure you, none of our diets are perfect and nobody exercises every day for months on end,” I said, before I pulled my hand back to my side of the table. “If you don’t want me to look at your food journal right now that’s okay. We can do that some other time.”

Tara took a deep breath and then agreed to let me see the records. She logged into her app and handed me her phone. She squirmed in her chair and quickly pulled her shirt away from her body.

Tara’s anxiety was clearly related to mind reading. She made assumptions about what I believed about her, and that would interfere with treatment until I, and the rest of the team, could establish trust. I’ve worked with many people who think like Tara — people who won’t go to a gym or walk outside because they know what others will think of their size; or clients who practice tremendous restraint with eating around others because of similar fears of what people will think if they see an overweight person eating something unhealthy. Of course this restraint can’t be maintained, and when the person is alone the wheels fall off.

The fact of the matter is: We don’t know what others are thinking. To be honest, at times I don’t even know what I’m thinking myself. Things tend to jostle around in my head like a pinball machine. If I can’t tell you exactly what I’m thinking, how can someone else know what’s going on inside my head?

An assumption means you don’t have proof to support a belief. You are guessing. Is it really worth it to get worked up over a guess?

One way to deal with mind reading is to simply let go of assumptions. By definition, an assumption means you don’t have proof to support your belief. You are guessing. Is it really worth getting worked up over a guess? Another approach is to broaden your speculations about what others are thinking by using a variety of may statements. When we expand our guess it’s important to include opposing perspectives. If your mind reading keeps you from the gym because you believe people think you don’t belong there, you might tell yourself: “The buffed up guy may be thinking I don’t know what I’m doing, or he may be thinking way to go, or he may be thinking about the size of his biceps and have no idea I’m even around.”

Healthy Weight, Healthy Mind: The Problem with Filter Focus

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

A friend of mine used to say, “Filter-focus!” when she saw a good-looking guy who grabbed her attention. She would fan herself as she repeated the phrase filter-focus, filter-focus. Her objective was to filter out thoughts about him so she could focus on what she was doing.

At any given moment we’re bombarded by information from at least four of our five senses. As children we’re easily distracted and don’t always filter and focus well. For instance, kids may dart into traffic when they see something interesting. But as we learn and our brains mature, we become better at filtering out a tremendous amount of data by prioritizing. This mostly happens “behind the scenes” without our awareness. This filtering activity often affects our attitudes and behavior.

Depending on our personality and experiences, we can learn to filter out information — or we can prioritize it in ways that cause unnecessary and harmful stress.

Some people filter out accomplishments and focus only on their deficiencies, especially those related to weight. An example would be ignoring the two pounds you lost, while focusing on a package of cookies you ate this morning. This viewpoint leads down a road of frustration and hopelessness, paved with the perceived tragedy of many failures. Don’t get me wrong, we do need to understand and evaluate our mishaps, but only if we also enjoy our positive attributes and success.

Filter-focus fallacy can expand to include our overall moods and life perspective. Choosing to mainly focus on the positive aspects of life changes your outlook on every situation, the people you encounter, and yourself. If you’re accustomed to negativity, the idea of changing to a positive focus may seem “soft” and unrealistic. “The world is a hard place,” these people say. “Better get used to it.”

Yes, bad things happen all around us — but what about the good stuff? If you let your mind process life according to the nightly news, you won’t feel uplifted or positive toward your own life and the people around you. School shootings, murder, scandals, politicians verbally attacking each other, traffic congestion, and impending bad weather, slightly tempered with a sprinkle of a feel-good story or humor — that’s the news, every day. If we want to experience joy, we should avoid seeing our lives from a nightly-news perspective. Furthermore, if we want to stay committed                  to healthy living, we cannot filter out our achievements and focus only on failures.

When I review a food journal with someone who has filter-focus problems, the conversation often goes something like this:

“Thanks for letting me take a look at this. You did a nice job of consistently tracking your food. Tell me a little bit about what went well and what you’re still struggling with.”

“Well, I’m still snacking too much at night and I know I need to eat breakfast every day, but I don’t. This week has been terrible for exercise because I’ve been working more and I’m just so tired when I get home.”

“Ok, but you did eat breakfast four times this week, which is an improvement, and I notice you’re taking your lunch a bit more instead of going out to eat.”

“Yeah, but I’m still eating out too much. I want to get out of the office and when my co-workers suggest it, I go. I just don’t seem to have much willpower when it comes to lunch, especially on the days when I skip breakfast.”

“I understand you still want to make improvements, but over the past several weeks you’ve been moving in that direction. What do you think you did well that led to you losing weight?”

“Well I’m just kicking myself right now because I wanted to lose five pounds in two weeks and I only lost three. I need to dedicate myself much more to exercise and sticking closer to the plan.”

Despite promptings, this patient could not give herself credit for her accomplishments. If you’ve ever been involved with someone who filtered out your accomplishments and focused on your imperfections, you understand the consequences. No matter what you do it isn’t good enough, and if you succeed at something they remind you of previous failures with statements like these:

“I wish you’d done that a long time ago, I don’t know why it took you so long to figure it out.”

“I see you made the honor roll, but why did you get a ‘B’ in that class. Were you goofing off?”

“Your sales figures topped everyone else’s this month, but you should aim higher than that.”

“If you people really cared about this project you’d be working more overtime.”

Do comments like this motivate you to do your best? Do they spur you on? I doubt it. Instead you feel beaten down. The joy of accomplishment is easily squashed, and after a while you think, “Why bother? Nothing I do will be good enough.”

When we talk to ourselves in the same way, the same feelings emerge. The other harmful aspect of filter-focus is that constructive criticism is no longer effective. When you or someone else finds fault with everything you do, one criticism becomes just like all of the others. On the other hand, when you’re able to focus on what you’ve done well you’re more likely to appreciate a valid critique.

Healthy Weight, Healthy Mind: The Bad Smell of Stinkin’ Thinkin’

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

In this article, we’re exploring how the relationship of thoughts, feelings, and behavior affect our eating and exercise habits. Thinking takes center stage.

Before we get started let’s clarify a few concepts and terms. Each of us has thoughts we can’t entirely control. Sometimes we know certain thoughts are ridiculous and we can easily dismiss them and ask ourselves, “Where did that come from?” We won’t be scrutinizing those thoughts. Instead, I want to focus on thoughts that matter — the ones that influence behavior and shape our attitudes and beliefs.

Beliefs are simply thoughts we accept as true. If your mind was a garden, thoughts would be seeds that quickly developed into seedlings. Beliefs and attitudes are the mature plants. Therefore, thoughts are full of potential to help us and provide a sense of well-being. Too often, however, they derail us — and that’s where this chapter can help. Let’s look at three clients whose thinking directly affected their attempts at weight loss:

Can you see how John, Karmen, and Becky handicapped their weight management efforts before they even started? John’s belief that only freaks would eat a balanced diet was like putting up a huge DETOUR sign on the road to weight loss. Karmen was overwhelmed by thinking her metabolism was forever ruined, and only a lifelong extreme exercise program would treat her condition. She was bound to give up. Becky’s mother primed her to feel lonely and hopeless in pursuit of a relationship. She quickly dismissed any man who showed interest in her, yet paid close attention if anyone seemed put off by her weight. Eating would become her friend, her solace.

These three examples above show how thinking can have a clear, direct relationship to weight. However, sometimes the beliefs that affect eating and physical activity are more subtle and indirect:

The First Steps Toward Change

The first step toward thinking differently is to recognize beliefs and feelings behind the behavior we want to change. Examining situations and their outcome helps pinpoint our problematic behavior. For example, let’s consider Lisa from the last paragraph and imagine how she might respond to the following scenario:

Lisa’s boss asks for a volunteer to lead a fundraising project (situation). Lisa thinks, “My boss will be disappointed in me if I don’t do it,” (thought) and despite her already overcommitted schedule, she feels pressure (emotion/feeling) to take on the task. For Lisa, this becomes a question of which option is most unpleasant: the anxiety of not volunteering versus the anxiety and stress of accepting extra work she doesn’t want. Either way, she feels stressed because her thinking has created a lose-lose situation.

Lisa could think differently: “I’m not sure what my boss expects, but even if he does want me to do this (and I have no evidence that he does), it’s unreasonable for me to be everything for everybody. Other people in the office can benefit from taking a turn. The people who truly care about me will still feel that way even if I don’t always do exactly what they want.” She could also talk to her boss in private about his expectations. Thinking differently helps Lisa feel less anxious about her situation. Her new thinking may feel awkward at first but allows her to make the brave choice of saying “no” to more responsibility.

Healthy Weight, Healthy Mind: 7 Tactics to Avoid Emotional Eating

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

 

“Food is my drug of choice.”

I often hear that phrase while working with people who struggle to lose weight. Using food to cope with problems usually leads to later feelings of disappointment, anxiety, and even self-loathing. The cycle of “feel stressed, overeat, feel bad, overeat again” may continue for years and even become a way of life. The only way to break this cycle is by finding other, more productive, less harmful, ways to deal with emotional issues. Later I’ll discuss how modifying thoughts and beliefs can prevent us from feeling overwhelmed. But for now, let’s assume you’re already feeling pressured, threatened, sad, angry, anxious, or browbeaten. How can you cope?

First, consider a list of healthy, pleasurable activities. Using a delightful distraction like reading, crocheting, or working on a car remodel can provide temporary relief similar to the comfort and distraction you get from food. Adding to your list of alternative activities may help you with eating issues. Consider new hobbies you’ll enjoy—things you’ve always wanted to try. Don’t let your weight stand in the way of trying something new.

These activities promote relaxation and offer temporary relief. But some situations, especially ongoing sources of discontent, are best handled when we process the stress rather than distract ourselves from it. Developing coping mechanisms beyond food is the best way to find     peace in spite of undesirable feelings and events. Distractions only scratch the surface of our discontent, like applying a small Band-Aid to a deep cut. Effective emotion-focused coping often requires deeper processing of what’s happening. That includes learning to tell which problems we can solve, versus problems we need to live with for a while.

I admit, coping strategies that aren’t distractions may not be enjoyable in themselves, because you’re facing problems instead of avoiding emotional pain. Creating a relaxed environment for coping activities will help you glean as much immediate contentment from them as possible.

1. Journaling

Journaling has become a wildly popular activity in our culture. Your journal can be a friend who always listens and never says hurtful things. Writing in those pages can help you explore what lies behind feelings such as fear, anger, and pain. Getting specific about things that bother you can help erase superficial worry and uncover more deep-seated issues. With complete privacy, you can explore the past, let go of it, and begin planning for the future. No one has to see your irrational tirades or words that could hurt others. You can edit, keep those pages, or throw them away. Later you might re-read the journal and notice your own faulty reasoning.

But if a journal is only a punching bag of sorts where you vent anger, frustration, and pain, it may not live up to its potential for helping you through stressful times. The goal of journaling is to find meaning, clarity, and eventually peace. Ending some entries by completing statements such as:

“something helpful I’m learning is . . .”

“this probably happened because . . .”

“I want to use this experience to . . .”

“I can start letting go of this because . . .”

“I will be kind to myself because . . .”

. . .can make journaling more therapeutic. You might also finish a painful entry by redirecting your thoughts to the most meaningful parts of your life—things that bring joy, things you’re proud of, and things you look forward to doing.

In addition to your regular journal, keeping a special gratitude journal can direct your thoughts away from negativity and toward the things you’re most thankful for. Writing in detail about people who’ve blessed our lives, possessions we’re grateful for, and experiences that have helped us grow can be uplifting and get us through tough times.

2. Talking to Others

As an alternative to emotional eating, relying on close friends or family members who are good listeners and rational responders can help you deal with stress. Sometimes a quick, supportive phone call or text message can be enough to pull you through a difficult moment. However, keep in mind that friendship and family relationships are two-way streets. If you feel your conversations are burdening others, seek professional help. Therapists not only listen, but can guide you to develop coping skills and manage life in a healthier manner.

3. Religious-based Coping

Although religious practices and beliefs vary a great deal, most people worldwide believe in God or a higher power. The concept of an all-knowing, ever present, loving God is beyond our ability to fully grasp. This can be frustrating and confusing at times, yet accepting this belief can give us a great sense of peace.

When I was a child my family often took summer trips to the beach, which was a 14-hour drive when we were “driving straight through” and “making good time.” Sometimes we left home at 2:00 or 3:00 a.m. so we could check into our hotel in the afternoon. On the way back home we usually left around noon and arrived home a few hours before sunrise. Although my dad drove for many hours through mountains, heavy thunderstorms, and congested traffic, I never worried about safely arriving. I knew Dad would get us there. With no worries at all, I fell asleep alongside my brother and sister — who, by the way, always took more than her fair share of the large back seat in our Chrysler New Yorker. If you believe in an all-powerful God who has your best interests in mind, then you can relate to the peacefulness I felt while riding in our car.

An old saying tells us, “God can move mountains, but bring your shovel.” This is true most of the time. However, sometimes we simply need to wait and trust that, although life brings unexpected and painful turns, we will be okay in the end, even if the pathway is a journey we wouldn’t have chosen. In order to wait more effectively, we can pray, meditate, read faith-based literature, attend services, and socialize with others who remind us to embrace the idea that in the end something helpful will result from our difficult situation.

4. Exercise

Physical activity can relieve anxiety as well as treat and prevent depression. Studies even suggest regular physical activity compares in effectiveness to medications used to treat some mood disorders.

Combining activity with something else you find enjoyable can also be an effective coping strategy. Walking or working out with a friend, taking a group fitness class, walking your dog, or finding   a scenic place to ride a bike or walk can enhance your experience and help you deal with life difficulties. On the other hand, don’t underestimate the benefits found in the solitude of exercise. Even walking on a treadmill in a dark basement can be a time of reflection that leaves you more energized and able to think and solve problems more effectively.

5. Breathing

When we’re upset about something, focusing on our breathing is the simplest thing we can do to calm ourselves. Feeling stressed causes us take shallow, rapid breaths as the body’s fight-or-flight response kicks in. You’ll also notice a tendency to clench your jaw, furrow your brow, and tense your shoulders. This is the body’s automatic response to a threat, whether the threat is physical or emotional. When you’re facing an emotional situation, do you really need to run or fight? Instead, you probably want to relax and calm down. Instead of using food to feel better, try focusing on a simple technique you can do anywhere: Deep breathing. This diaphragmatic/belly breathing can slow the heart rate, decrease blood pressure, and calm your nerves. Here’s how to do it: Let your abdomen expand as you deeply inhale. Take the air in through your nose and release it slowly through pursed lips, while visualizing your muscles relaxing. You might also focus on accepting healing light as you inhale and releasing tension with each exhale. For better results, combine this with soothing music, yoga, or other relaxation activities.

6. Helping Others

When you’re dealing with issues that won’t go away overnight, consider helping other people with their problems. This may sound counter-intuitive, but it works. No matter what our circumstance, we can usually find others who are worse off. Feeding the homeless, volunteering at a women’s shelter, or assisting at a school, church, or hospital can take you away from your own issues and give you a sense of purpose. Plus, you’ll meet new people and possibly make friends, while making the world a better place.

Although helping others won’t erase your problems, it may give you a different perspective. When I help transport someone in a wheelchair it’s easier for me to accept the moderate amount of pain in my arthritic joints. When I help families of children with cognitive or physical limitations, my own children’s meltdowns are put into perspective. Providing a backpack with school supplies for a child of an inner-city family reminds me of how fortunate I truly am.

7. Medication

For some people, taking medication is a helpful strategy for coping with stress and psychological conditions. Although you may want to try other strategies first, medication has a place for treating anxiety, depression, and mental illness. You shouldn’t feel ashamed or embarrassed if your doctor prescribes something to help. However, don’t forget that medication is never a substitute for healthy coping; rather, it should be used to make healthy coping easier.

 

Healthy Weight, Healthy Mind: Are You an Emotional Eater?

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017).

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

 

People commonly use food to deal with stress. After all, food is an enjoyable distraction and easy to find. When you feel stressed at work, a vending-machine candy bar may only be steps from your office. At home, our well-stocked pantries and refrigerators make emotional eating an easy way to cope. And once in the kitchen, what foods call to us? It certainly isn’t lettuce or carrots. Most likely we hear a siren song from ice cream, chips and salsa, cake, or some other high-calorie food.

One TV commercial shows a sniffling, downtrodden young woman paying for items at a convenience store. She places ice cream, potato chips, and a box of tissues on the counter. The elderly cashier empathetically says, “Oh, honey, he broke up with you again?” Viewers understand this because emotional eating is so common. This young woman is using food to deal with sadness, abandonment, and anger.

In my weight management groups and individual sessions with people trying to lose weight, I frequently ask, “What influences you to eat when you aren’t hungry?”

Many people respond by saying, “I’m an emotional eater.” Even among those who deny emotional eating, we often discover patterns of weight gain during stressful times and life transitions that suggest otherwise. And it’s not just negative stress – positive stress also can influence eating and physical activity. Exciting life transitions, sometimes referred to as eustress, can impact our behavior. These stressors may include the birth of a child, a job promotion, a new house, or a new relationship. We might gain weight because we party and stop exercising at college, take on the unhealthy habits of a spouse during our first year of marriage, use food as entertainment when we travel, or celebrate anything and everything with cake. Over time, eating during periods of eustress or distress becomes a pattern that seems normal. We eat without much awareness of the circumstances and emotions that contribute to our food choices.

Redefining pleasure can help us eat healthy during times of celebration and still enjoy life. Monitoring weight, physical activity, and diet can keep us from veering off track during exciting times. But for many people, persistent distress is more connected to unhealthy weight than positive stress. With or without awareness, stressed-out employees, moms and dads, college students, and even children self-medicate with food.

I don’t want to turn you into an unemotional robot when it comes to eating. I do want to help you become intentional about how you react to stress. Being deliberate and aware of our reactions is often a challenge, because the interaction between emotions and eating is complex. Fortunately, we can begin making positive changes without understanding every detail of why we eat.

To simplify, let’s accept that emotions affect everyone’s eating habits to a certain degree. Your unique patterns may be so ingrained that you barely notice them. To better understand your patterns, it may help to answer the following questions:

As the questions above illustrate, people have different patterns of emotional eating. You may be a grazer — tasting food as you hurriedly prepare dinner or inching your way through a sleeve of crackers while helping a reluctant child complete his homework. Maybe you tend to not eat when you’re stressed, but overcompensate later when the pressures of life subside. Or you may be a frequent binge eater, consuming food until you’re uncomfortably full, feeling out of control and only eating in private, and feeling embarrassed and guilty when you finish. If the last sentence describes you, consider seeking professional help. A therapist skilled in eating disorders can help you better understand your behavior.

In the next article, we’ll cover how to cope with emotions in a healthy manner.

Come back each week for more healthy weight loss advice from Dr. David Creel.

 

Healthy Weight, Healthy Mind: Why You Should Track Your Physical Activity

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of Dr. Creel’s columns here

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

You’re busy, but are you physically active? This may be a tough question. Perhaps you have a sedentary, yet high-paced job that leaves you feeling drained at the end of the day. This tired feeling can fool us into thinking we’re more physically active than we really are. If you exercise regularly, you probably have a good idea of how much time you spend being active, but how does all of that add up when you consider what you do the other 15 hours of the day when you’re awake? A fitness tracking device can help answer these questions. Wearables include wrist worn devices, pedometers that can be attached to a belt, bra or shoe, and activity trackers built into your smartphone.

Of course you can be active without using devices, and having one doesn’t guarantee you’ll be more dynamic. But paying attention to the numbers does make you more aware of physical activity patterns. Just as a food journal helps you become more mindful of eating, a wearable fitness device such as those made by Fitbit, Jawbone, Misfit, Garmin (and three other companies that have likely emerged since I started writing this sentence) can provide feedback on your physical activity and help you set objective goals.

I was leading a weight management class on the topic of physical activity. We compared the pros and cons of exercise, and I asked the group why people (and especially overweight folks) often avoid exercise. Karen, who had been quiet and seemingly uninterested in the topic up to that point, chimed in.

“It’s torture.”

I had turned to write some of the responses on the whiteboard, and I wasn’t sure if I heard her correctly. “What was that, Karen?”

“It’s torture,” she said without a smile.

She actually seemed sort of angry. It was as if people had been telling her to exercise for years but they just didn’t understand how terrible it felt for her. Karen was a generally pleasant 40-something lady, about 150 pounds overweight.

“Exercise is exhausting, boring, and it hurts my knees,” she said.

As she freely expressed her disdain for exercise, I noticed a bright pink fitness device on her wrist.

“Karen, I notice you have a Fitbit,” I said. “Do you like wearing it?”

“I love my Fitbit. It tells me how many steps I’ve accumulated, and I try to reach at least 5,000 per day. I know you’re supposed to get 10,000 steps per day, but I really can’t do that yet. Reaching 5,000 is really an improvement for me. I started taking the stairs down at work, and I look for ways to walk around more at home in the evenings. Sometimes if I’m getting close to my step goal, I’ll walk my little dog for five or ten minutes in the evening. This thing even tells me how much I move in my sleep.”

After hearing her say exercise was torture, I didn’t expect her to sing the praises of a wearable fitness device. After a bit more interaction, it became clear that Karen viewed “exercise” as long bouts of intense physical activity at a gym. This didn’t appeal to her. On the other hand, she enjoyed accumulating physical activity throughout the day with feedback from her Fitbit. Would it be wonderful if Karen had a change of heart and began a structured exercise program? Sure. But tracking her fitness made her more aware of physical activity, and she was setting progressive goals in the right direction.

If you aren’t into gadgets or don’t want to shell out the money for one, simple fitness tracking techniques can be helpful. Setting a goal to exercise 20 minutes during 20 out of 30 days a month can easily be tracked on a calendar. Each “X” is one step closer to your goal. Other people have set distance goals, planning to walk the equivalent of 500 miles in a year. Every day they mark down their mileage, knowing that ten miles per week keeps them on target. Some of our patients have even placed thumbtacks on a map to show how far they’ve gone toward their planned destination.

Going with the flow” of society’s eating and exercise habits probably won’t lead to long-term weight loss. Instead, we must be intentional about changing our habits. One of the first steps in this process is to pay closer attention to eating and physical activity. When we track our weight, diet, and movement, we heighten our awareness so that progress is clear. This self-monitoring forces us to decide between the short-term pleasures of food and inactivity, and the long-term benefits of restraint and self-discipline.

Come back each week for more healthy weight loss advice from Dr. David Creel.

 

Healthy Weight, Healthy Mind: Gaining Weight After Quitting Smoking

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

This week’s column is based on a question from a reader. Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

 

Reader Question: Help!!!  I am one of those older women who finally quit smoking and find myself twelve pounds heavier. I eat the same way I have always eaten, although not necessarily the healthiest. All the weight is in the midriff/waistline area. I am so uncomfortable I can barely bend down. I hate the word diet, but I need to do something that I can hopefully stick to. Can you help?

 

First of all, congratulations on your persistence with quitting smoking—what an accomplishment!

Although smoking cessation often leads to weight gain, the net effect is generally a great improvement in overall wellbeing. One large study published in the Journal of the American Medical Association showed gaining weight after smoking cessation did not offset the beneficial effects on heart health.

But to your point, weight gain is something few desire, and gaining fat around our organs is related to increased risk of diseases. The obvious, ideal situation is to remain tobacco-free while maintaining a healthy weight.

Although there might be a slight change in metabolic rate after quitting smoking, it appears that increased appetite is more to blame. Although it might not seem like your eating has changed since you stopped smoking, sometimes these changes are so subtle we don’t recognize it. Consuming only 100 calories more than we burn each day can lead to 10 pounds of weight gain in one year. So, to your question—what’s a person to do?

There is no perfect diet for weight loss. In order to lose weight, we must create a calorie deficit. Many different diets/plans can help you accomplish this. Unfortunately, successful weight loss is often short-lived because the plan is unrealistic or people struggle to commit to a new lifestyle. Although I don’t know anything about your medical conditions, limitations, or preferences, I usually encourage the following:

Thank you for your question. We’d love to hear back from you in the future. Good Luck!

 

Healthy Weight, Healthy Mind: Pay Attention to Lose Weight

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

As we go through daily life, multiple thoughts enter our heads like a parade that never ends. Each thought may lead to an action that can trigger more thoughts, more behavior, and so on. Our minds relentlessly create judgment, worries, memories, and ideas. For those of us concerned about weight, these thoughts are often related to eating. Like a game of tennis played on the court of life, our thoughts and behaviors are constantly in flux, moving us toward or away from healthy places. When it comes to food, the back and forth of our tennis match may go something like this:

It’s nine p.m. and you just finished watching your favorite TV show. Now the food commercials start. In less than 30 seconds you see a woman seemingly transformed by a bite of creamy Greek yogurt. Her eyes close and her head tilts slightly to the side as her lips close softly around this magical spoonful of raspberry swirled yogurt. “Wow, that looks great,” you think. You respond to that thought by heading to the refrigerator. You pull the door open and see yogurt, some cheese sticks, and, oh—there’s the chocolate sauce. Seeing chocolate sauce reminds you of ice cream in the freezer. Perhaps you should make sure it’s there.

Yep, you still have ice cream. You open up the container and consider “cleaning up” the ice cream stuck to the inside edges of the carton and then scraping and tasting until all is symmetrical and level. Should you scoop some into a bowl?

If you decide to eat ice cream, your beliefs about that behavior also have a lot to do with how much you eat. Thinking about the flavor instead of the health effects of ice cream can lead to overeating.

Over time, strings of behavior and thoughts like the ones above can lead to bad habits. It’s like we’re stuck playing tennis on one part of the court. Upcoming chapters will help you learn to change your environment and alter your thinking, but the first step to interrupting these thoughts and breaking bad habits is to pay closer attention to what you’re doing.

The first step to interrupting these thoughts and breaking bad habits is to pay closer attention to what you’re doing.

We have discussed motivation and the idea of committing to the process of weight management. This commitment is not simply about how we think—we also commit to taking action, because actions propel us to improve our health and transform our bodies. More importantly, some practices eventually shape our perspectives and become part of who we are.

As a young man, I learned a valuable lesson about dangerous patterns of thoughts and behavior—a lesson that would eventually help me break the risky and costly habit of speeding. At two different times in my 20s, I received multiple traffic tickets within a year. Not only did it cost me money I didn’t have to spare, it earned me two separate trips to defensive driving school. If you’ve never attended a defensive driving class, take my word, it isn’t a great way to spend Tuesday evenings. After my second set of enthralling group interactions, I decided I didn’t really like the idea of paying fines and watching videos about the dangers of speeding. But speeding was sort of a habit with me. I told myself I was driving with the flow, but in reality I drove with the flow in the far left lane. To avoid getting additional traffic tickets I did two simple things: I noticed the speed limit wherever I was driving, and I frequently checked my speedometer. I stopped “going with the flow.” I began paying attention.

“Going with the flow is one way of describing ingrained habits for eating and exercise. We need to pay attention in order to change eating and activity levels. It may seem you don’t eat differently than other people, and that may be true, depending on who you compare yourself to. But if you’re gaining weight, or maintaining excess weight, then going with the flow probably won’t lead to weight loss.

Come back each week for more healthy weight loss advice from Dr. David Creel.

 

Healthy Weight, Healthy Mind: The Difference Between Motivation and Desperation

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

Do you have a weight loss question for Dr. Creel? Email him at [email protected]. He may answer your question in a future column.

 

When you’ve failed at weight loss many times, your desire to change can turn into something that seems like motivation but isn’t. Loretta’s story is a good example.

Loretta showed up 15 minutes late for her psychological evaluation for bariatric surgery. I knew little about her aside from the information in her medical records. In her chart, I found that Loretta weighed well over 400 pounds and had diabetes, sleep apnea, arthritis, and low back pain. She checked the African American box on her intake form, and I noticed her address was in the middle of a crime-ridden part of a nearby city. When I met her in the waiting room she rocked backward and then forward while pushing on the arms of the chair in order to get to her feet. She groaned and grimaced with pain while walking with me to my office, barely acknowledging my introduction. She didn’t apologize for being late and seemed uninterested in small talk about weather or traffic. After we sat down, I explained the purpose of the required evaluation was to make sure surgery was a good fit for her, and if so, determine what things she could do to best prepare for the operation.

As Loretta began telling me about herself, it was clear our lives were only similar in the sense that we were both raised without much direct influence from other cultures and races. Her urban speech patterns were unlike mine, and her life was riddled by poverty and family members incarcerated or addicted to drugs. She casually admitted to having a drug problem in the not-so-distant past. On the other hand, I grew up in a Mayberry-like small town insulated from most of the problems found in inner cities.

Although I’ve tried to educate myself about other cultures and interact with people different from me, I can’t change the color of my skin or how I grew up. I could not simply, without invitation, step into Loretta’s world and understand her life. Our differences were important to her and she didn’t want to talk about the thing that was most personal to her—her weight—with someone like me. How could I blame her? After all, it’s hard enough to talk about personal struggles with someone who understands where you come from. Revealing these things to a stranger from a different culture and race adds to the difficulty.

I listened intently to Loretta and paid close attention to her body language. Although I tried hard to connect, she spoke to me with distrust, answering my questions with curt frustration. She was holding her cards close to her chest, afraid if I got a glimpse I’d take advantage of her. She feared I would win the game and taunt her with condescending psychobabble. Like many patients in this situation, she probably believed I’d use her words against her when it came to deciding if she was an appropriate candidate for surgery.

My attempts to convince her we were “on the same team” and I wanted to help did not resonate. I had real concerns that her lack of a support system, combined with financial hardships, would cause problems for her after surgery. Would she be able to afford the vitamins she needed to take daily for the rest of her life? When she couldn’t use food to cope with life difficulties would she turn to drugs again? Although she couldn’t see it, surgery could make her life worse if she wasn’t ready and equipped to make the necessary changes. As I continued to probe about how she would manage various aspects of her life after surgery, she stopped me.

“I don’t like where this is going.”

I put down my pen and stopped taking notes. “What are you concerned about?”

“I want to change my life.”

“How do you want your life to be different?” I asked, as our eyes finally connected.

Her expression softened and her eyes welled with tears. Like the small movement from the torque on a lid of a never-opened jar, I could sense something was about to give way. At that moment I didn’t notice her body that 30 minutes earlier had fallen into the oversized chair, out of breath from walking to my office. I didn’t notice her skin tone or the fullness of her face. Our age difference and dissimilar upbringings were insignificant. I just looked into her eyes and felt the gap between us closing. In a strained, high-pitch voice required to delay an ensuing sob, she quickly exclaimed,

“I can’t even wipe my own ass anymore.”

I didn’t know what to say. There it was, one of the most personal and embarrassing aspects of her life, out in the open. In those few words, she ripped through the veil I’d been tugging at the entire session. But I wasn’t ready for it; I could no longer sustain eye contact. It was like I accidentally saw her naked and was sorry I embarrassed her. As I felt the weight of her troubles, compassion stole my words. I looked down, nodding my head.

“I can only imagine how that makes you feel,” I said, after a long pause.

Her size had robbed her of her dignity. She was angry. As we continued talking, I learned she had been this size for quite some time. She depended on her husband to prepare food and help her dress, bathe, and get into and out of her car. It seemed illogical that up to the point of seeking bariatric surgery, she had done little to change course. How could it be that Loretta, like many other people, hated her situation so much, wanted to change, yet seemingly did nothing about it for so long?

Clearly, Loretta wanted to lose weight. In fact, she told me she’d wanted to lose weight for a very long time. Despite her desire for a different life, I imagine she had misguided family members who said, “When she wants it bad enough, she’ll do it.”

But Loretta’s problem wasn’t lack of desire. She had a strong desire to lose weight, but she wasn’t motivated: Loretta was desperate. A simple comparison will help explain what I mean.

Imagine you’re stranded on an island by yourself. You have sources for food, water, and primitive shelter. You’re happy to be alive, but also desperate to leave the island, interact with other humans, and enjoy a hot shower. Month after grueling month you try everything to escape the island—sort of like the old TV show Gilligan’s Island. After years of failed attempts, you still want to leave, but you’ve given up hope. Deep down you believe nothing will work—and you’re losing motivation. Any new idea to get off the island leads to a half-hearted pursuit before giving up. You’re so demoralized that you can no longer tell the difference between good ideas and dead ends—they all seem alike.

This is the point Loretta reached with weight management. Someone told her about bariatric surgery and she felt so desperate she made an appointment. She wanted to lose weight, had many good reasons to change, but wasn’t motivated. Our conversation revealed that, to her, bariatric surgery was no different than the grapefruit diet, the cold shower and potato diet, or having her mouth wired shut. In her desperation she hadn’t considered how this procedure was different than everything else she had tried.

Because of her perspective, she wasn’t ready to do the work required to be successful with bariatric surgery. When we offered to help Loretta prepare for surgery by changing her diet and beginning a modest physical activity program, she seemingly lost interest. Maybe over time she became motivated and pursued help elsewhere. Perhaps she’s still on her island—I hope not.

Desperation occurs at the intersection of hopelessness and motivation. We want to change but have lost hope.

Desperation occurs at the intersection of hopelessness and motivation. We want to change, but have lost hope. We consider drastic efforts without truly believing they’ll lead to success, and after a while the drive to change begins to fade away.

Desperation can rob us of clear thinking and make us vulnerable to things that will harm us, while safer solutions rest quietly within our reach.

Desperation can lead to motivation, but not always. Desperation can also rob us of clear thinking and make us vulnerable to things that will harm us, while safer solutions rest quietly within our reach. Many times people repeat the old saying: “You have to hit rock bottom before you can change.” In other words, life has to get really bad before we’re desperate enough to make changes. This can be true for weight loss, and sometimes it works, but it only works if someone will help you out of the mire and offer a safe, realistic plan. Even then, you must accept the help, believe in the plan, and do your part to make it happen. Otherwise, desperation usually leads to taking whatever someone will give you and hoping things will miraculously work out.

 

Come back each week for more healthy weight loss advice from Dr. David Creel.

Healthy Weight, Healthy Mind: Tips for Eating Smart, Part 2

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

 

Last week I offered four eating tips to help you lose weight and keep it off in a healthy manner. Here are three more helpful hints to help you manage calories and develop sound eating habits.

5. Choose Whole Grains

Our bodies like to operate on sugar (glucose), especially when we exercise at high intensities. When we eat whole grains, complex carbohydrates break down and sugar slowly enters our bloodstream, ready for use by our brain and working muscles. Whole grain foods such as wheat bread, brown rice, quinoa, and oats are rich in vitamins and minerals as well as fiber. Whole grains can be slightly higher in calories, which you will see if you compare white bread to whole wheat bread, because they contain the germ of the seed — a source of healthy fat. Despite the slightly higher calories, you’ll probably feel fuller longer because the whole grain fiber slows the rate at which food empties from the stomach. In addition, many foods made with refined grains (crackers, muffins, pastries, cookies, etc.) have added fats and sugars that boost the calorie count and increase our drive to overeat them.

6. Eat Lean Protein at Meals and Snacks

Calorie-for-calorie, protein tends to be more satiating than fat or carbohydrates. If I asked you to rate your fullness after eating 300 calories of pasta with red sauce (carbohydrates) versus the same calories worth of cheesecake (a tiny piece loaded with fat), compared to boneless skinless chicken breast (almost entirely protein), which would fill you up the most? Studies show it would be the chicken breast. Protein is important to help us feel satisfied after eating. Thus, adding an egg to your breakfast or a low-fat cheese stick to your afternoon snack may help curb overeating later in the day.

7. Watch for Hidden Fat

For several summers during college I worked breakfast and lunch room service in a high-end hotel. Each morning, dressed in my white Oxford shirt, black pants, and bow tie, I would grab something quick to eat between orders. Oatmeal was my favorite. I wasn’t sure why, but this was the best oatmeal ever. I thought maybe the hotel ordered exotic oats from overseas, which would explain the silky texture and rich flavor. Each morning I scarfed down a bowl or two of what I thought was the healthiest thing I could get my hands on. One morning I happened to enter the kitchen when Ms. B, as we called her, was making a large batch of the good stuff. Ms. B was a sweet black lady from Alabama who called everyone Honey. She seemed to cook from the depths of her soul and her food tasted better because you know she prepared it just for you. I can only imagine she learned to cook from her mother, who learned to cook from her mother.

Having family from the South, I knew all about the fat-is-flavor style of cooking. But I couldn’t believe my eyes when I walked in on Ms. B mid-oatmeal and saw her pouring a large carton of half-and-half creamer into the oats. I never imagined someone could do that to oatmeal! That day I learned a valuable lesson about hidden fat, especially when dining out. People often underestimate the calories in food because they don’t account for added fat, especially when others prepare it. Remember, one gram of fat has nine calories. A teaspoon of butter contains about four grams of fat or 36 calories. A stick of butter has over 800 calories (think cookies), compared to an equally sized banana of around 90 calories.

 

Follow This Diet

In summary, there is no best diet for weight loss and weight loss maintenance. But consuming a diet that’s rich in vegetables, lean protein sources, fruits, whole grains, and low-fat dairy will make weight loss more likely and give you the best chance of preventing diet-related diseases. In addition, eating a balanced diet can make you feel more energetic and give you the fuel to exercise consistently.

Come back each week for more healthy weight loss advice from Dr. David Creel.

Healthy Weight, Healthy Mind: Tips for Eating Smart, Part 1

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

Although people who lose weight in a healthy way and keep it off don’t eat exactly the same way, we know that eating within a certain framework will promote health and increase your likelihood of success. The following recommendations are consistent with The Dietary Guidelines for Healthy Americans. You can safely follow these guidelines to lose weight and keep it off in a healthy manner. Of course, if you have a medical condition that requires a special diet, you should consult a registered dietitian.

1. Eat Foods from Each Food Group

Over the past 60 years The United States Department of Agriculture has promoted healthy eating through The Basic Four Food Groups, The Food Guide Pyramid, MyPyramid and MyPlate. Even though the recommendations change slightly over time, research continues to support the importance of eating a variety of foods from different food groups. In order to avoid malnutrition, people either have to eat this way or take supplements. Although supplements can play a role in our health, especially for people who have malabsorption issues, food allergies, or intolerances, relying on supplements for health and nutrition isn’t ideal.

Scientists are still discovering compounds in foods that may help prevent diseases such as cancer and heart disease. Since we still don’t know how all of this works, we can’t simply pull out all the beneficial compounds in foods and put them into a pill. For instance, fruits and vegetables contain many phytochemicals (plant chemicals) that play a role in preventing cell damage or assist in health-promoting enzymatic reactions. A typical multivitamin doesn’t contain these phytochemicals. Frozen pizza, chicken nuggets, and a handful of supplements are not equal to a diet rich in vegetables, fruit, lean protein sources, whole grains, and low-fat dairy. When we eat selections from all the food groups we naturally maintain a reasonable balance between protein, carbohydrate and fat, and we’re likely to consume adequate amounts of vitamins and minerals. People who undergo bariatric surgery are an exception and require vitamin/mineral supplementation.

2. Eat Different Kinds of Vegetables, and Lots of Them

Eating a variety of vegetables is not only good for you; it also makes weight management easier. Vegetables, especially the non-starchy ones, are mostly water. Chewing these water-filled nutrition giants will help you feel satisfied on fewer calories. Suppose you’re having a turkey sandwich for lunch and decided to have a two-ounce bag of potato chips along with it. The chips contain about 300 calories and 20 grams of fat. If instead you chose to eat raw cauliflower, you could eat two small heads, or about 100 florets, for 300 calories. Of course you’d end up eating much less than that, and therefore consume fewer calories.

3. Ditch the Sugar-Sweetened Beverages

This is easier said than done for many people. I’m not generally one to promote absolutes when it comes to diet. In fact, I often try to help patients eat problem foods in moderation rather than avoid them altogether. But for the person who drinks multiple regular sodas every day and describes it as an addiction, abstinence is probably the best goal. Why the different approaches with food versus drinks? The healthfulness and allure of most sugar-containing foods vary a great deal. For instance, if someone tells me he’s “addicted to sweets,” I don’t really know what that means. Anything with sugar, like canned corn and pickled beets? Is a graham cracker a sweet, or how about a macaroon? You get the point. With drinks, the categories are easier. Either it’s a regular soda or it’s not.

People who regularly drink sugar-sweetened beverages often follow patterns like people with addictions, such as smoking. A smoker may always smoke at certain times of day, and soda drinkers often have similar patterns they find hard to break. Studies suggest that regularly consuming sugar-sweetened beverages probably doesn’t impact everyone’s weight in the same way. The people most likely to gain weight are those with a genetic predisposition for obesity. If you have certain obesity promoting genes (many different genes influence body weight), it’s a bad idea to regularly drink sugary beverages. You’re like a person with a genetic tendency for asthma who lives in a polluted city. Just as it may be best for that person to find a better place to live, you may want to consider avoiding sugar-sweetened drinks. Although water is probably the best replacement, drinking liquids with artificial sweeteners will greatly reduce calories and can help you lose weight.

4. Eat Your Fruit, Don’t Drink It

Fruit is also relatively low in calories and packed with nutrients. Many well-intentioned people drink fruit juice rather than other sugar-sweetened beverages in an attempt to be healthier. Although fruit juice is more nutritious than soda, the calories are about the same. In addition, research is clear that chewing food makes us feel more satiated than drinking those same calories. Let’s say you typically feel satisfied after eating a breakfast including two eggs, two slices of toast, and a twelve-ounce glass of orange juice. If you substituted water for orange juice and ate a clementine instead, you could save calories. In fact, you would need to eat five clementines to equal the calories in twelve ounces of orange juice.

Next week, I’ll share a few more tips to help you devise a healthy eating plan.

Come back each week for more healthy weight loss advice from Dr. David Creel.