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?
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.”
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.
Creating and maintaining a food diary is one of the best ways to increase awareness of what you’re doing. A food journal is to an overweight person as a speedometer is to a speed demon trying to slow down.
If you dread the idea of having a paper journal you must pull out each time you eat, hide for fear someone might look at, or misplace multiple times a day, you can relax and let technology eliminate these barriers. A multitude of apps allows us to discreetly track eating and physical activity. It’s as simple as pulling out your phone and entering a little information each time you eat. Many of the applications have features that allow you to scan the UPC code of a food in order to add it to your diary. At all times during the day you can see how many calories you’ve eaten and how many remain, which will guide you during situations like that late-night trip to the refrigerator. You can also pay attention to other dietary factors such as percent of calories coming from fat, protein and carbohydrate, the grams of fiber you have consumed, and so on. If you aren’t into technology, there’s no reason you can’t keep a paper food journal. Many of my patients prefer this simple pen-and-paper method. If you’re working with a professional to manage your weight, a food journal highlights the strengths and weaknesses of your diet, and can guide the discussion about your eating patterns.
Tracking food intake will help you pay attention to what you’re eating, educate you on the source of calories, allow you to examine patterns of behavior you may want to modify, and help explain why your weight is changing. Whether you use a paper journal, an app, or a website to track your eating, the following suggestions will help you get the most out of self- monitoring.
1. Include everything you eat
The primary goal of keeping a record is to increase awareness and ultimately change your behavior. Therefore, you should “partner” with your journal, agreeing to report everything you eat. That includes a handful of peanuts, a small piece of candy, a bite of your spouse’s cake, etc. Having incomplete or inaccurate food records will frustrate you, because according to the records, you should be losing weight, but aren’t. Yes, it’s a bit inconvenient to record every little thing you put in your mouth, but therein lies the beauty of self-monitoring. It can cause you to pause and ask yourself, “Do I really want these peanuts if I have to record them? Am I really that hungry?” If you’re eating out of habit, your food journal is a deterrent to mindless eating and grazing.
2. Include all beverages containing calories
Many people who record their intake are lackadaisical about including beverages. Soda, juices, alcohol, sport drinks, and even some diet beverages contain calories and can be a significant contributor to weight.
3. Measure your portions
Although researchers have developed a way to determine portion sizes by taking photos of our food, there is currently no good, commercially available technology to track portion sizes without some work on your part. Weighing and measuring food can be helpful because our eyes fool us into believing we’re eating less than we really consume. Although a food label may list ¾ cup of cereal as a serving, that may not be typical for you. Once you determine how much a cup of milk fills your glasses, what one cup of pasta looks like on your plates, and the size of three ounces of meat (about the size of a deck of cards), you may not need to get the measuring cups and food scale out for each meal. However, spot-checking portion sizes is generally a good idea to make sure your perception isn’t drifting. If you aren’t losing weight as expected, returning to exact measuring may be helpful.
4. Include the good days and the not-so-good days
We often learn more from our struggles in life than we learn from success. Although it’s psychologically challenging to record food intake when we feel as if we’re going off the rails, this can be immensely helpful. Tracking deviations helps reveal our relationship with food. Behavior is easier to correct when we’re aware of food-related triggers and typical responses. For example, perhaps you overeat when dining out with friends or after a stressful day at work when you feel too tired to cook. People who pay attention to these trigger events usually get off track less often and stay off track for shorter periods, compared to those who feel discouraged, stop being mindful, and abandon the food journal.
Food journaling is part of a larger process of changing your relationship with food. In order to get the most out of it, you need to reinforce healthy behavior, but also understand and change your unhealthy responses to stressful situations.
5. Record as you go
Record the foods you eat as you eat them. Waiting until the end of the day to write down what you’re doing is like waiting until you get your credit card statement to determine if you’re sticking to a budget. Tracking as you go leads to awareness. You are self-monitoring your behavior rather than just producing a record. In addition, the longer you wait to record your intake, the more you misremember what and how much you ate. It’s easy to forget exactly what you consumed, and portion sizes tend to shrink when you rely on memory.
6. Tell a story
Your food journal should tell a story. When you’re losing weight it should be evident why this is occurring. Remember, it takes approximately a 3,500-calorie deficit to yield a pound of weight loss, so we aren’t looking at food records to explain day-to-day changes in weight. Rather, we can examine eating patterns over several weeks to explain weight changes. If the numbers don’t add up, look for sources of error in your reporting.
I’ve often reviewed patients’ food journals that indicate they eat less than 1,200 calories per day, yet aren’t losing weight. Sometimes patients attribute this lack of weight loss to a slow metabolism, decreased physical activity, or having a Martian-like physiology that defies the laws of thermodynamics. But the true reason is usually based on inaccurate reporting. The most common errors come from waiting too long to record intake or failing to weigh and measure food. Other patients may be eating a lot of unknown calorie foods. They may frequently stop at a mom-and-pop diner for lunch, and although they do their best to determine portion sizes and calories, they really don’t know what’s in the food. Lastly, people using electronic apps make mistakes by selecting foods from the database that don’t match what they actually consumed.
7. Consider the peculiar
Spray margarine is a great way to get the flavor of butter without the calories. The primary ingredients are water and oil. If you look at the food label it indicates “0” calories. In fact, it does have calories because it contains oil. But the serving size is “one spray” and rounding the calories of one spray to the nearest digit allows the manufacturer to indicate it has no calories. I’ve never seen anyone stop after one squirt, but nevertheless, it’s a lower-calorie alternative to other added fats.
Tammy, who liked the taste of butter but didn’t want the consequences of calories, was an avid food label reader and decided to use spray margarine. In her eyes this was a “free food” because the label clearly read it had zero calories. Since it was calorie-free, she didn’t bother putting it in her food journal. Due to great investigative work by one of our registered dietitians, we were able to solve the mystery of why Tammy was gaining weight; she consumed up to two bottles of spray margarine every day. She would take off the spray top and pour it on almost everything she ate. This gross-me-out use of spray margarine obviously contributed to her unexplained weight gain.
Another client asked me if she needed to include sugar-free gum in her food journal. My first response was “no.” Sugar-free gum only has five calories per stick and the act of chewing gum actually burns a few calories and may prevent someone from mindlessly eating snacks. To me, the calories in the gum were a wash. But as we continued to talk, I began to understand she really liked gum. In fact, she was compulsive about chewing it. She was an ex-smoker who used gum to deal with anxiety. She would chew a piece of gum just long enough to get the sweet taste from it, and then she would spit it out and get another piece. She was going through five or six of the 10-piece packs per day. She consumed enough sugar-free gum every day to equal the calories in two regular sodas. Although her breath was always great, she wasn’t adequately handling the stress of work. She had a good sense of humor about her gum issue but realized this compulsive chewing was contributing to the problem with her weight. We worked together to help her manage stress in better ways.
8. Remember the spirit of the food journal
The goal of keeping a food journal is to become more aware of your relationship with food, which will help you establish healthy eating habits that lead to weight loss or maintaining a healthier weight. Most people, even those who are successful, don’t use the journal every day for the rest of their lives. However, self-monitoring your diet regularly in the early stages of weight loss is extremely important in order to learn more about your eating patterns and educate yourself on where, when, and under what psychological or environmental circumstances you consume extra calories.
Over time you may decide to only record your food during the times you struggle most, such as evenings or weekends. You may eventually stop recording everything you eat and simply have a daily checklist. Others have successfully used food journaling in tandem with self-weighing, only recording their foods when weight begins to climb.
Come back each week for more healthy weight loss advice from Dr. David Creel.