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 simple process can help you change your thinking for more successful weight management. Based on the work of Albert Ellis and Aaron Beck, cognitive behavioral therapy includes identifying a situation (activating event) that leads to a thought/belief, that in turn yields an emotional reaction. In Lisa’s case the process looked like this:
Activating Event (A): Boss asks for a volunteer.
Belief (B): “The boss will be disappointed if I don’t volunteer.”
Consequence (C): Feeling pressured, overwhelmed, and even angry.
Patients come to see me to lose weight. But my patients don’t lose weight before every visit. Sometimes they gain quite a bit, depending on how long they’ve been away and events in their lives. Body language usually reveals their expectations even before they step onto the scale. Patients who know their weight is up are sometimes tearful, disgusted with themselves, and embarrassed. After a weight check, our interaction might go something like this:
“You seem upset, what’s going on?”
“It’s just that my weight is up. I’m so frustrated.”
“Were you expecting it to be up?”
“Yeah, I guess, but seeing it reminds me that I’m not reaching my goals.”
“So you’re upset because you feel like you’re not making any progress right now?”
Weight gain is the activating event here. Patients tell me they’re upset by the added pounds, but that is actually not why they’re upset. They are unhappy because of beliefs about increased weight. If gaining weight automatically caused distress, then everyone who added a few pounds would be unhappy. Yet, weight gain is often desirable for people who are too thin. Therefore, seeing numbers go up on a scale isn’t guaranteed to cause unhappiness. Our personal beliefs about weight gain inspire feelings like these:
“I’m hopeless at losing weight.”
“This diet and exercise thing isn’t going to work for me.”
“People are laughing at me.”
These beliefs—not the actual weight gain—lead to the consequence of negative feelings. And those negative feelings make us want to give up, which would create even more emotional distress.
Activating Event (A): Gained 10 pounds.
Belief (B): “I have absolutely no willpower.”
Consequence (C): Feeling frustrated, angry, and hopeless. Tempted to stop trying.
You may be asking, “How can I think more positively if my weight gain was caused by ignoring my goals, emotional eating, or late-night snacking? In these instances, we are not necessarily looking for positive thoughts, but instead rational, functional thoughts that can help you get back on track. We want to think in a way that’s functional without making it personal and judgmental.
Instead of using beliefs to put yourself down, translate your beliefs into rational, functional thoughts that will help you move forward without overwhelming blame and shame.
Activating Event: Gained 10 pounds.
Belief: For me, snacking late at night leads to weight gain. But I can control this behavior with a reasonable plan.
Consequence: I feel hopeful and will plan my snacks this week.
Thoughts Are Automatic
The bad thing about dysfunctional thinking is that our thoughts are often automatic. We respond to a situation in the same way for so long that the situation-thought-emotion cycle becomes like a bad golf swing repeated over and over for years; it seems almost impossible to change. We begin telling ourselves, “That’s just how I think. It’s part of my personality.” Even if we want to think differently, those knee- jerk-reaction thoughts keep popping up, and we don’t even realize the damage they’re doing until we’ve lashed out at someone, checked out with three glasses of wine, or polished off a bag of Ruffles. The thoughts are as automatic as flipping on a light switch even after you’ve lost power in your house.
We could compare the brain’s neural networks to a daily commute. Perhaps you’ve taken the same morning drive for fifteen years, which includes traveling the same roads and encountering familiar traffic lights, merges, and landmarks. This daily routine is a highly organized schema in our mind and requires little thought or processing. You can do it on autopilot and barely remember the trip after you arrive. Even if the streets are congested and dangerous you take them anyway, because it’s the only path available, or is the most reasonable option to take you where you need to go. But what if you discovered a newly constructed road that was safer, required less time, and was more scenic? Would you take it? I’m guessing you would, but you’d need to be intentional about the choice. If you forgot to focus on the new route, in a morning stupor you might still drive the old way.
Sometimes change requires great effort. Our home is in a newly developed neighborhood and the builder piled huge mounds of dirt in an empty lot about 50 yards behind our property. We could see the pile of dirt from the sunroom of the back of our house, and of course my children wanted this to be their new playground. So I checked it out and decided they were unlikely to become permanently maimed by playing there.
I spoke to my wife about letting the little ankle biters expend some energy playing “King of the World” and “Mountain Tag,” and she agreed, as long as it happened before their baths. We still had one problem: The only reasonable trek to this alluring dirt pile meant walking to the front of our house, along the road, and then along a dirt path created by the builder where work trucks frequently traveled. From inside our house we couldn’t see our preschoolers walk this way, and even if we could see them, we didn’t feel the route was safe without adult supervision. So if they wanted to play, my wife or I needed to chaperone them to the pile. This round-about trek was a major inconvenience because as soon as we reached the dirt pile one child needed to go to the bathroom or was hungry and wanted to come back to the house, and then back to the mountain— and back—and forth.
If only the kids could just walk out the back door and run safely to the dirt pile. We could keep an eye on them from the rear of our house and easily hear what was happening. But the landscape in between included high weeds, sticker bushes, and insects. I even saw a small garter snake back there. The weeds were so high we’d lose sight of our kids if they tried to hike through them. Besides, a previous attempt led to ouchies, bug bites, and a quick return to our backyard after four steps into the tangled mess of vegetation. After a weekend of walking the kids back and forth to the dirt pile via the road, I decided we had to find a better way.
I got out a hatchet and begin cutting down the weeds and brush that separated our backyard from the dirt pile. With the big stuff out of the way, I took our push mower and began making a path. The mosquitos were terrible and my mower wasn’t made to cut tall weeds, but with persistence I eventually reached the dirt pile. The kids now had a safe, short, and efficient route to their playground that didn’t require hand-holding.
Our thoughts are sometimes like the first route my kids first took to the dirt pile. They cause anxiety, are inefficient, and require a lot of support from others in order to make them work in our daily lives. Changing these entrenched thoughts often requires the tough work of creating a new set of beliefs and different neural pathways in the brain. This can take determination and, like making a path to the mountain, it requires tools and persistence.
One of the first steps to changing your thinking is to identify thoughts that get in your way. Categorizing these irrational beliefs can lead to building a shortcut that will bypass the weeds and lead directly to functional thinking and healthier behavior.
In the next few articles, I’ll cover many of the common types of dysfunctional thinking and how to avoid them.
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:
- Begin monitoring what you are doing—track your food intake and your physical activity.
- Identify problem areas such as mindless snacking, skipping meals and overeating later on, late-night eating, portion problems, dining out, eating too few vegetables, or low levels of physical activity.
- Focus on a few small changes related to improved eating and increased physical Perhaps you could start by walking an extra mile per day and decreasing your calories by 300-500 per day.
- Consider professional accountability with a registered dietitian, fitness professional, physician or mental health provider specializing in weight management.
- Monitor trends on your scale to help you figure out what is working.
- Lastly, be patient. Frustration and perfectionism can kill commitments before they ever begin.
Thank you for your question. We’d love to hear back from you in the future. Good Luck!