Skills for Successful Dieting
By Judith Beck
Why is it so difficult to lose weight and keep it off? By now, the "how" is no mystery: everybody knows the drill, whether you want to lose 2 pounds or 200. Just decrease your calories and get more exercise. And millions of people routinely set off with high hopes determined to do just that. Nevertheless, study after study indicates that while many succeed in losing some weight, the long-term results are overwhelmingly poor. The unfortunate reality is that if there's one thing as common in America as someone on a diet, it's someone who's fallen off a diet—who's gradually (or quickly) regained every ounce he or she struggled to lose, often adding pounds along the way. Why is it so hard to stick to a healthy eating plan and a reasonable exercise regimen?
From the viewpoint of Cognitive-Behavioral Therapy (CBT), the reason isn't hard to find: knowing what to do and knowing how to get yourself to do it are entirely separate skills. When it comes to changing behavior, especially long-term, habitual patterns, getting yourself to do something different, even when you know it's good for you, depends largely on what you tell yourself: that is, on your thinking.
For example, let's say you're at a dessert party and see five really delicious pastries. Will you end up eating too much? You probably will if you think, I don't care. I don't want to deprive myself. It isn't fair that everyone else gets to eat whatever they want, and I have to settle for one small piece. By contrast, if you say to yourself, "I'm going to pick my favorite dessert. I'll eat one small piece slowly and enjoy every bite. I know I'm going to feel so proud of myself," you stand a much better chance of not overeating.
To be sure, dieters aren't alone in having difficulty in getting themselves to take action to alter lifelong behavior patterns. When I began practicing CBT in the mid-'80s, I was struck by how hard it was to get many depressed clients to stop spending hours on the couch watching TV and begin to carry out the simplest tasks of daily life, even when it was apparent that taking such action was essential to improving their condition. But once we focused more closely on what these clients' unexpectedly active minds were telling them in the midst of their inactivity, it became clear that the roots of their apathy lay in their internal cascade of negative and pessimistic thoughts: This is too hard. I won't enjoy myself. It won't be worth it. What's the point? They got caught in a vicious cycle of dysfunctional cognitions: the more they believed their thoughts, the worse they felt and the less they did. The less they did, the more depressed they became and the less motivated to make changes.
Like depressed clients—or those with anxiety, substance abuse, or eating disorders—people who repeatedly find themselves unable to regulate their own weight typically can't get past their negative, dysfunctional thinking. After many years of practice, it's clear to me that to achieve their goals, unsuccessful dieters don't need to uncover hidden motivations or explore the hypothesized childhood origins of their problems. Instead, they need to learn how to address the dysfunctional thinking that leads to overeating.
I've developed a program for nonpsychiatric (and noneating-disordered) individuals that utilizes the basic principles of CBT to address overeating directly. For all their differences in personality, background, and psychological profile, I've found that unsuccessful dieters all have one characteristic in common: self-sabotaging thinking. A day, a week, three weeks into a diet, they're tempted to eat something that's not on the plan because of what they think: It's OK for me to eat this because . . . I'm really sad and need to cheer myself up. . . . I feel happy right now, and I want to keep this good mood going. . . . I'm working really hard and I need a reward. . . . I'm celebrating! . . . If I let myself get too hungry, something bad will happen: maybe I'll faint! . . . There's no point in continuing to diet, since I've lost only a couple of pounds after two weeks.