Stage 1: Developing Pre-Dieting Skills
In this first stage, dieters don't change what they eat, although they can gradually reduce portion sizes, if they like. Too much attention to food at this point means less attention to mastering essential skills. Instead, dieters learn the skills mentioned above and others in a step-by-step fashion, practicing each new skill over and over until they've mastered it. Then they learn and master the next one. For example, they learn how to motivate themselves by creating a list of all the reasons they want to lose weight, and then they read this list each morning and again later in the day.
Most dieters come up with at least 15 to 20 reasons initially. ("I want to feel better about myself. I want to look better. I want to have more energy. I want to cut back on my medication.") While it's easy for dieters to read the list, it's more difficult to respond to sabotaging thoughts that get in the way of reading it. (I don't have to read it: I know what the reasons are. I'm feeling motivated right now so I don't need it. I can rehearse the reasons in my head.) At this point, we usually discuss how effective their dieting efforts were in the past when they didn't have a list to read each day. I ask them about the last time they ate something they were sorry for, and whether all the reasons for losing weight were really clear in their minds at that moment. Eventually most clients get the point: if they want to be successful, they have to learn to do things differently.
Some Stage 1 skills were easy for Jean to learn: she had no trouble reading her list of reasons to lose weight and taking a short exercise walk every day. But initially, she had a great deal of difficulty eating everything slowly and mindfully while sitting down. "I like to eat standing up—and I like to eat fast," she said. "I don't see why I need to sit down. It's the same food, isn't it?"
I explained that she couldn't possibly enjoy every bite fully if she ate quickly, while standing up. As we spoke, she recognized that all of her minibinges occurred when she stood in front of her open refrigerator and food cabinets, quickly shoving food in her mouth so she wouldn't notice how much she was eating and feel guilty. She realized that good eating habits had to become a lifetime rule if she wanted to quit minibingeing and lose weight permanently.
By the end of Stage 1, which took Jean almost four weeks, she'd lost a few pounds even though she wasn't following a diet plan. Savoring every bite enabled her to get more satisfaction from food, and she naturally began to eat a little less. She also learned to get over her intense fear of hunger, a powerful negative emotion for many unsuccessful dieters. Previously she'd believed that she should avoid ever becoming hungry—she thought that if she did become hungry, it would get worse and worse until she could no longer stand it. With the approval of her doctor, she skipped lunch one day, eating nothing from breakfast until dinner time. This experiment proved to her that hunger was only mildly uncomfortable and that she didn't feel hungry throughout the whole day: she had short periods of hunger, which she tolerated fairly easily.