A Cognitive-behavioral Approach To Weight Management

A COGNITIVE-BEHAVIORALAPPROACH TO WEIGHTMANAGEMENTJudith S. Beck, PhDPresident, Beck Institute for Cognitive Behavior TherapyClinical Professor of Psychology in Psychiatry, University of PennsylvaniaDeborah Beck Busis, LCSWDirector, Weight Management Program, Beck Institute for Cognitive Behavior TherapyB EC K I N S T I T U T E .O RG

Have you ever lost weight on a diet,only to gain it back again?Have you felt out of control of youreating and at the mercy of your hungerand cravings?Have you made eating decisions thataren’t in line with your goals andregretted them afterwards?Have you used food as a copingmechanism when you felt stressed,anxious, tired, or bored?Have you worried about the impactyour weight is having on your health,but felt powerless to change it?If so, please know that you are in very goodcompany. These are common challenges amongmost people who struggle with their weight andeating. But please know that there is hope. Thereason you have not been successful in the pastis not because you didn’t want it enough or tryhard enough. It’s because you didn’t know how.By learning and practicing specific CognitiveBehavioral Therapy (CBT) techniques, youwill learn to make permanent changes in yourbehavior by making changes in your thinking.This can help you build habits that supportyour personal weight loss and health goals.SABOTAGINGTHOUGHTSCBT teaches us that our thoughts influence theway we feel and behave much more than thesituations we experience on a day-to-day basis.Many people initially believe that a situationautomatically leads them to engage in a specificbehavior, such as eating something that’s notin line with their goals. If they were feelingstressed, they might think the stress causedthem to go to the kitchen and overeat. But it’snot the situation that made them overeat. It’stheir thinking about the situation.When someone who struggles with weightmanagement gets stressed, they may think,“I’m so stressed; eating is the only thing thatwill make me feel better.” Or they may think,“I’m so stressed, I deserve to eat to help myselfcalm down.” We call these sabotagingthoughts – thoughts people have in triggersituations that lead them to eat. CBT teachespeople to recognize what sabotaging thoughtsthey’re likely to have (and what sabotagingthoughts they’ve had in the past) and respondB EC K I N S T I T U T E .O RG

to them effectively so they are less likely toengage in unhelpful behaviors.HOW TO ADDRESSSABOTAGINGTHOUGHTS WITH CBTLearning how to respond to sabotagingthoughts is an important part of CBT. Nexttime you feel stressed, instead of thinking, “I’mstressed, so I deserve to eat,” you may say toyourself:“I’m stressed, and I deserve to feel better.But I also deserve to achieve my health andweight loss goals, which are so importantto me. Instead of eating, which ultimatelysabotages other goals, I’m going to gofor a walk/do a five-minute mindfulnessmeditation/listen to some music/call and ventto a friend, etc. These things will help me calmdown without any negative consequences.”Here are examples of common thinking errorsand sabotaging thoughts, along with helpfulresponses that can keep you on track:All-or-nothing thinking: You see things inonly two categories, when they are really on acontinuum).highway, I wouldn’t think, “Well, I’ve blownthis trip. I might as well keep driving five morehours in the wrong direction.”Self-deluded thinking: You tell yourselfthings that you really do not believe at othertimes).Example: If no one is watching me eat, itdoesn’t really count.Response: My body processes calories in thesame way whether zero people or 100 peopleare watching me eat.Mind Reading: You are sure you know whatothers are thinking, (even in the absence ofcompelling data).Example: Everyone will think negatively of meif I eat differently.Example: “I’ve made an eating mistake, so I’veblown my healthy eating plan today and mightas well give up and start again tomorrow.”Response: It’s likely that some people will behappy for me if I’m eating healthfully and somewon’t notice or won’t care what I’m eating.Response: One mistake does not mean I’veblown anything! If I get right back on trackthis minute, I can go to bed feeling proud ofmy ability to recover. If I missed my exit on theEmotional Reasoning: You think yourthoughts must be true because they feel true,even if there is evidence to the contrary).Example: Since I feel so hopeless about losingB EC K I N S T I T U T E .O RG

weight, it must really be hopeless.Response: Everyone gets discouraged fromtime to time. It’s normal. I’ll only stop losingweight if I decide to give up.COGNITIVE ANDBEHAVIORALTECHNIQUES FORWEIGHT LOSSCBT for weight loss and maintenance teachescognitive and behavioral techniques, includinghow to: create new, healthy eating habits,like eating sitting down, slowly, andmindfullymotivate yourself daily and giveyourself credit for your successesdifferentiate between physicalhunger and emotional hungerdeal with negative emotions withoutturning to foodcreate and stick to a food planstay on track, even when you’retempted to give in--and recoverimmediately when you do make amistake.Most importantly, you will learn to reflect ondifficulties you may have putting each of theseskills into place, identify sabotaging thoughts,and effectively respond to them. Once you learnhow to respond to sabotaging thinking that caninterfere with your progress, you’ll be able toconsistently make decisions that support yourgoals.MAINTAINING YOURPROGRESSSuccessfully losing weight and keeping it offis not about avoiding triggers. Everyone feelsnegative emotions; everyone is in situationswhere others are eating and drinking differentthings; everyone makes mistakes. It’s aboutlearning to identify the sabotaging thoughtsyou’re likely to have once you’re triggeredand responding to them effectively so you canmake progress and maintain it long-term. CBTfor weight management can help you buildresilience and confidence through everydaychoices that support your desired lifestyle.B EC K I N S T I T U T E .O RG

CBT RESOURCESBECK INSTITUTEThe nonprofit Beck Institute for Cognitive Behavior Therapy was established in 1994 by Dr. Aaron T. Beck andDr. Judith S. Beck as a setting for state-of-the-art psychotherapy and professional training in CBT.BECK INSTITUTE WEIGHT MANAGEMENT PROGRAMDr. Judith S. Beck and Deborah Beck Busis developed the Beck Institute Weight Management Program to bedifferent from other weight management programs. Using cognitive behavior-based strategies, the programempowers clients to make healthy lifestyle choices. The program includes easy-to-use tools, including hungermonitoring scales, daily planning schedules, weight loss graphs, and motivational cards for handling time/energy hurdles, eating out, and other high-risk situations. Learn more at beckinstitute.org.PSYCHOTHERAPYCognitive behavior therapists can help you identify, evaluate, and modify your unhelpful ideas and behaviorthat lead to negative conclusions about yourself and others. They can also help you figure out ways to moreeffectively manage day-to-day problems. With your effort and their guidance, you can learn skills to reduceinterpersonal conflict and help you feel better and stay better. To learn more about clinical services at BeckInstitute, call 610.664.3020 or email intake@beckinstitute.org.ONLINE RESOURCES: Visit beckinstitute.org for webinars, video clips and multimedia resources Read the Beck Institute blog (beckinstitute.org/blog) Shop for books, DVDs and more in our CBT Store (beckinstitute.org/store) Sign up for the Beck Institute Newsletter (bit.ly/beckinstitute) Engage with Beck Institute on social UPPORT BECK INSTITUTEBeck Institute is a 501(c)3 nonprofit with the mission of improving lives worldwide through excellence andinnovation in Cognitive Behavior Therapy training, practice, and research. Help us continue our work with agift today!Give now at beckinstitute.org/give-now.B EC K I N S T I T U T E .O RG

weight, it must really be hopeless. Response: Everyone gets discouraged from time to time. It's normal. I'll only stop losing weight if I decide to give up. CBT for weight loss and maintenance teaches cognitive and behavioral techniques, including how to: create new, healthy eating habits, like eating sitting down, slowly, and mindfully