THE BLOG
09/26/2012 05:05 pm ET Updated Nov 26, 2012

Why Would You Need a Shrink to Lose Weight?

Is weight loss psychological? Is it something that a shrink can help you with or not? Have you tried hard to lose weight on diet programs and not been successful? Do you know why that is?

I believe that weight loss is complicated, individual and has many facets. It is not one-size-fits-all, and it requires different approaches for different people. That being said, it is entirely possible for anyone, and everyone, to lose weight.

To lose weight and keep it off, one must change one's behavior, permanently. Behavioral psychology directly addresses this aspect of weight loss. The pull to the familiar, to revert to old and well-practiced behaviors, is very strong. A good therapist or weight-loss program that includes the psychological can be invaluable in helping one deal with the difficulty that comes with change. This is true no matter what substance or behavior you are trying to give up or change.

Let's take my client John (not his real name), for example. John came to see me weekly for psychotherapy. I would offer him a cup of water each time, and he would throw the empty cup out in my office trashcan at the end of each session. One day, I decided to rearrange some things in my office. I decided to move the trashcan to another location because I thought it looked better there. John came in for his appointment, got his cup of water and at the end of the session went to the trashcan to throw it out and realized I had moved it. I showed him where it was now, and he went there and threw it out. Next week John came to session, went to the old location to throw out his cup and then remembered and went to the new location. This happened for about two months before John went straight to the new location. I didn't have the heart to rearrange my office after that.

I use the example of John to illustrate just how entrenched our habits become. We go to a certain restaurant and we always get the fettuccine Alfredo. We stop at the market and always get the cake before we leave. We come home from work and head straight to the snack cupboard for some pre-dinner chips. These entrenched habits take time, energy, focus and often professional support to change. It takes work to maintain those changes as well. Over time it does get easier. John learned the new location and no longer went to the old one, but it took time.

To go to the same restaurant and get the chicken salad with dressing on the side will be hard and strange at first. Some of my clients choose to just go to a different restaurant, or not go out at all for a while, rather than be tempted by their favorite dish.

To stop at the market and get fresh fruit instead of cake, will take focus and energy. We may even find ourselves with the cake in our carts before we realize that we don't do that anymore and put it back. It's not easy to stay awake and focused when automatic pilot would like to take over.

When we come home from work and find ourselves heading straight for the chips, we have to use energy to redirect ourselves either to healthier, lower-calorie snack options or distract ourselves from eating completely. That is hard. Especially if the chips are still in your house. In my last blog, I covered how to keep your home environment safe from poor food choices.

That's just a few examples of the behavioral aspect of weight loss. Then there are the cognitive, emotional, and physical aspects as well. All these need to be addressed to achieve lasting weight loss. It is very hard to do alone. If you have tried to do it alone in the past and failed, get support. If you can afford individual psychotherapy, do yourself a favor and go. If you are a group person, join Weight Watchers (or a similar program) where you can have that type of group accountability and support while you learn healthier habits. There are also lots of online programs, some are free, that offer group support, calorie- and weight-tracking and education.

In my next blog I will cover the cognitive aspect of weight work.

That's it for now. Be well and let me know how you're doing!

For more by Irene Rubaum-Keller, click here.

For more on weight loss, click here.

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