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Weight Management Through Cognitive Emotional Techniques

Posted: 12/25/10 09:17 AM ET

You've done it all: appetite suppressant pills, obsessive calorie-counting, punitive exercise regimens and seemingly every diet on the face of the planet. You still yo-yo up and down the scale, frustrated with yourself for not being able to keep the weight off. Take comfort: You are just one of millions of Americans who spend $40 billion a year on weight-loss programs and products that typically fail.

Meanwhile, obesity is growing at staggering rates and is a leading cause of numerous illnesses -- some of which are life-threatening. That's because until we address the root causes of eating disorders, we will continue to treat them ineffectively. To change the way we eat, we often have to change the way we think and feel.

"Emotional eating," turning to food to cope with stress, anxiety, and obsessive worrying, is a major cause of overeating. Comfort foods like ice cream, French fries, and pastries really do the trick of calming us down. That's because sugar, fat, and refined flour alter receptor sites in the brain, physiologically reducing our experience of anxiety and stress.

While emotional eating gives us temporary relief in the heat of the moment, over time it can lead to diabetes, heart disease, high blood pressure, obesity and other related illnesses. Meanwhile, reaching for anxiety and stress medications is not always a smart alternative. Not only can these pills trigger addiction, but new research indicates they also increase the mortality rate by 36 percent among users over 55.

Fortunately, there is a healthy and effective way to cope with stress. By learning good thinking habits, through cognitive emotional techniques like mindfulness, guided imagery, and "good worry", we can interact directly with the emotional parts of our brains -- taking the edge off without putting the weight on. And here's the cherry on top: Research indicates that by using relaxation and guided imagery (sometimes called hypnosis) as part of a weight-loss program, we can lose double the weight and keep it off twice as long.

Here's one young woman's story: Danica, a 28-year-old assistant bank manager, had a long-standing problem with her weight and was particularly prone to overeating at night. "I know what I should eat, and for the most part, I eat well," she told me. "Then all of a sudden, I'll find myself staring at the shredded wrapper of a giant chocolate bar. It's like someone else took over my body!"

I encouraged Danica to let an image come to mind for the part of her that took over when she ate that way. A frenetic honeybee, buzzing about in chaotic patterns, came to mind for her. Danica said it gave her an uncomfortable feeling that she knew well. I prompted her to invite another image that would help the bee settle down, and she imagined a beautiful flower. In her mind, she held out the flower, and as the frantic bee landed on it and drank its nectar, it seemed to become much more content. Danica started to relax as well.

When I next saw her, she said that she had used this simple image to calm herself whenever she had begun to feel anxious and scattered. She said the bee imagery reminded her to look for things that were enjoyable to her, rather than running around, trying to satisfy everyone else's expectations. Danica found that stopping for lunch and snacks, breathing deeply, taking short breaks, and seeing the humor in situations calmed and energized her, as the flower calmed and energized the bee. She told me, "I see that if I don't get physically and emotionally nourished during the day, I am more likely to pig out sometime later that night." As Danica nurtured herself better during each day, she found that her nighttime cravings went away.

Danica changed her behavior through the use of imagery, the inner language of the emotional/intuitive brain.

Our emotional/intuitive brain has formed and guided us since we were born. It began its work when we first looked into our mother's and father's eyes, felt their touch, breathed in their smell and heard their voices. Some say that our emotional bonding began even earlier, in the womb, with our responses to our mother's chemistry, heartbeat and emotions. Once we were born, we reacted to the facial expressions, tone of voice, and body posture of others, as well as to our own feelings, to determine whether we were doing well, were loved and accepted, or were in danger or being threatened. These early perceptions have profound effects on whether we feel that we belong in this world, and whether we feel safe and comfortable.

As we grow up, our emotional brains continue to be an important influence on how we make friends, interact in social groups, and form crushes or infatuations. Dating, marriage, and children, as well as the development and maintenance of work relationships and friendships, all depend on our fluency and comfort with emotions. As with most abilities -- whether athletic, musical, or logical -- some of us are gifted with emotional competence; some are clueless; and most fall somewhere in between. And, as with most abilities, we can improve our fluency in this arena, if we so choose.

Like most practicing physicians, it is clear to me that our feelings influence how and what we eat, our level of physical activity, what kind of relationships we seek and develop, and ultimately, the overall state of our health. Unresolved emotional pain or conflict often presents itself in the doctor's office, sometimes as anxiety or stress, but often as body pain, fatigue, insomnia, or the toxic effects of coping methods like smoking, excessive alcohol, drug abuse, Type A behavior, or obesity and other eating disorders.

The emotional/intuitive brain can only express itself in a few ways -- directly, through emotional expression, or indirectly, through our behaviors and physical symptoms. This part of our brain can be accessed and influenced most effectively through imagery -- a natural language that can be learned with relatively little effort. The payoff is empowerment, freedom, emotional understanding, and, often as a bonus, easier and longer lasting weight loss.

Sources:
1. Johnson, D.L. Weight loss for women: studies of smokers and nonsmokers using hypnosis and multicomponent treatments with and without overt aversion.

2. Bolocosky DN, Spinler D, Coulthard-Morris L. Effectiveness of hypnosis as an adjunct to behavioral weight management. J Clin Psychol 1985 Jan; 41(1):35-41

3. Dornelas EA, Wylie-Rosett J, Swencionis C. The DIET study: long-term outcomes of a cognitive-behavioral weight-control intervention in independent-living elders. Dietary Intervention: Evaluation of Technology. J Am Diet Assoc 1998 Nov; 98(11):1276-128

4. Rapoport L, Clark M, Wardle J. Evaluation of a modified cognitive-behavioural programme for weight management. Int J Obes Relat Metab Disord 2000 Dec;24(12):1726-1737

5. Kirsch I. Hypnotic enhancement of cognitive-behavioral weight loss treatment - another meta-re-analysis. J Consult Clin Psychol 1996 June;64(3):517-9

6. Rossman J. Director of Behavioral Medicine at Canyon Ranch. As yet unpublished study.

7. Belleville G. Mortality hazard associated with anxiolytic and hypnotic drug use in the national population health survey. Can J Psychiatry. 2010 Sep;55(9):558-67.


 
 
 

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You've done it all: appetite suppressant pills, obsessive calorie-counting, punitive exercise regimens and seemingly every diet on the face of the planet. You still yo-yo up and down the scale, frustr...
You've done it all: appetite suppressant pills, obsessive calorie-counting, punitive exercise regimens and seemingly every diet on the face of the planet. You still yo-yo up and down the scale, frustr...
 
 
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01:40 PM on 01/18/2011
Do your self hypnosis session everyday until you achieve your desired outcome, during the day repeat as much as possible (at least ten times at morning, noon and evening) the I CAN sentence.

http://www.facebook.com/SelfEsteemAffirmations
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jgarma
01:49 AM on 12/29/2010
Yes, the key is to established a wanted habit to combat the unwanted habit.

Breathing techniques, mental images, etc. can be helpful, but I find that taking action is good, just a different action than perhaps you're first inclined to do in the usual knee-jerk reaction.

Think of it as a substitution effect. Apple pie pops into your head and you jump up (take action) and go grab an apple instead.

(more about that here in "Mind Over Food": http://www.garmaonhealth.com/2009/12/mind-over-food/)

Along with this, it's important to get out of a self-deprivation mentality. You need to remind yourself that the apple does not deprive you of the pie, but empowers you to get healthy, meet your goals, whatever.
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captainindustry
then that will be my story.
09:51 PM on 12/28/2010
I need help.

Dec 21 I had a Snickers and Fried Chicken for dinner. I drew the line in the sand, but now I have no idea what to do. Vegeterian? Fish? Carbs? Maybe I'll just fast, but then I get a headache.
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Dr. John Salerno
04:19 PM on 12/28/2010
Indeed, patients who come to see me in my New York medical practice for weight management often bring with them a lifetime of guilt, bad habits, and misinformation they've gotten from mainstream medicine. I applaud Dr.Rossman for focusing on the importance of the emotional, and would point out that our patients thrive on a diet based on facts, easy to follow instruction, and the understanding that its not their fault they are fat. 5 small meals a day, plenty of protein and natural fat, wild caught fish, grass fed beef, 9 servings of organic fruits and vegetables a day. It works for lifetime weight control. Dr. John Salerno, co-author
www.thesilverclouddiet.com Read our website daily for new recipes, encouragement, and facts. Our book is available in paperback, kindle, nook, Ipad and as an e-book from our site.
05:17 PM on 12/27/2010
When I feel stressed I the image I use is my body being tied up and wound very tightly with rope (especially around my chest) so my imagery that follows is me calmly taking the rope and unwinding it. It is really helpful. The more rope I unwind the deeper I can breathe.
02:39 PM on 12/27/2010
Thank you for this wonderful read! Mind and body is a non existing division.

Kris Verburgh
10:43 PM on 12/26/2010
It seems a good method. I'm going to try it.
Thanks for this information.
www.welcomeget.com
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07:15 PM on 12/26/2010
I have used mindfulness techniques (and EFT) to lose weight but also to get living under control. I find that I need to lay traps in every day activities to call me to mindfulness (washing dishes, walking the dog, phone ringing, climbing stairs, getting in or out of bed). One of the benefits has been that I can now tell (with attention) when I am really hungry and when I am simply craving (needy, emotional, etc).I find eating to be an addictive activity because of the sugar and have taken it out (as completely as possible) from my diet, including white flour, potatoes, etc. In other words, Dr Atkins had it right. Processed foods, sugar, flour, rice all make me crave more. I am also becoming vegetarian from this revolution.
03:18 PM on 12/26/2010
Its amazing that neuro-cognitive techniques aren't more used still, like EFT. The NFL uses it for crying out loud. Its take what is being done in the above article and in only 10% of the time with longer lasting effects. Anyone reading this struggling with any issue like emotional eating, PTSD, addictions, check out EFT. When you have an emotional experience hooked in with a physiological loop, you can just think your what out, you have to work and the physiological and neurological aspect in tandem with retraining your thought process. It gave me my life back.
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02:37 PM on 12/26/2010
Dr. Albert Ellis has a wonderful book about "rational" eating.
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babybelle
EARTH without art is just EH
02:10 PM on 12/26/2010
I use imagery to not overeat or eat junk.
I draw up an image of my size 6 clothes and how good it feels to wear them.
If I need reinforcement I imagine lying on the bed sucking my stomach in trying zip up blue jeans that are too tight .
That's enough to keep me on the straight and narrow path! :)
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gialla
question authority
09:00 PM on 12/26/2010
Three weeks ago when I was lying on my bed sucking in my tummy to get anything to zip up was the day when I said enough. That image is powerful.
01:45 PM on 12/26/2010
Dear Doctor Rossman: I believe that one CBT technique is keeping a therapy journal or diary. Could this be combined with a diet journal or diary to track not only our moods but also our foods? I've recently seen a lot of smartphone apps for diet journaling (e.g. http://bit.ly/eLYj0l) and was wondering if there might be a useful connection. --Thanks
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Marty Rossman
11:11 AM on 01/01/2011
Yes, this helps a great deal. Keeping a journal or log of not only your eating and exercising, but of your moods before and after eating is a great tool for becoming more aware of any possible connection. Once you are conscious of these links, it becomes more possible to change them, or develop new ones that support the changes you are trying to make.
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nolabear
01:44 PM on 12/26/2010
Good article. As a psychotherapist who has her own weight issues I'm becoming more and more interested in a multidimensional approach that includes addressing the attachment issues you mention, and how early emotional patterns and disruptions in self-soothing can be addressed along with CBT techniques, meditation, and supportive therapy. Seems that long term use of multiple approaches might provide the necessary internal structures that help people to keep dealing with the issues in the long term. Losing weight and regaining it because behavior reverts when the day-to-day program stops is common. Weight Watchers seems to have the best success rate but I wonder if a more directed, many-faceted technique would work even better.