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Weight Management Through Cognitive Emotional Techniques

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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, 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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