Most of the dieters whom I treat overeat when they're feeling stressed or experiencing a negative emotion such as anxiety, sadness, anger, shame and so on. They often have one or both of the following unhelpful ideas:
"There's nothing I can do to calm down when I'm upset."
"I deserve to eat when I'm upset."
As long as they hold beliefs like these, they will remain vulnerable to regaining the weight they have lost. They need to change their thinking. They need to learn how to accept and tolerate negative feelings and how to cope with stress in more healthy ways.
Katie, a dieter whom I saw last year, had been doing so well initially. Early on, she was highly motivated and was able to stay on track, even when she was upset. When she became upset, she would tell herself, "No choice. It's not time to eat. I can't eat now." She would turn her attention to something else, her negative feelings would slowly subside, and she'd feel proud that she had stuck to her plan.
But then Katie went through a particularly stressful period. Her father was hospitalized. Her youngest child started having problems in school. She got a new supervisor at work who was making unreasonable demands on her. Katie continued to follow her eating plan throughout each day. But come 9 p.m., when her children were in bed, the permission granting beliefs above led to Katie's consuming "all the carbs I can get my hands on," until she went to sleep. She quickly started regaining the 22 pounds she had lost. She was frustrated and angry at herself but couldn't seem to stop.
First, Katie and I did some problem solving. As soon as she got her kids in bed, she would decompress by doing deep breathing and then she'd have a cup of herbal tea. Next, we did some cognitive work. Following our discussion, Katie composed messages on index cards which she was to read each day after work, just before she walked in the house. She was to read them again as she was sipping her tea. This is what Katie's cards said:
"If I want to lose weight permanently, I have to stop eating when I'm upset -- every time. People without weight problems don't eat when they're upset. They either tolerate their negative emotions, or try to solve the problem, or call a friend, or take a walk, or go online, or read a magazine, or watch television. But they don't eat."
"Negative emotions are uncomfortable but not dangerous. I don't have to "fix" them. I've had lots of times when I've felt very upset, but I haven't eaten. I've never exploded or lost control. The worst thing that will happen if I don't eat is that my distress will peak and then the intensity of my emotions will go down. "
"If I eat, I'll be temporarily distracted from my distress, but whatever problem led to my distress in the first place will still be there and then I'll also have the problem of feeling badly that I ate and I'll really feel badly when I see that the scale has gone up."
Katie also started back on day one of the cognitive behavioral program for weight loss and maintenance so she could sharpen her skills of re-motivating herself, gaining confidence by giving herself credit, tolerating cravings and getting back on track immediately when she made a mistake. The incidence of her eating for emotional reasons declined sharply. She slipped a few times, but the challenge became easier and easier as time went on.
The chance that Katie will be able to maintain her weight loss into the future has increased.