Tuesday, February 18, 2014

What Do Your Thoughts Have to Do with Eating and Weight Loss? Using Cognitive Behavioral Therapy to change your behavior around food. By Jen Nash, DClinPsych

This article continues the theme of emotional eating, diabetes, and weight loss. So what do your thoughts have to do with weight loss? We have many thousands of thoughts every single day and it is likely that you rarely pay much attention to them. However research has demonstrated that our thoughts contribute much to our decisions around eating behavior. If we can become aware of them, we can influence them, and therefore dramatically change our behavior around food.

Psychologists began paying attention to the role of thinking styles back in the 1960s as a reaction to traditional Freudian psychoanalysis, which has considerable value but could often take many years to achieve long-lasting results. Aaron Beck, the founder of Cognitive Behavioral Therapy (CBT), was a psychiatrist who worked with patients with depression. He found that they experienced streams of negative thoughts that seemed to pop up spontaneously. He termed these "automatic thoughts," and discovered that their content fell into three categories: negative ideas about themselves, about the world, and about the future. Beck found that his clients would tend to accept these thoughts as true and valid, without reflecting on the authenticity of their content.  He began helping his clients identify and evaluate these thoughts and found that by doing so, they were able to think more realistically, which led them to feel better emotionally and behave more functionally. He termed this therapy Cognitive Behavior Therapy to reflect that it addresses both cognitions (thoughts) and behavior.

CBT is now widely used to treat many emotional problems, including issues with food and eating, Further, the tools and strategies it provides are useful life skills for everyone. Although many people work with a therapist, counselor, or psychologist to learn the skills of CBT, it is not essential. CBT can be used at home without a therapist, as long as you understand the principles of treatment. CBT is a skill, and like any skill it takes time and effort to learn it well. It isn't a quick fix. By learning the skills and practicing their implementation you will develop control over your eating, weight, and also your general well-being.

According to the theory of CBT, there are four aspects to any of your experiences. First, there are the physical symptoms – what happens to you physically and the sensations you are aware of in your body. Secondly, there are your moods, emotions, and feelings. Thirdly, there your thoughts – what goes on in your mind and your thinking styles, images, and memories. Finally, there are your behaviors — the actions that you take or fail to take. These four categories of your inner experience all interrelate. Your thinking affects your body sensations, which affects your behavior, which affects your moods.

So what does this mean in practice? Let's look at an example to help us. Claire wants to lose weight and has been attempting to eat more healthily for a week. She steps on the scales at the end of the week to check her progress and discovers that she has not lost any weight despite all her efforts. Claire's thoughts may be, "What's the point of trying? I have tried to eat healthy and I have not lost any weight! There is nothing I can do to change this." If Claire were thinking these thoughts it is likely that her mood would decline and she may feel fed up, anxious, and/or depressed. If she were thinking these thoughts and feeling these emotions it is probable she would experience some changes in her bodily sensations such as fatigue and irritability. If she were thinking these thoughts, feeling these emotions and experiencing these bodily symptoms, it is likely that her subsequent actions may be affected. For example she may snap at a family member who asks how her healthy eating is going. Or she might decide to eat something fattening as a ‘treat' to cheer herself up.

According to the theory of CBT, all of these experiences — thoughts, emotions, body sensations and behaviors — interact to bring about a certain outcome. CBT focuses on your thoughts as playing the central role in our psychological wellbeing. Therefore by changing your thinking patterns you can change the emotions you are experiencing and the behaviors you are most likely to engage in. this means if you can gain insight and control into your thinking styles, you can gain control over your eating behaviors. Exciting isn't it?

So how can you change your thinking patterns? Perhaps you can identify with the example of Claire and have had the experience of getting on the scales, realizing you hadn't lost any weight and feeling disappointed. However Claire's reaction was only one of a number of possible ones. Other possibilities are, "Well it's only been a week – I'll keep going for another week and see how I get on." If you were thinking these thoughts it is likely you would have a different set of moods, a different set of body sensations, and therefore a different set of behaviors. Instead of snapping at your partner or deciding to eat a sweet treat to comfort yourself you may instead think, "This IS frustrating, but what can I have for dinner tonight that is healthy and will help me stay on track to reach my goal next week?" You might tell your partner you are disappointed and ask for a hug or a reminder of how good you'll feel once you've reached your goal.

This shift in thinking has the potential to profoundly affect both your emotional experience around eating and your subsequent behavior. Focusing on your thoughts and replacing unhelpful thoughts with more supportive and empowering ones can help you to reach your weight loss goals and overcome the barriers that prevent you from behaving the way you would like in relation to eating.

In the next article I'll be discussing the 5-step process of how to challenge the thoughts that don't empower you around food. Looking forward to connecting with you then!

Dr. Jen Nash is a clinical psychologist who has lived with diabetes for more than 20 years. She runs www.PositiveDiabetes.com, an education, therapy and coaching service that supports people with type 1 and 2 to manage the emotional and psychological impact of day to day.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.


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