I have recently begun working with a few clients who are interested in losing weight. The therapy treatment plan I use is one based on Cognitive Behavioral Therapy (CBT). CBT was developed by Dr. Aaron T. Beck and is a form of psychotherapy in which the therapist and the client work together as a team to identify and solve problems. CBT helps clients overcome their difficulties by changing their thinking, behavior, and emotional responses.
Dr. Judith Beck (daughter of Dr. Aaron Beck) writes in “An Open Letter to Carnie Wilson: What you need to know to keep the Weight Off” a detailed description of the first step in using CBT to help with weight loss.
Judith Beck’s letter:
Dear Carnie,It’s not surprising that you gained back most of the weight you lost after your first weight loss surgery — so many people do. I’m glad to hear that you’ve now lost 30 pounds following a second lap band procedure. There are, though, a number of important skills you need to learn if you want to keep the weight off for good this time.
I would bet that no one ever taught you essential skills such as: how to motivate yourself to make healthy choices every day, what to do when you experience a craving; how to get yourself to exercise (even when you don’t feel like it), how to get immediately back on track when you make an eating mistake, and how to cope with negative emotions without turning to food.
My guess is that the number on your scale is still going down and so you probably feel quite motivated at the moment. But what will happen once your weight loss plateaus? Your daily weigh-ins on the scale won’t be so thrilling then. And you’ll probably experience more temptations and cravings. Is this what happened last time? Did you begin to have (sabotaging) thoughts like, “I don’t care. I know I’m not supposed to eat this, but I’m going to anyway?” These types of thoughts are common among dieters, especially dieters who struggle with keeping weight off. Fortunately, though, you can start practicing now for the difficult times you’re likely to face.
One important technique I want you to know about is predicting the kinds of sabotaging thoughts you’re likely to have in the future. You probably had these same types of thoughts in the past. Write each one on a card. Then write what you wish you would be able to remember so that you can respond to them effectively, not give in to them, and stick to your new eating plan.
You might have the thought, for example, “It won’t matter if I eat this food that I’m not supposed to eat.” How do you hope you might respond to that thought? Do you think it would be helpful if you told yourself, “No, it absolutely does matter! I’m just fooling myself.
Thoughts like that have always led me to gain back weight in the past. And every time I give in, I increase the likelihood I’ll give in the next time. It’s so worth it to me to stick to my plan and resist temptation. I’d rather reach my weight loss goals than eat this now.”
This is just one technique from our cognitive behavioral program for weight loss and maintenance. There is a lot to learn, but won’t it be worth it if you can keep the weight off for good this time?
Judith S. Beck, Ph.D.
Beck Institute for Cognitive Behavior Therapy
I highly recommend her book, The Beck Diet Solution, to anyone who is interested in a new approach to losing weight.
Marc Elliot was born with no large intestine, 4 feet of small intestines, and has Tourette syndrome. Yet, he has learned to control the symptoms of his disease and have a great life with the classic Cognitive Therapy techniques of Reframing and Challenging Thoughts.
How does Peer Pressure affect your teenager?
Adolescents often have several groups and layers of friendships. They may have a couple of close friends, different larger groups of friends with common interests, and friends who come in and out of their lives. Friendships during the teenage years tend to be fluid and changing over time. Teens most often choose to spend time with others of the same age and background and select friends from the same ethnicity, gender, and socioeconomic status.
Peer friendships can provide some of the most healthy and happy experiences for a teenager. Strong peer-to-peer relationships help teens develop important skills of communication and compromise. In a positive environment, adolescent friendships can be one of the most important developmental experiences in your child’s life.
Unfortunately, situations exist where peer influence and peer pressure can lead a teenager to choose unhealthy and unsafe behaviors. In these cases, parents want to help guide their child to make positive choices. Some effective strategies recommended by adolescent development experts Dr. B. Bradford Brown and Dr. Laurence Steinberg are:
1. Nurture your child’s self-esteem. An adolescent with a positive self-concept and strong since of self worth is less likely to be influenced by outside influences.
2. Encourage your child to form positive relationships with other adults. These relationships can help a teen learn good models for healthy relationships. Encourage your child to spend time with a teacher, counselor, or relative who you believe who be a positive mentor to your child.
3. Encourage diverse relationships. Parents who model diverse friend relationships in their own lives help teens learn to do the same. Encourage your child to create friendships across ethnic, gender, and socio-economic or religious lines.
4. Teach your child specific skills to make good decisions and resist negative behaviors. Adolescents need to be taught methods to properly analyze a situation first, and then make a decision. The most basic concept is the cost vs. benefits analysis. Teach your child to evaluate the positive outcomes with the negative outcomes of several possible scenarios. Be specific with respect to consequences for behaviors.
5. Teach your teen exit strategies and ways to say “no” to negative pressures. Preparing your teen in advance for ways to deal with specific circumstances will help when they are faced with a “real life” situation. Role-play examples of common peer pressure moments such as being offered alcohol or drugs. Help your child prepare positive responses that are comfortable for them.
Remember, peer relationships can be one of the best experiences for your child’s healthy development. Following the above recommendations will put your child in the best possible position to avoid negative influence and make positive choices.
For more detailed information on the above, consult the following sources:
Brown, B. B. (2004). Adolescents’ relationships with peers. In R. M. Lerner & L. Steinberg (Eds.), Handbook of Adolescent Psychology, 2nd edition (pp. 363-394). New York: Wiley.
Friendships, cliques, and crowds. In G. R. Steinberg, L. (2005). Adolescence. New York, NY: McGraw-Hill.