Weight Loss


Do I work with people who want to lose weight? Yes, but sparingly. Usually either by special request, or if I've already worked with someone to resolve a different issue and he or she now wants to focus on weight loss. Notice I'm using "weight loss" not "weight management." That's because I know next to nothing about how to help people gain weight. Most of what I've learned relates to weight loss. That and helping people quit smoking was my bread and butter during my dissertation stage in graduate school. And I've applied the basic principles of weight loss for myself. Perhaps I'll post a clip of me doing a show when I had more pounds vs. how I am now, though I do look down on testimonials!

What's frustrating about weight loss for me as a therapist is that often times, the client and I are on different pages in terms of a time line. With the anxiety spectrum, most people intuitively realize that reducing anxiety takes a little bit of time. With phobias, I can help a person within a few hours if they have a flight the next day. Likewise, with smoking, a lot can be accomplished in a few hours. But with weight loss, typically the client wants to lose five lbs, that week. And another five pounds after that. I on the other hand am more interested in how the client is at month five or month six. The client is interested in fitting into the dress or bathing suit that summer, I'm interested in establishing a long-term way of eating, which can take a little bit of time.

Do I help people lose weight? Yes, but though a process of habit changing, which can take a bit of time.

This long-term view can be frustrating for the client because typically they find me after seeing a show where I hypnotize people and it seems like magic. Alas, if I could hypnotize a person to lose weight and be at a happy 110 pounds as easily as I could hypnotize someone to forget their name during a stage show, I'd be so wealthy I'd own every high rise from here to the ocean. Remember, the show is about the sub-conscious going along with my suggestions because it doesn't have a problem creating a change for an hour or so. It's a different story to create a more long-lasting change.

So what I'll do is briefly go over the behavioral steps to my weight loss program, then you can better decide what you want to do. Some common options might be:

1. You can see if you can do these steps on your own (which may just work for you).

2. You can decide these steps might just work for you and you'd like to work with me.

3. You can decide this isn't for you.

4. You can decide that you already have a plan or a dietician and just want to resolve an emotional issue that relates to your weight loss.

Believe me, due to my schedule, I have no problem with options 1, 3, and 4. I know a few really good dieticians, including one whose office is right next to mine. I have no problems referring; just let me know what exactly you're looking for. Actually, as dieticians will often refer to me clients who need to quit smoking or reduce anxiety, I tend to work more with people who have their own diet plan and just want to focus on their emotional issues. As we work together, if I find that my plan for behavioral change doesn't quite suit you, I may refer you to a dietician. The dietician will work on your actual eating habits and nutritional needs; I'll handle the emotional issues.

Weight loss involves both a behavioral and emotional component. Depending on client needs, I'll focus on one or both components.

Llet's go over the emotional component of my weight loss program and then we'll go over the behavioral component. But before we do, just as a reminder, remember that I'm a psychologist, a Ph.D. I have a medical doctor friend who's quick to say that means "Phake Doctor." There's some truth to that! I'm not a medical doctor. I'm not giving out any medical advice here. My role is simply to restore your mental health, help you better cope with your environment, and share concepts germane to your personal goals, whatever they may be. If your doctor tells you to eat a certain way, that pre-empts any recommendations I may have. In essence, think of me as your pathway to better deal with emotional stress and to better learn about how hunger works.

On that note, let's briefly look into the emotional issues. Then we'll cover the behavioral changes.

Emotional issues:

There are four common emotional areas that relate to weight loss: stress, cravings, hunger, and aversion to exercise. Let's leave the last two for the next section as they relate more to behavioral changes. That leaves us stress and cravings.

Stress

I typically help people with stress the same way as I help people with anxiety. Included in the concept of stress is the loneliness or boredom that often contributes to snacking. Many of those who come in for weight loss also realize they have a bit of a self-image or anxiety problem. We can work on them at the same time because often the behavioral process of weight loss takes a bit of waiting time, as you'll soon see.

Cravings (The Meteor Goal)

This is where the hypnosis will come in. The idea is to create a detachment from some of the food that creates the craving but on a more general basis. In addition to creating a specific detachment from craving items (e.g. chocolate, potato chips), we have the Meteor Goal. What's the meteor goal?

Let's say a meteor is going to strike the earth tomorrow, sterilizing the surface and killing everyone. Nuts. You have one last day on earth, what do you eat? If you say, "Oh, I'd eat a whole pint of Ben & Jerry's," you failed the meteor test! The goal is to honestly think, "You know, I'd probably eat the same as I do any other day, but I'd be sure to..." or to get as close as possible to that thought process. In my case, I'd probably skip the oatmeal for breakfast and have a big cheese omelet, but I wouldn't have the same desire for the really bad food, as I probably would a few years ago.

The ultimate goal for craving management is that even if a meteor were to strike the earth and we were all doomed, you wouldn't have a desire to indulge in your past cravings.

The idea is that, though it's unlikely we'll be seeing a meteor any time soon, there are all kinds of stressors out there that can elicit that similar sense of "fuck it" (if you'll pardon my French). It might involve getting fired, getting hired, going on vacation, or coming back from vacation and having to sort out everything at work. Pretty soon, that sense generalizes until our eating habits get way out of line and we fall off the wagon.

So the goal is to have the mentality that even if things were to get really bad there just wouldn't be that much of a desire to eat X, Y, or Z. We'll deal with this a lot with hypnotherapy along with issues of anxiety & stress. Now we turn to behavioral changes.

Behavioral Changes:

Meal Replacement

The idea behind meal replacement is to first determine which meals are "stable" vs. "unstable." Meals in the first group are those that you make yourself or otherwise eat the same thing on a day-to-day basis. These are typically breakfast, lunch, and snacks. For most Americans, dinner is the meal that is "unstable" in that the meal is unstable, has more fluctuation, and is more likely to involve social settings.

The second step would be to commit to keep those stable meals stable. This means making the commitment to not eat out for breakfast or lunch or for snacks. If dinner is the variable meal, it's often helpful to eat the same breakfast, lunches, and snacks consistently up until, let's say, 6pm.

By keeping most of the meals stable, consistent, and nutritious, we can afford more leeway with the meals that involve variety or social situations. For most Americans, this is the dinner meal.

We then target one meal, typically breakfast first. The idea is to replace what you used to eat with foods that are low-calorie but highly filling. Typically those foods that are low in what's known as "glycemic index" or "glycemic load." For example, my breakfast each morning is non-instant oatmeal with different types of fruit. A recent study showed that people who ate a high-fiber breakfast such as non-instant oatmeal (the instant kind didn't seem to work as well) were far less likely to snack during the day, they actually ended up eating 987 less calories per day.

But what if you don't like oatmeal? The idea is that you'd spend some time finding a low glycemic-load breakfast you can enjoy. That you can make permanent. This can take some time. Adjusting to a completely new meal should be a gradual process. It also takes some time to really commit to not having the occasional egg-and-cheese breakfast sandwich. The idea being it's far better to "cheat" during dinner. Having a good, stable, healthy breakfast sets a sort of mental precedent.

Sometimes this process of finding the right breakfast for you make take up to two weeks to experiment and fully acclimate, hence a need for some patience. If you make too many food changes at once, it becomes a temporary diet, not a long term change in eating.

Next step is lunch. Again, a low-glycemic load meal is the trick. I'll have a bowl of low-fat soup. I'll also microwave a baked potato and frozen veggies (typically broccoli & pees), chop them up and put them in the soup. This creates a very filling soup that's just about 200 calories.

Again, it takes some time to find the right lunch. Your lunch will vary. For example, I can tolerate collared greens, pees, carrots, and broccoli in my soup but very much dislike cauliflower or onions. Even though a microwaved potato isn't as low as rice in terms of glycemic load, I find that it really fills me up and by slicing it up and having it in my lunch, I'm not tempted to have the high-fat toppings that usually go on a baked potato. As a snack, I'll have about a half-cup of high fiber cereal.

For my meals, I'm typically looking at 500 calories consumed before 6pm. As I can have about 2,500 calories, that means I can basically eat 1,700 calories and still lose weight. That's actually a pretty big dinner. For my dinner, I'll generally, well, cheat! I'll have pizza, a cheeseburger, even fettuccine alfredo.

My having a large, higher-fat meal for dinner serves two purposes. One, it serves as motivation to eat healthy during the day. I can always look towards dinner as my reward. Second, it serves as motivation to not eat any of the really bad food, such as donuts, or potato chips, or what not during the evening time. Even though I've used cognitive techniques as well as self-hypnosis to resolve any of those "addictions," I still like to know I'm not depriving myself.

I apply the harm reduction model to dietary change. Eat dinner the way most people do but focus breakfast, lunch, and snacks on nutrition & fullness, thus limiting the impact of dinner.

I've seen this way of eating work for me and for others but this strategy is not without controversy. It's a well established fact that the best way to lose fat is to spread out the calories throughout the day. To not eat 1,500 or more calories all in the evening, especially before going to bed.

I've chosen to ignore this advice. Why? Well, calories in, calories out. If I burn more calories than I take in, I'll lose weight. If they match, I maintain my weight. I've found that for me, if I eat a larger breakfast or lunch, or even eat more calories through more snacks during the day, I'm just as likely to end up eating a large dinner anyway. It's quite easy to control my food intake during the day. But at dinner, I'm out with a friend, or a fellow psychologist, and it's more difficult to control food intake in social settings. I'm just not going to restrict myself to a salad.

A slight variation I've adopted is to somewhat count calories and pick dinner meals that are a tad below the number of calories I should be eating, and eat those meals five night out of the week. Then, two nights out of the week, when I'm eating socially our out-on-the-town, I have a lot more freedom.

The important distinctions in my own diet plan are an emphasis on slow, gradual weight loss and a balance between discipline & freedom.

So this is the meal-plan I've engineered for myself. Lots of nutrients and low-calorie food during the day, eating like a typical American (within reason) at night. I don't feel as deprived. In fact, I think it would pass the meteor test. I don't feel like I'm on a diet, though as of this writing, I'm losing about a pound a week, on target to lose another four pounds.

What works for me may or may not work for you. The idea is that we'd work together to find something that best suits you. This might take some time, as you have to learn what works for your own body type and disposition, even your work & social habits. The good news is that once you have a good plan where you're not as hungry & don't feel deprived, you can have a steady weight loss that almost happens in the background. You can move on with your life and simply notice that you look and feel better.

So where does exercise fall into the equation?

Exercise

Exercise can be a tough nut to crack. Most Americans don't end up exercising consistently for long periods of time. Fitness centers often make a killing offering low-cost memberships because most people don't end up going, yet are reluctant to officially cancel their membership. So for exercise, I throw everything at the issue--behavioral strategies, cognitive restructuring, hypnosis, all of the metaphorical tools in the toolbox.

To start, let's look at what really motivates people. If you've read the section on smoking cessation or on social anxiety, you'll know that what really motivates people is the idea of being accepted, of being a contributing member of a group. What is threatens people is the opposite. For men that often means losing social status while for women the threat is losing social connectedness. These gender differences are not absolute but we see them often enough to maintain these assumptions. We can apply these assumptions to help set an exercise pattern. Based upon this knowledge, the three steps I use to bring about the exercise habit are:

1. Find a sport or physical activity that, once you join it, you'll be motivated to perform well based upon social acceptance.

What brings about social acceptance? For men, it often means competition. Basketball, football, dodge ball. For women, it often means social connection. Group jogs or group biking. For both genders, the ideal is to pick an activity where they'll notice if you're not there and they'll notice when you're doing well. This will be an activity you'll do once a week. Why once a week? Because it gives you flexibility to pick the activity. Let's say there's a great ultimate Frisbee game in North Hollywood. You're in Marina Del Rey. If it's once a week, you'll be more willing to schlep up there for the game.

What motivates human behavior is a desire to be accepted. We use this knowledge to encourage exercise behavior.

2. Focus your daily exercise just on doing better for that once-a-week sport.

Have the mentality that you're not exercising, you're training. You're training so that in your sport or physical activity you selected in step 1, a given person isn't able to outrun Person X, or that you're able to keep up with Person Y. Focus your training on being able to--well, show off.

Think about what motivates the sub-conscious. What would motivate a caveman? He wouldn't do something to "reduce incidence of cardiovascular disease," which might not even occur for another 10 years. No, what would motivate a caveman would be out performing the other caveman and impressing anyone who might be watching. Now, we're all modern, adults here. Many of you may already be in committed relationships. But that doesn't change the fact that, deep down, we all desire to be accepted and we all have a competitive streak. It's much more motivating than abstract concepts of disease incidence reduction.

Think back to high school. What often motivated you was competition and superficial contests. This motivation still exists and it can be fostered for positive change as adults.

I play ultimate Frisbee once a week. It's fun. I enjoy doing it. But there's competition. Depending upon who's playing and who's watching, there can be a whole lot of competition. When I train, I focus on which exercises will better help me run and what make me look better when I'm out in shorts and a t-shirt. How absolutely juvenile and superficial, right? Yet when I feel like ducking out early of my exercise, that's what I think of to finish that last set. And more often than not, it works.

3. Pick a consistent time to train, typically during a higher energy level.

Many people are tempted to look at their schedule, determine the time they spend watching TV for an hour and think, "well, if I just exercised instead of watching TV, then I'd be all set!" Typically, this doesn't work very well. You're watching TV for a reason: you're on low-energy mode. It's just not a good time for your body to be doing anything strenuous, mentally or physically. A while ago, I decided to not watch TV any more. And I was able to do it! I now surf the internet and watch clips on youtube. Leave yourself some time each day to zone one.

Resist the temptation to think you can exercise when you're used to zoning out. There simply won't be enough motivation.

Find a time during the day when you have more energy. That's a good time to do your workout. The workout doesn't need to be that long, just consistent. The time period should be similar each day, so that your body gets a natural rhythm , though this would apply mostly to people who are already schedule oriented. If at all possible, focus on activities that don't require a set-up time or a long drive. That just seems to take time away from the training.

In Conclusion

So there you have it. Once again, consider all this information as from my own research and my own personal experience. It should not replace what your doctor says or be taken as medical advice. It's important to find your own diet and exercise plan that works for you. I'm just presenting what works for me and what I've found works for others. I'm a psychologist, not a fitness trainer or a dietician. I believe my plan takes a unique psychological approach that's beneficial in the long term but your results might vary! Consult a physician before undergoing this or any other type of dietary change or new form of exercise.

Any change in diet & exercise often involves some emotional, cognitive, or behavioral management. I help people in these areas but change won't occur overnight. It takes some time to find the right meals and exercise program for you.

Consider what might be a good match for you. If you have any questions or would like to come in and seem me, click here.