OVERCOMING WEIGHT PROBLEMS
1. Understanding Weight Problems
About a quarter million people across the world have serious weight problems. Many people have tried dieting but if the diet works the weight usually goes back on when the diet is stopped. You may feel hopeless about ever losing weight and keeping it off – but it can be done.
More people are becoming overweight due to an environment which encourages eating more than is necessary and being less active. At the same time the media portrays an ultra-slim figure to be the ideal shape.
FAT = FOOD – EXERCISE (David F Marks)
So if you want to lose weight you need to eat less of fatty foods and exercise more.
Find your Body Mass Index to see how healthy you are – remember weight fluctuates either way by 2-3 pounds. It is necessary to lose weight in a healthy way by changing your activity level and eating habits. You then need to maintain this and keep the weight off.
If you have a serious weight problem it is wise to see a doctor and rule out any medical reasons. You are advised against taking weight-loss pills as there is no evidence that they work, they are costly and can be detrimental to your health. However, your doctor may prescribe drugs to help you in the short-term. You will have to make changes in your activity level and eating habits as well as taking these drugs; this way when you come off them your weight loss will be maintained.
Those who are severely overweight may opt for surgery but this is a drastic approach and needs to be discussed with your doctor.
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2. Body Mass Index (BMI) and Weight Graphs
BMI is given by weight (in kg) divided by height squared (in m) [i.e. Wt/Ht²]
The thresholds of BMI are:
Significantly underweight: 17.5 or below
Underweight: 17.6 to 18.9
Low weight: 19.0 to 19.9
Healthy weight: 20.0 to 24.9
(Somewhat) overweight: 25.0 to 29.9
(Significantly overweight) obesity: 30.0 or more
Weight graphs: Note that weight fluctuates by 2-3 pounds in either direction. Weigh yourself once a week at a set time for 40 weeks. Plot a graph with your weight (in lbs) on the y-axis and the weeks (0 to 40) on the x-axis. From the graph by joining the points you will be able to see the emerging weight trend.
BMI 20.0 (120 lbs) to BMI 25.0 (149 lbs) is a healthy range.
Below BMI 20.0 (120 lbs) is the underweight range.
Above BMI 25.0 (149 lbs) is the overweight range.
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3. Starting to Change
You need to be motivated to change. It must be your decision to follow this program and lose weight. You will have to tolerate short-term discomfort for long-term gain and always keep in mind your personal reasons for wanting to change.
Make a list of reasons to lose weight and keep copies where you can see them. How have you dealt with difficulties in the past? What motivated you to keep going? Think about what is important to you (values/reasons) in each area of your life (family, work, leisure etc.), and how much each reason matters to you – write these down in positive terms.
Imagine in as much detail as possible yourself in ten years’ time:
You have lost no weight – visualize: where you will be; what you will be doing; how you and others around you will feel; how significant events will turn out; your age and that of others close to you; a typical day. Include positives and negatives and be realistic.
You have lost substantial weight – visualize: where you will be; what you will be doing; how you and others around you will feel; how significant events will turn out; your age and that of others close to you; a typical day. Include positives and negatives and be realistic.
Guilt and demands from others or yourself will not work as motivation.
See Program 1: Coping Strategies Counselling Advice – Troublesome Emotions.
Also - See Program 1: Coping Strategies Counselling Advice – Forgiveness, Program 6: Overcoming Anger, Program 8: Overcoming Anxiety, Program 12: Overcoming Depression and Program 15: Overcoming Grief And Bereavement.
Low self-confidence can make you susceptible to anxiety.
See Program 1: Coping Strategies Counselling Advice – Assertiveness Training, Neuro-Linguistic Programming (NLP), Building Confidence I, Building Confidence II, Building Confidence III, Building Confidence IV and Program 16: Overcoming Low Self-Esteem.
For further help:
See Program 4: Overcoming Addiction, Program 5: Overcoming Alcohol Abuse and Program 3: Overcoming A Smoking Habit.
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4. Dealing with Negative Thoughts
Negative thoughts are not always untrue but they tend to be biased, unhelpful and give a limited view of the situation (e.g. ‘I hate trying to lose weight – I’ll never do it!’).
See Program 1: Coping Strategies Counselling Advice – Modifying Maladaptive Thinking.
Consider a recent upsetting situation and identify your negative thoughts. Challenge these thoughts using Socratic questioning.
See Program 1: Coping Strategies Counselling Advice – Distorted Thinking.
Think of alternative helpful thoughts and strengthen your conviction in them.
See Program 1: Coping Strategies Counselling Advice – Strengthen Conviction in Alternative Functional Beliefs.
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5. Monitoring Activity and Eating Habits
It is necessary you understand your own eating habits then you can gradually change them. Monitor your activity and eating habits every day for about six weeks. Record separately for both activity and eating – the situation/trigger, date, time, details of eating/activity (sitting, standing, walking, exercise), your emotions/mood (e.g. sad, happy) and physical sensations (e.g. hungry, tired), who you were with, the action you take/lack of action (behaviour) and any thoughts that go through your mind (cognitions).
Recording is best done as soon as possible and must be done on the same day. From analyzing your monitoring records you may notice patterns (e.g. you may eat more at night or when drinking alcohol).
Consider the situations, moods and physical sensations correlating with times when you eat large amounts, are inactive for a long period and change plans at the last moment. Also, note any excesses in what may appear to be a moderate and healthy eating pattern.
Changing Your Activity Level:
Choose exercise you enjoy and build up gradually. An activity schedule can help you make the most of your time and include adequate regular exercise.
See Program 1: Coping Strategies Counselling Advice – Planning an Activity Schedule and Exercise.
The more you exercise the healthier your heart will be and the less fast it will have to beat to circulate the blood around your body.
Activity is likely to take time to show results – be realistic in your expectations and persist despite the frustration of slow progress. Perfectionism – striving for the unobtainable ‘ideal body’ can lead to a negative body image.
See Program 1: Coping Strategies Counselling Advice – Competitiveness and Perfectionism, Frustration, Procrastination and Persistence.
Also – See Program 1: Coping Strategies Counselling Advice – Coping with the Need for Approval, Improving Your Self-Image and Combating Self-Harm, Criticism and Countering Self-Criticism.
Exercise can reduce stress and can be combined with socializing (e.g. day in the park with family).
See Program 1: Coping Strategies Counselling Advice – Problem-Solving, Program 22: Overcoming Stress and Program 23: Overcoming Stress At Work.
Consider: How activity will benefit you? What is stopping you from exercising?
What changes are required so that you do exercise? Which kind of activity is best for you?
Be aware to avoid rewarding yourself with fatty foods for increased activity. Also, make sure you drink water before and after exercise, to prevent dehydration. Cut down on sedentary activities (e.g. watching television), be more active as part of your routine (e.g. walking between places) or planned timetabled exercise (e.g. going for a swim).
Changing Your Eating Habits:
Avoid perfectionism – realize that you need to make changes which are realistic and which you can sustain in the long-term. Small changes can add up to a big difference in weight control.
Planning your meals in advance means you ensure healthy eating and do not grab fatty snacks at the last minute. It is also a good idea to limit the amount of fatty foods available at home. Consider previous attempts at weight loss – what was helpful and what was not?
Stop labelling food as ‘good’ or ‘bad’ – permit yourself high-calorie foods (e.g. chocolate) in moderation and have healthy foods (e.g. salad) regularly. Skipping meals will lead to difficulty in controlling weight.
A regular meal plan (three meals and two or three snacks a day) will help you manage your weight. Control eating between meals by implementing a regular meal plan of: breakfast, snack, lunch, snack, dinner, snack. Eat only at these times, eat moderately and reduce the fat content of the meals especially that of your snacks. Monitor daily what you eat between meals: When? Where? How often? What? Try snacking in only one place.
Note there is scientific evidence that: the higher your weight, the higher will be your metabolic rate.
Contrary to belief, eating late at night does not lead to greater weight gain – it is the balance between the calories consumed and the calories used up through exercise that determines weight loss/gain. Avoid quick-fix, extreme diets – a better approach is to make modest reductions in your fat intake.
See Program 1: Coping Strategies Counselling Advice – Nutrition.
Consider how you could reduce what you eat just a little in quantity – cutting down on fatty/sweet foods will be most helpful. Reduce snacking between meals to only 2-3 times a day. Try using a smaller plate as well as a smaller portion. Time your meals to spend about 15 minutes on each meal. Try putting your cutlery down between mouthfuls and taking sips of water. Eat slowly and savour your meal. Make conversation while eating and eat at the same speed as others. Take a break of 1-2 minutes during the meal. Count how many mouthfuls you eat. Try to be the last to finish.
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6. Changing Your Lifestyle
Losing weight needs to be supported by significant others and by our lifestyle. Learn to deal effectively with relationship problems.
See Program 1: Coping Strategies Counselling Advice – Social Skills Training, Communication Training, Negotiation Training, Troublesome Emotions and Program 13: Overcoming Destructive Relationships.
Maintain good physical health.
See Program 1: Coping Strategies Counselling Advice – Nutrition, Exercise and Sleep Management.
Make two SMART plans, one for activity and the other for eating.
See Program 1: Coping Strategies Counselling Advice – Managing Your Time.
Write down each plan in detail: What is the plan? What support do you need? When will you start and when will you review/check your progress? What are the good reasons motivating you to change?
The plans need to be something you would do for the rest of your life. They need to be modest changes, with variety and treats to reward your efforts and every little success. Resolve any negative thinking and keep track of your progress – are your plans working?
Your life will be constantly changing (e.g. changing jobs or relationships) and you need to incorporate these into your plans. Think about how you can cope with such changes. By sticking to your plans through good times and bad, your behaviour will change and you can gradually build up to bigger changes. Eventually you will lose weight and keep it off. Remember to reward yourself for succeeding with a plan – but probably not with food.
If your plans are not working you need to think about the things that have worked and what you could do differently.
See Program 1: Coping Strategies Counselling Advice – Problem-Solving.
Deal with your distress in situations you fear by exposure – FEAR (face everything and recover).
See Program 1: Coping Strategies Counselling Advice – Controlled Breathing and Relaxation Techniques, Eye Movement Technique (EMT), Mood Induction Procedure, Rational Emotive Imagery (REI), Imago Graded Exposure and In Vivo Graded Exposure.
Emotions both positive (e.g. pleasure) and negative (e.g. sadness) affect weight loss, as do physical sensations (e.g. cravings, tiredness). Make a list of any feelings and physical sensations which cause problems with your plans to eat less, eat more healthy foods and get adequate exercise, for example: ‘This is delicious – I’ll eat just a bit more’ or ‘I’m tired – I’ll rest briefly and exercise another time’.
Consider what triggers these feelings/sensations; when they occur; where and whom you are with at the time; the action you take as a result; how you are affected in the long-term.
Even if these feelings/sensations make you feel better it is likely to be only for a short time. Succumbing to your feelings and sensations will only make them stronger while refusing to give in to them will weaken them. Realize that these feelings and sensations will pass if ignored and you can tolerate them.
You cannot always trust your feelings of hunger and tiredness as they may or may not reflect your bodily needs.
We have learned what is ‘normal’ from others, but actually these are beliefs and thoughts. It may be you think unhealthy eating/exercise habits are ‘normal’.
Biased, unhelpful thoughts are often present with emotions and sensations (e.g. anger related thought – ‘It’s not fair I have weight problems’). Manage these as you learned in Dealing with Negative Thoughts.
Other people may affect your weight loss plan by:
Giving you a bad environment (e.g. a spouse who insists on having unhealthy foods you cannot resist, in the house or having a job that keeps you inactive).
Not providing the support you need (e.g. there is no one to look after the kids when you go to the gym or your partner may refuse to pay your gym fees).
Write down which people’s behaviour has the greatest effect on you. Consider who is not supporting you in losing weight and precisely what you need them to do. Let others know what you expect from them.
Learn to assertively request others to change.
See Program 1: Coping Strategies Counselling Advice – Assertiveness Training, Social Skills Training, Communication Training and Negotiation Training.
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You may have mixed feelings about losing weight – try to identify and challenge any related unhelpful thoughts. When setting a weight loss goal, a ten percent loss of current weight is realistic although people can lose more or less.
When you have a setback keep in mind your good reasons to lose weight and the progress you have made so far – this way you will resume your motivation to change. Use your problem-solving skills, make SMART goals and deal assertively with interpersonal problems. Review your progress at regular intervals.
Good luck with losing weight and keeping it off!
See Program 1: Coping Strategies Counselling Advice – Relapse Prevention.
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