This morning I had the privilege of speaking with Dr. Judith S. Beck Ph.D., Director of the Beck Institute for Cognitive Therapy. She is also a Clinical Associate Professor of Psychology in Psychiatry at the University of Pennsylvania. Previously, she has published four professional books and over 100 articles. Cognitive Therapy has been used and studied in over 400 clinical trials. Dr. Beck, one of the world’s foremost authorities of Cognitive Therapy, travels the world teaching and continually researching its benefits and uses.
KJ: Dr. Beck, I understand the principle behind your latest book–The Beck DIET Solution to be that one must superimpose old habits with new and better habits. Is this correct?
Dr. Beck: That’s right. The book has a six week program in which dieters learn a new thinking or behavioral skill every day. They practice some skills just once and others for the rest of their lives. These skills are very common sensical. In fact, dieters often know what habits they need to adopt. They know they need to limit their eating, not eat on the run, not overeat at parties, and so forth. The problem for most dieters is that they can adopt new habits for a short period of time. But unless they change their thinking, they invariably revert back to their old habits.
KJ: What are some other examples of bad habits?
Dr. Beck: Many people eat standing up; they eat quickly and they don’t pay enough attention to what they’re eating. They don’t realize that when you’re restricting your eating, it’s essential to notice and enjoy every bite, otherwise you won’t feel psychologically satisfied. Also, when people eat too quickly, their food is gone before they know it and they may still be hungry–and unwilling to wait for up to 20 minutes for a sense of fullness to set in.
KJ: How do people have to change their thinking about these habits?
Dr. Beck: Dieters have all kinds of sabotaging thoughts that get in the way. “I really like to eat standing up. What’s the harm? I’m just a fast eater–it would take too much effort to change. My life is too hectic. I don’t have time to sit down for every meal and snack.” These kinds of thoughts are exactly the ones that get in the way, that lead people to stray from their diet. They have to adopt a new mindset: “If I want to lose weight and be able to keep it off permanently, I have to change my eating habits permanently. I can’t have it both ways. I can’t eat the way I want to and be thinner.”
KJ: So, a person will retrain her brain?
Dr. Beck: Actually, people retrain their minds. In my program, they learn the skills of identifying and forcefully responding to their sabotaging thinking. For example, most dieters have thoughts such as the following from time to time: “I know I really shouldn’t eat this, but…..it looks really good/I really want it/I’m celebrating/I’m tired/I’m stressed/I’m upset/it’s just a small piece/no one is watching/I don’t care/it doesn’t matter.” What I teach people to do is to prepare for these kinds of thoughts ahead of time and practice what they’ll need to say to themselves. For example, it’s often helpful to say, “I’m just trying to fool myself. It matters. If I eat this food that I’m not supposed to eat, I’ll strengthen my “giving in” habit which makes it more likely that I’ll give in next time and the time after that. I’ll never be able to maintain whatever weight I manage to lose if I don’t learn the skill of not giving in. Besides, if I eat this, I’ll get only momentary pleasure. In a few minutes, I’ll feel really badly that I ate it.”
KJ: Where do these bad habits originate?
Dr. Beck: We can develop bad habits any time. Some people grew up with the idea that you should eat when you’re hungry, for example, instead of waiting until meal time. Other people grew up with better eating habits but developed bad habits as a result of dieting. They restricted their eating too much, then tended to binge. At some point, they also became overly concerned with being hungry. Instead of seeing hunger as a natural state, they try to avoid it, either by overeating at meals or by eating too frequently between meals.
KJ: This works with any diet, right?
Dr. Beck: It works with any nutritious diet. If you’re spending too many calories on non-nutritious food, if your diet isn’t well-balanced, if you’re not getting the nutrients you need, your body will rebel and you’ll start to eat too much. I’ve found that different diets are best for different people. Some do better counting calories; som do better measuring portion sizes; some do better counting carbs. The diet you choose had better contain foods that you like and that are easy for you to prepare. I counsel people as to how to modify the diet they choose–in advance. I want them to plan to have small portions of whatever food they want, as often as daily.
KJ: Do thin people really think differently than heavier individuals?
Dr. Beck: Not necessarily, but people who are chronic dieters definitely think differently. For example, they fear being hungry, they think it’s unfair that they have to restrict their food, they fool themselves about how much they’re eating, they think it’s a catastrophe if the scale goes up. Naturally thin people or people who have dieted and have successfully maintained a lower weight may not like being hungry, but they just don’t pay much attention to these sensations. Many of them restrict their eating to avoid gaining weight or just to be healthier. They don’t see it as unfairness but rather as a normal consequence of achieving their goal. They don’t deceive themselves about what and how much they’re eating; they don’t make excuses. If the scale goes up, they don’t get worried. They just eat a little more carefully for a few days.
KJ: You state that the dieter needs to read your book first, before beginning the diet. Why is this necessary?
Dr. Beck: They don’t need to read the whole book but I do want them to learn a new skill each day for 14 days before they start restricting their eating. I’ve found that when dieters take the time to learn these skills first, they maximize their success. These skills incude how to continually motivate themselves, what to say to themselves before they get on the scale, how to get themselves to use good eating habits consistently, how to give themselves credit to build their confidence, how to fit their lives around exercise and dieting activities, instead of vice versa, and several others.
KJ: This retraining of the brain is known as Cognitive Therapy. It is the only psychological method known to help dieters keep off excess weight once lost. Could you define “Cognitive Therapy?”
Dr. Beck: Cognitive Therapy is a time-limited, very practical, problem-solving oriented psychotherapy that has been demonstrated in over 400 research trials all over the world to be effective for a wide range of psychological problems, from depression and anxiety to substance abuse, eating disorders, and even chronic pain.
KJ: The average person probably hasn’t heard of Cognitive Therapy. Is it widely practiced?
Dr. Beck: A majority of mental health professionals in the United States occasionally use some cognitive therapy techniques but only several thousand probably actually practice Cognitive Therapy.
KJ: So, by practicing what’s laid out in The Beck DIET Solution, I’d be using Cognitive Therapy?
Dr. Beck: Yes, in fact what we tell our clients, and not just those who want to lose weight, is that the goal of Cognitive Therapy is to teach you to become your own therapist. We not only help you with problems; we teach you all the skills you need to solve your own problems in the future.
KJ: I really like your “What are you thinking?” pages. Perhaps the negative thought–positive responses help not just a dieter, but anyone. These are self-esteem issues, are they not?
Dr. Beck: Everyone, no only dieters or people with psychological problems, have unhelpful thinking at times. Fortunately, there is a straight-forward way to learn how to think in more realistic, more helpful ways. This applies to dieting, to your view of yourself and others, to your experience, to your ideas about the future.
KJ: My husband comes from a family of “food pushers.” They mean well, but it’s a cultural difference between them and me. Over the years, I’ve learned to tell them that the meal is one of the best I’ve ever eaten, but I get sick if I overeat, or I explain that I’m on a diet (and laugh). (I’ve been offered and given three desserts in one sitting.) What are some other means to deal with “food pushing?”
Dr. Beck: I don’t let people push food on me. I just use, and counsel dieters to use what we call the broken record technique. I very politely just keep saying, “No, thank you.”
Would you like some cake?
No, thank you.
But I baked it ‘specially for you!
Thanks, but no thank you.
I know you’re watching your weight, but this is a special occasion!
No, thank you.
You’re going to hurt my feelings.
I’m really sorry, but no thank you.
KJ: How will your book help a dieter, like no other can?
Dr. Beck: No other book teaches people the thinking and behavioral skills they need to succeed, on day and one skill at a time.
KJ: Dr. Beck, thank you for your time. The Beck DIET Solution will certainly be a success!