CBT Essentials for Weight Management.

 Cognitive behavioural therapy (CBT) was developed by Psychiatrist Dr. Aaron Beck in the 1960s as a conceptual model for Depression. He noticed that the prominent theme for patient who struggled with depression was that they would commonly have a stream of distorted thoughts that fell into three categories: negative thoughts about themselves, the world/experience, or the future. He coined these terms ‘automatic thoughts’ and postulated that they led to negative emotions and dysfunctional behaviour. As a result, Dr. Beck found that by having patients change these negative automatic thoughts to realistic, reasonable thoughts, that it resulted in improved mood and functional behaviour.

If you have struggled at losing weight and keeping it off in the past, you have likely developed automatic thoughts that speak negatively regarding your ability to succeed. These thoughts are typically the key obstacle to sustained weight loss.

Cognitive restructuring is a 4-step process of becoming aware of your automatic thoughts, challenging and replacing them with more balanced thoughts, which leads to a change in behaviour.

1. Identify the unhelpful thoughts. These tend to occur in times of craving, an overeating episode, looking at the scale, or looking at the mirror. Every time you experience a negative shift in your mood, or a behaviour that is off track from your health goals, think about the automatic thoughts you are having in that moment.
Examples:
– I have room in my calories, I’m going to eat something
– I worked out today, so I definitely deserve this treat
– The scale has not budged all week. This is never going to work.
– I’m so tired from work. I’ll just order in tonight, surely that won’t make a difference.

2. Label the unhelpful thought for what it is. Much like a person with asthma experiences cough as a symptom, people who struggle with their weight often experience unhelpful thoughts about their weight or behaviour. Unhelpful thoughts can fall into multiple categories. These include: Permission Thoughts, Self-Critical thoughts, Catastrophizing Thoughts, Fortune Telling Thoughts. Labeling your thoughts validates that it is, in fact, distorted and not rooted in any truth.

3. Challenge the thoughts. Now that you know that the culprit thought is a distortion, it’s time to disprove it. Use facts that would support the thought being true and that would support the thought being false. If you want a shortcut, ask yourself – Is this thought a lie? If it’s going to lead to an unhelpful behaviour, then yes. It is a lie.

4. Create a new balanced thought. A new balanced thought, compiled from the evidence from Step 3, is used to replace the distorted thought. Remember that your thoughts affect your mood and behaviour so we’re trying to come up with thoughts that will enable improved mood and functional behaviour in line with our health goals.