Updated: Oct. 22, 2023

“I need to lose this weight,” Rachel said, crying as she sat in my office. “I want to be able to play with my daughter. I want to be around for my daughter.” Rachel told me she’d been struggling with her weight for years, since she was a teenager. She had tried every diet and program out there, she said, with little long term success. She had lost a significant amount of weight before, so she knew she could do it – it was keeping it off that was the issue.

So many women like Rachel come to me desperate to do something about their life long struggle with their weight. They know that being overweight isn’t a healthy way to live long term, but no matter what they have tried, nothing has helped.

They’re all surprised when I start talking about emotions and the mental games we play with ourselves that makes changing habits so hard. But it’s this piece that holds far too many women back, keeping them stuck in old patterns of behavior that, in turn, keep them stuck at a frustrating, unhealthy weight.

I often recommend that clients work with a therapist to uncover feelings and beliefs about themselves that are buried deeply in their subconscious but have real power over their everyday lives.

One of the methods that I’ve seen have real success is cognitive behavioral therapy (CBT), which helps people change old patterns and develop new, healthy ways of thinking and being. Some promising research supports the idea that creating change in how we think is a valid treatment – and one that works – for obesity. A 2020 meta-analysis of 16 studies concluded that CBT is an efficient treatment for weight loss.

I wholeheartedly believe it! When we break free of old stories and habits, we can achieve real success in our goals – including weight loss. And even if you aren’t ready for formal CBT with a therapist, you can benefit from the theories behind CBT. Let’s take a look at what CBT is and how it can help, and then I’ll give you some basic cognitive behavior approaches that may help you begin your own successful weight loss journey.

What is CBT and how can it help?

True cognitive behavioral therapy means participating in talk therapy with a mental health counselor, such as a social worker, psychologist or therapist. This type of therapy has a specific structure followed over a number of sessions.

CBT helps change behavior by making you aware of negative thinking that has been holding you back. When you understand your thinking, you can look at and respond to certain situations – like overeating – differently. CBT alone may not be enough to help you reach the end goal when it comes to weight loss – you may need to participate in another weight loss program (many women have found great success with my Drop20Now weight loss program) or get treatment for other issues, such as depression and anxiety, alongside the CBT.

But CBT can get you started and make following another program easier, once you’ve learned to manage stressful situations and negative responses to these life events. That’s because CBT will help you do the following:

  • Identify issues that are impacting your life (and possibly your weight), such as a medical condition, grief, mental health, or past trauma.
  • Bring awareness to the way you think and feel about weight issues, and the hidden beliefs you hold around them.
  • Point out negative and incorrect thinking/beliefs and help you reframe these in a positive way.

None of this is easy – but it’s worth the time and emotional work it takes. Identifying (and disputing) stories that you’ve carried around since childhood is hard, but it’s likely time to let those stories go. They may have served a purpose when you were a child (and had less control over your own life), but they probably aren’t serving you well now. When you can let them go, you can develop new, positive habits that help you meet your goals.

Here’s an example of reframing thoughts when it comes to eating: Imagine you are out with friends, and everyone else is ordering fried appetizers, main courses dripping in rich sauces, and decadent desserts. Will you follow suit? If your first thought is “I shouldn’t have to deprive myself of these delicious foods. Everyone else is enjoying themselves without worrying about it – why should I have to suffer?” then the answer is almost certainly yes. You’ll order what you want at that moment and probably beat yourself up over it later.

But if instead you think, “I am working so hard to be healthy. I don’t want to undo that for temporary pleasure. I will choose one small indulgence and enjoy every second of it, then stick to healthy choices for the rest of my meal,” then you will more likely stick to your goals and feel energized and proud of yourself afterwards.

When you begin to change your thoughts as you change your eating behaviors, your goals are well within your reach. CBT approaches can help you notice (and stop) emotional eating, give you non-food related strategies for comforting yourself when needed, help you understand hunger, identify your eating patterns, establish better habits, and set up a sustainable, long-term plan to maintain a healthy weight.

Cognitive Behavior Approaches for Managing Weight Loss

Now that you know a little bit about how CBT works, you may be able to see how the following behavior management approaches could help you. Try one, several, or all of these. None of them will harm you in any way, so there’s no risk in trying them to see what might work for you!

Set an eating schedule – and stick to it

When you plan when you will eat, even if you don’t yet tackle planning what you’ll eat, you are far less likely to indulge in the foods that sabotage your efforts. I often suggest three meals and two snacks per day as a healthy eating pattern, although there are others that work as well – particularly if you are doing intermittent fasting. Whatever your schedule is, if you know what time you’ll be eating in advance, it may be a lot easier to resist temptation offered outside that schedule. And, you’ll never let yourself get so hungry that you go crazy eating everything in sight.

Make small changes

Big change can be overwhelming. Trying to overhaul all of your eating and/or exercise habits at the same time sets you up for failure. You’ve built these habits over years, maybe even decades, so you need to give yourself adequate time to change them all. This is why restrictive diets seldom work – that kind of deprivation isn’t sustainable. Choose ONE thing to eliminate from your diet (I suggest starting with sugar, since it is so damaging to our health). Start by noticing how often you consume that one thing. Choose one instance where you’re likely to eat it, and cut it out. For example, if you put sugar in your coffee, try it with cream only, or sweeten it with Stevia instead; or if you eat something sweet at each mealtime, eliminate it from just one meal per day. Once you’ve mastered one change, you can try another, and another until you’ve built the habits you want to sustain for life.

Plan ahead

Nothing sabotages dieting efforts more than being caught unprepared. Special events can be especially tricky, since they often include ample foods that are less than healthy. But you can change your thinking around these events. Why are you going? Usually, it’s not for the food. You may be celebrating a loved one, gathering to see friends you haven’t seen in a while, or heading to a work event. Before you go, decide how you will handle food. Will you consciously enjoy some of what’s on offer? Will you decline dessert? If it’s a buffet, how much will you put on your plate? When you make these decisions ahead of time, you can choose to indulge – or not.

Write it down

I am a big fan of journaling, because I have experienced first hand the power that putting something in writing can have. I have discovered so many truths that allowed me to change my thinking when I journal. You can too!

I also like to write affirmations and positive thoughts on sticky notes and post them where I will look at them often. When trying to lose weight, post a note to the fridge that says “I will eat with intention,” or “I will make choices that help me reach my goal.”

Finally, keeping a detailed log of what you eat and when you exercise can be a great source of information if you aren’t seeing progress. It’s so much easier to spot patterns when you have things laid out in front of you instead of trying to rely on memory.

Divert your attention

When hunger or cravings hit, make a point of pausing before heading to the cupboards or vending machine. Tell yourself you can get up after you finish one more task. Take a walk around the block or up and down the stairs. Drink a glass of water. Read an article or skim through the daily news. Ask yourself if you are really hungry? Or are you hungry for something emotionally? If that’s the case, food won’t help. Often, when you focus on something else for just a few minutes, the craving passes and you can move on with your day – without derailing your weight loss efforts.

Set concrete goals

Make sure you have specific goals, not vague, general ones. For instance, instead of saying your goal is to lose weight, choose a habit you want to change, like snacking between meals. Break goals down as much as you can. The more specific it is, the more likely you will be to succeed. Make sure your goals are realistic and motivating. You may have a long term goal to lose 100 pounds, but if you’re focusing on the end goal only, healthy progress may feel discouraging. Monitor your progress and celebrate small achievements.

Notice what’s holding you back

Don’t beat yourself up when you go off course. Instead, notice what happened to make you falter. Did you miss physical cues (such as early signs of hunger)? What challenges did you encounter that led to eating differently than you wanted? What barriers came up that you could plan for in the future? Judging yourself harshly typically only leads to more self-destructive behaviors.

Positive mental attitude

It’s important to realize that if you approach any situation with the idea that you will surely fail, you are very likely to be correct. Attitude is so important in reaching your goals. Positive affirmations can help you flip your script. Each morning, before you do anything else, try saying an affirmation aloud five times. This can be anything that motivates you. Some of my favorites are “I am enough” and “I have the power to control my own health.” If you don’t believe these in your heart yet, say them anyway. The repetition will help you change the negative thoughts you are holding on to.

Use incentives – as long as they aren’t food related!

It can be all too easy to slip into the “I did great all day, so now I can treat myself with a piece of chocolate” mindset. But using food incentives when you are trying to lose weight is a bad idea. Instead, look for other rewards that will motivate you – such as discounts your insurance company offers for achieving certain health standards or discounted fitness memberships. Other incentives may be allowing yourself to watch a favorite TV show after a certain amount of exercise or meeting up with a friend for a walk or exercise class.

Take action – no matter how small!

Sometimes, the end goal is so big that you simply can’t fathom ever reaching it. But if you never get started, you’ll never make progress! Start with very small actions – walking up and down the stairs once, or throwing out leftover sweets. Little by little these small actions will add up to big progress.

Don’t try to go it alone

Even if you aren’t interested in traditional therapy, you need to have a support system. Check in with your health care provider regularly to monitor progress or try telling a trusted friend your goals and ask them to help you be accountable. A support team can also help you notice if goals are too ambitious and may be stalling your efforts.

And let me just add that true CBT can be very powerful. There are many things you can try on your own to begin moving towards your weight loss goals, but if you’re finding it difficult to get started, working with a practitioner trained in CBT could be very helpful.

Achieve a healthy weight by examining thoughts and behavior

There’s still a lot of people that think losing weight should be simple. If they simply eat less and move more, they think, all will be fine. But they soon discover that those two things aren’t as easy as they sound – and that’s because of the power our thoughts have over our behaviors.

When you notice the thoughts that trigger eating, it’s much easier to stop yourself from going off course. Identifying unhelpful thoughts (I am miserable and this cookie will help me feel better) with helpful, positive thoughts (I am miserable, but eating this cookie will only make me happy temporarily – and then I’ll feel worse) is one of the key things that makes CBT effective.

It takes time and practice – don’t get discouraged if you find yourself defaulting to negative thoughts. Notice them, be compassionate with yourself, and focus on the process. With time and intention, you can change your thoughts – and your behaviors – and meet your goals.

I told Rachel about CBT, and she found a therapist she connected with. After several months of hard work and support, she was well on her way to her long-term goal. Last time we talked, she was thrilled to tell me she’d taken her daughter to the playground and played an exciting game of tag. This time, she said, she really felt like the changes she was making were permanent, because it wasn’t just her habits she’d changed – it was the way she thought about food. She just didn’t have the same urges any longer – she was having far too much fun being there for her family! “If I can do it, anyone can,” she said last time we talked. And I would have to agree – CBT strategies are a powerful tool for anyone!







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