How Can Cognitive Behavioral Therapy (CBT) Help You Lose Weight?

Can your thoughts and feelings be connected to your weight?

According to experts, yes. Cognitive behavioral therapy (CBT) is a popular form of talk therapy that focuses on how your thoughts, feelings, and behaviors are connected. It is effective for many types of problems. This includes helping you achieve and keep the healthy weight.

On the WebMD Webinar “How Can Cognitive Behavioral Therapy (CBT) Help You Lose Weight?” Rachel Goldman, PhD, explained to over 2,200 attendees how CBT techniques can be key to weight management.

“These are also called lifestyle modifications, behavioral interventions, or behavioral weight management,” Goldman said. “They give people a set of skills to help them achieve a healthier weight while learning to deal with obstacles and potential challenges along the way.”

Audience polls and questions

In an audience poll conducted during the webinar, nearly half of respondents said stress was the most likely emotional trigger for overeating. Another poll found that 28% of viewers are interested in how CBT can help manage stress and curb comfort eating.

Question: The emotional trigger for overeating seems to be:

  • Stress: 47%
  • Boredom: 33%
  • Loneliness: 6%
  • Sadness: 6%
  • Something else: 5%

Question: I am interested in how CBT can help someone:

  • You can better control what you eat: 37%
  • Manage stress to avoid comfort eating: 28%
  • Be motivated to exercise: 18%
  • Improves their opinion of their body image: 13%
  • Something else: 2%

Goldman also answered questions from the audience during the webinar. These included:

“Why do people eat because of stress?”
“How can CBT be used to stop midnight snacking?”
How can you avoid or control snacking in a social environment that revolves around food?”

Goldman explained that eating in response to emotions such as stress is common. Perhaps overeating or unhealthy eating on stressful days has become a habit. When we eat certain foods, our brain’s reward center is activated, making us feel good—and we want them again. When we feel stressed, we get instant gratification from food. This can be a problem if it is a coping mechanism for stress.

When we snack at midnight, we may think we are hungry, but we are actually thirsty or tired. First, stop for a short break before eating a snack. Ask yourself, do you just automatically grab the snack? If you’re really hungry, if you just want to enjoy yourself, eat. But first, stop and define what you are doing.

If you don’t need or want it, replace the behavior. Drink a glass of water, some herbal tea, hot water, or just lie down.

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Maybe you want to prepare for a social meal. Don’t go into events too hungry. It can be useful to eat a little before you go somewhere. But remember, social dining is fine if you want to and if you feel in control.

“How does one find a therapist who is experienced in using CBT for weight management?”
“How can you be responsible when dieting if you don’t have access to a registered dietitian?”
“How to avoid becoming discouraged during a diet?”

You can find a therapist through the Obesity Action Coalition (OAC), Psychology Today’s “therapist” button, or with a simple Google search of providers in your area, Goldman suggested.

But if you don’t have access to a professional, you can use self-monitoring to keep yourself accountable. Goldman says the key is to be consistent, patient and persistent. Love yourself.

You can also create a team of supportive people in your life. Find a friend to be accountability buddies with.

He also pointed to apps or social media experts that can provide information for less than a dietitian.

“Can you lose weight after menopause?”
“What weight loss challenges are there in postmenopause?”

Weight is not just about calories in, it’s about calories out, Goldman said. There is more to it, such as hormonal changes. First of all, during menopause, it is important to take care of your sleep.

He said to get help from your doctor and get lab work done to understand your body during menopause. This will help you understand what is going on with your hormones. Regulating hormones is important because they play a role in weight control.

Another tip is to think about what worked for you when you were premenopausal, Goldman said. What did you do differently (eating, sleeping, or otherwise) when you felt good about your body and weight?

What is CBT for weight management?

Before CBT was part of weight management treatment, experts focused only on how your behavior affected your weight. But as time has passed, CBT has been recognized as an effective part of certain weight management plans.

Doctors now understand that your weight is influenced by much more than your behavior. Today’s treatment of obesity and weight management is more complex. It focuses on several areas, including past experiences and current lifestyle changes.

How does CBT help with weight loss?

The way you understand and think about something can affect how you feel and behave. CBT techniques change your thoughts and emotions.

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These tools are:

Goal setting. CBT focuses on both long-term and short-term goals. “Identify your long-term goal and then think backwards. Ask yourself how you’re going to get there,” Goldman said. Create short-term goals that lead to your main goal. Focus on small steps that relate to your behavior.

You can set your goals using the “SMART” goal setting tactic. These:

  • Special
  • It can be measured
  • Available/Available
  • Relevant/realistic
  • Timely

But it’s important to avoid specifics like weight goals or the words “less,” “more” or “better,” she said.

Selfcheck. You can check almost anything. CBT can help you focus on your food, emotions, activities, sleep, weight, or feeling full. These are all data points that can help you on your weight management journey.

You can keep track of the food you eat with the help of a food diary. This can help you track the type of food you eat, when you eat it, and how much. You can do this with a journal you create or a phone app like MyFitnessPal, FitDay, or SparkPeople.

But this is not a good idea for everyone. “Food can be unhealthy to control when someone has an eating disorder or an eating disorder,” Goldman said.

Mindful eating habits. This can help you be more conscious about food in general. Conscious eating not a diet. It’s a tool that can help you learn about your own eating habits. You can pay special attention to the times you eat emotionally, when you eat, the quality of your meals, or how you feel about different foods.

Mindful eating can remind you to enjoy the moment and slow down when eating.

Cognitive restructuring. Our thoughts are powerful. “Some ideas are useful, but others are not,” Goldman said. “The key to cognitive restructuring is to identify, challenge, and change or refine our unhelpful thoughts.”

With weight control, useless thoughts can hold you back. Goldman pointed out some harmful ideas:

  • “All or nothing thinking” which makes it difficult to find a happy medium. For example, if you can’t work out for a full hour, you might end up forgoing exercise for the day altogether.
  • “Overgeneralizations” that involve defeating self-talk such as “I’ll never be able to reach my fitness goals” or “I’ll never be able to lose weight.”
  • “Jumping to conclusions” assumes things that may not be true. You may decide before you are doomed.
  • “Should” statements can make you feel like you “must” go to the gym for a certain amount of time every day, or that you “should” be able to lose a certain amount of weight. But these comments put me in a negative mindset. Focus on the small steps that can be implemented in your life right now.
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Behavior changes. Since your thoughts and emotions shape your behavior, it’s important to avoid the negative. If you can rewire your thinking, you can achieve greater success in weight management.

But it can be difficult. You may have had negative, automatic thoughts for years. To combat these, Goldman recommends the following:

  • Be kind to yourself and validate your feelings. Also stay away from toxic positivity. Losing weight is hard and you have to admit it.
  • Be more aware of your thoughts and practice mindfulness. Ask yourself if your thoughts are useful, how they make you feel, and what purpose they serve.
  • Accept your thoughts for what they are, challenge them, and replace them with helpful thoughts. Remember, not all thoughts are facts.
  • Talk to yourself kindly. Self-talk creates your reality. Formulate your words in a healthy and realistic manner.

Future planning to avoid setbacks. To continue to be successful in weight management, you need a plan. Find the things that motivate you.

There are two types of motivation: extrinsic (like a nice comment from a friend) and intrinsic (feeling good about your own health).

“Extrinsic motivators tend to get people to make the first change,” Goldman said. “But ultimately, when we engage in behaviors that make us feel good, most people are motivated by internal feelings.”

To plan ahead, be ready to problem solve. There will be moments when weight management is difficult. Expect challenges and face them with a healthy mindset.

“We all lose sight of our goals,” he said. “When that happens, it’s important to go back to the ‘why.’ Why do you want to make these changes? Why are you setting these goals?”

Your plan may not always work out perfectly because life happens! External stressors, the actions of others or the reactions of your peers are beyond your control. But you can control your own reactions, thoughts and behavior.

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