YOU WON’T SHIFT THE POUNDS UNLESS YOU CHANGE YOUR MINDSET
WHEN I began work at a hospital bariatric [weight loss] surgery service as a psychiatrist some 18 years ago, the surgery itself was a real innovation.
What’s more, having psychiatrists involved in assessing patients’ readiness for the operation was then rare.
Yet attempting weight-loss surgery before someone is psychologically prepared to change their behaviour around food can often lead to weight being regained.
Some patients still managed to keep eating after their newly shrunk stomach felt full by liquidising high-calorie foods such as chocolate or grazing (eating frequent snacks).
The same sort of emotional challenges exist for all those who are trying to lose weight — and the difference between success or failure often lies in people’s heads, rather than just on their plates.
To lose weight successfully and sustainably, we need to adopt effective psychological strategies to help us. This is how changing your mindset can make all the difference.
KEEP A MOOD DIARY
WHEN I was a medical student, almost nothing was taught about the psychological aspects of eating and obesity. I only remember hearing of a single study that discussed this.
The research showed that overweight people, when stressed, will eat snacks as a means of trying to calm their anxieties.
Other internal triggers that can make people eat impulsively include emotional upset, frustration, boredom and even, surprisingly, happiness.
All of these can become linked with wanting to try to control our emotions through eating.
Other overweight people habitually scroll through online menus and recipes as a form of entertainment. But this only serves to trigger their hunger.
Identifying your individual triggers for eating and keeping consciously aware of them can be very helpful when sticking to healthy eating patterns.
One of the best ways to do this is by recording everything you eat and how you were feeling at the time. This can empower you to resist your triggers.
Keep a food and mood diary for at least several days. Patterns concerning internal triggers and eating usually emerge quite quickly. It’s important to fill in the diary just after eating, as it can be hard to remember emotions and the amount of food you ate, after even only a short while.
SHOP DIFFERENTLY
I TELL patients that changing their eating habits begins with the food that they put into their shopping trolleys. This might sound obvious, but it’s often not until you draw attention to the problem that they realise they’ve been buying food that undermines their efforts. Many people are now familiar with the idea of mindful eating — taking time to notice the taste, smell and texture of your food (rather than just eating it mindlessly in front of the TV). Enjoying and appreciating the food means you are less likely to overeat without thinking. We should also shop mindfully. It can involve making a shopping list based solely on what we need to eat healthily — and sticking to it. In stores, be aware of tactics shops employ to get you to buy more — particularly calorie-laden treats placed by the checkouts. It’s tempting to think you’re only buying treats for visitors, but once the food is in your shopping basket, you will end up eating it.
BE KIND TO YOURSELF
PEOPLE internalise a lot of negativity about their size and weight. We live in a culture suffused with negative judgment, and it’s a common but mistaken belief that overweight people lack moral fibre and self-control, or are weak.
Overweight people often internalise this and start to think of themselves in the same unhelpful way.
This only makes them feel even worse, intensifying any feelings of defeatism and despair. The answer lies in developing selfcompassion and realising that you are doing your best.
Be supportive of yourself. Don’t say things to yourself that you would not say to someone you love.
It also helps to understand that making a change should be driven by something that you want to do in a healthy way to improve your wellbeing.
If your motivation comes from peer pressure or a punitive internal dialogue, then you are in danger of perpetuating a cycle of shame that leads to low mood, anxious eating and feeling depressed.
This, in turn, may make you feel socially isolated and in danger of again turning to food for support.
Trying to control your weight can, in itself, seem a miserable and daunting task. It’s important to begin positively by remembering that every journey starts with a small first step.
SET POSITIVE GOALS
IT IS IMPORTANT to motivate yourself with positive goals that will genuinely improve your lifestyle and health. Many people who lose weight successfully set themselves the goal of improving their health, such as fending off type 2 diabetes, stopping snoring or giving their knee joints an easier time. It’s all about developing a more positive relationship with your body.
AND FIND SUPPORT
IF FOOD is a way of coping with anxiety, then you have to find another way of dealing with it. You can’t just remove eating as a means of coping without replacing it with something else. The eating is an outward manifestation of inner distress.
While normalising your relationship with food, you need to ensure that the old eating patterns aren’t replaced by an equally unhelpful way of coping with difficult emotions, such as smoking or using alcohol.
Healthier ways of dealing with anxiety that don’t involve food might include taking regular walks or immersing yourself in a hobby — anything you find relaxing, distracting and enjoyable.
Some people will need support and advice from professional services. Consult your GP and use the help that is on offer.
Closer to home, you may find help from friends or relations with whom you can discuss your anxieties. You’ll find many people are only too happy to lend their support when you are making positive changes.
Dr ALASTAIR SANTHOUSE is a consultant psychiatrist in neuropsychiatryt. His new book, Head First: A Psychiatrist’s Stories Of Mind And Body (€20.70), is published by Atlantic Books.