Cognitive Behavioral Treatment

Cognitive Behavioral Treatment

The Obesity Society and the Endocrine Society are the world’s foremost scientific societies of professional weight loss specialists. They have established guidelines for safe, effective weight loss and they recommend:

“that diet, exercise, and behavioral modification be included in all obesity management approaches for body mass index (BMI) 25 kg/m2 and that other tools such as pharmacotherapy (BMI 27 kg/m2 with comorbidity or BMI over 30 kg/m2) and bariatric surgery (BMI 35 kg/m2 with comorbidity or BMI over 40 kg/m2 ) be used as adjuncts to behavioral modification”.

Please allow us to translate this for you:
Psychology (cognitive behavioral treatment) is the one weight loss strategy that helps everybody.
Weight loss medication is a good strategy for SOME overweight folks.
Bariatric surgery is a good choice if you are obese and sick.

At the weight loss and diabetes center, we offer diet, cognitive behavioral modification and medication treatment services.
We don’t specialize in bariatric surgery or treating extremely sick folks, as we can’t do it all. We rely on our health care partners in the local community who can help those folks.

So what does Cognitive Behavioral treatment mean?

When we are eating due to something other than hunger, our brain is using food for something other than fuel, (e.g., negative mood relief or pleasure). Unfortunately, most American adults eat as their primary form of pleasure, explaining why most of us are overweight.

Negative Mood Relief

It sometimes seems there is no better way of getting through a period of negative emotions than eating. It is a wonderful short-term solution. In the long run, however, it destroys us with weight gain and diabetes. The short-term solution comes at too great a cost. Unfortunately, most of our brain is dedicated to short-term projects. If we want to keep the long-term consequences in mind, it takes a conscious effort. Our brain will automatically remind us of short-term rewards, but we’ll have to remind ourselves of the long-term rewards because they are not automatic…yet. No magic fairy is going to do this for us, and our brain is not going to take over our long-term life management on its own.

Our brain is like a credit card; it focuses on short-term needs and wants until we accrue more debt than we can manage. For us who are overweight and have diabetes, the bill collector is at our door, and it is time to develop a long-term plan to pay off our debts. Losing weight and controlling our diabetes will take work, but if we do it the right way, it will not require us to feel deprived, be constantly hungry, or rely on extraordinary willpower.

When we become more aware of our thoughts, which we can do by thinking about our thinking, we usually learn two different things:

We generate an untold number of automatic thoughts each day. Some of those thoughts build us up, and others put us down. Those automatic thoughts are like bad habits, and they pop up unintentionally. Through awareness of our thinking, and then practice and repetition, we can change those negative automatic thoughts to positive ones. The magic is that we believe and react to what we tell ourselves. Tell yourself often enough that you’re fantastic and you will feel fantastic. Tell yourself you are stupid, and you will feel stupid. Feelings come from our thoughts and positive thoughts lead to feeling good. When we feel good, we rely less upon food to alter our feelings.

We help people to change those cognitions, improve mood and prevent overeating. Prevention is worth a pound of chocolate.

Eating has become the main form of Pleasure in somebody’s life

There is emerging evidence that overeating, like some drugs, can be addictive. For example, methamphetamine (meth, crystal meth, Tina, etc.) releases a tremendous amount of dopamine into the brain, more than any other known substance. Because dopamine feels so fantastic, we are driven to continuously have that feeling. When dopamine drops, the brain seeks an increase to bring it up to the level it just had. It demands we “do” it again. The drive is so strong that it takes priority over all else. Satisfying the brain becomes a way of life, a lifestyle. It is no coincidence that the first two letters of “dopamine” are “do.” When addicts say, “There is nothing as good as that first high,” they are actually saying that a dopamine expectation level was set upon their first use, and life becomes dedicated to trying to relive that initial high.

Food follows this same path, but obviously on a much diminished scale. Food doesn’t raise our dopamine level as high as meth, bit it does raise it substantially. When we stop eating, our dopamine levels drop and we look for a refill of happiness by eating. We can turn a negative emotional state into an extremely positive state simply by grabbing some chips. Scary.

The six activities that increase our dopamine and lead to addictive behavior are

  1. eating
  2. drinking
  3. doing drugs
  4. gambling
  5. shopping
  6. sex

Of these, food is both readily available and most socially acceptable. If you do drugs on the job, have sex on your desk, toast your boss with a shot of tequila at each meeting, meet openly with your bookie, or constantly shop on the Internet, you’ll likely be fired. We don’t openly take shopping breaks, sex breaks, or drug breaks, but we do take food breaks. No one blinks an eye if you tear open a bag of corn chips or cookies, of if you partake of the spread laid out for an important meeting.

It sometimes seems there is no better way of getting through a period of negative emotion than eating. It is a wonderful short-term solution. In the long run, however, it destroys us via weight gain and diabetes. The short-term solution comes at too great a cost. Unfortunately, most of our brain is dedicated to short-term projects. If we want to keep the long-term consequences in mind, it takes a conscious effort. Our brain will automatically remind us of short-term rewards, but we’ll have to remind ourselves of the long-term rewards because they are not automatic…yet. No magic fairy will do this for us, and our brain will not take over our long-term life management on its own.

We’ll help you and your brain create the lifelong plan.

We do not have to give up pleasure to lose weight! Most people who think about weight loss imagine they have to live a deprived, highly disciplined life, especially with regard to food and exercise. They imagine having to graze almost exclusively on salads and exercise in spite of pain. Self-discipline is fine if you have a good plan. The problem is, most people have a lousy plan–one full of pain, hard work, and constant hunger. Many weight loss plans expect success in the absence of pleasure and moments of satisfaction. They also treat eating as if it is cut off from the rest of our lives, which it is not. A successful plan has to be comfortable and rewarding enough with which to live permanently. We don’t want to exchange happiness and satisfaction for a slimmer body. Being thin but miserable is hardly an attractive goal. Living a life full of pleasure, you’ll find, is indeed powerful medicine.