In fact, we all know very well what to do to lose weight: When the calories we take in are less than the calories we expend, we lose weight. Despite such a simple formula, why is it that we cannot lose weight or gain it back in a short period of time? Because we have thought and behavior patterns that prevent us from losing weight or cause us to gain weight. Unless we change these, we will continue to diet, lose some weight and then gain it back (or even more) at certain periods of our lives. How familiar is this vicious cycle? For those who want to get out of this vicious cycle, we recommend Cognitive Behavioral Therapy, a psychotherapy method. Proven and widely used all over the world, Cognitive Behavioral Therapy will teach you how to think and live like a weak person.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT), like all other types of psychotherapy, is a type of talking treatment. It is an evidence-based psychotherapy that is widely used all over the world. It is based on the premise that certain patterns of thought and behavior disrupt a person's harmony. The main goal of the treatment is to recognize these thought and behavior patterns and to teach techniques to change them.
What role does Cognitive Behavioral Therapy play in weight loss?
In fact, the only condition for weight loss is to restrict the daily calorie intake and increase the calorie expenditure. Moreover, this is completely under the control of the individual; no one can force us to eat anything. Despite this simple fact, why is it so difficult to lose or maintain weight? When we look at the personal life stories of obese people, we see that they repeatedly make unsuccessful attempts to lose weight, and even if they manage to lose weight, they soon regain the weight they lost or even more. The main reason for this is the repetitive maintenance of thought and behavior patterns that cause the person to gain weight. The main goal of CBT is to make the person aware of these thought and behavior patterns that cause weight gain or inability to lose weight and to teach techniques on how to change them. In a way, this can also be called changing one's lifestyle in terms of weight and eating and starting to think and behave like thin people.
Why can't I lose weight or gain it right back?
Going round and round in a vicious circle using the same patterns of thinking and behavior will not help you lose weight. If you go on a strict diet for a few days or weeks, you may lose some weight, but if you go back to the same eating patterns, it is inevitable that you will gain weight. Remember, no one in this world can lose weight as long as they keep their calorie intake higher than their calorie expenditure. It is not possible to eat the high-calorie, delicious foods you love so much and stay thin. You have tried this many times and each time you have gained weight. You cannot use the same strategy and expect a different result. Therefore, the way to lose weight and keep it off is to break out of this vicious circle. To do this, you need to change the behaviors and thought patterns that cause obesity.
What are the behaviors that lead to weight gain?
Eating fast and without realizing it: We often have limited time to eat in our fast-paced lives. We even make it a habit to eat while doing something else (for example, at the computer or watching TV). However, this type of eating increases the amount of calories we take in. The duration of a main meal should be at least 30 minutes. This is because we need this much time for our blood sugar to rise and for the message "you are full" to go to our brain. However, in a main meal eaten quickly in 10 minutes, the message "you are full" has not yet gone to the brain, so when the meal is over, we continue to eat, saying "I am not full", which inevitably increases the amount of calories we take in.
Keep "dangerous" foods out of the environment: "Dangerous" foods are foods that contain high amounts of calories and are consumed without bothering to prepare them. Chips, chocolate, cookies, nuts are the best examples of this. If you have a weakness for these foods and they are easily accessible, you will be more likely to consume them.
Inactivity: We have already mentioned the simple formula for weight loss; as long as the number of calories you take in is lower than the number of calories you expend, you will lose weight. Calories are spent in only two ways; basal metabolism (the body's expenditure of calories to function during the day) and movement. By movement we do not just mean exercise. There are countless opportunities throughout the day for us to expend calories; we can take the stairs instead of taking the elevator, we can walk instead of taking the elevator, we can walk instead of driving to a nearby destination, we can pacing instead of sitting if we are waiting. These may seem like very simple and small actions, but when we do them repeatedly throughout the day, they can help us burn a lot of calories.
Emotional eating: For some people, eating is the main way to get rid of negative emotions or feel a positive emotion. "I feel happy when I eat" or "I eat when I'm bored and I feel better" are typical examples. But eating has nothing directly to do with relieving a negative emotion; we have conditioned ourselves that way. Moreover, eating is only a temporary relief; in the long run, we feel guilty and our negative emotions increase even more.
Not knowing how to say 'no': People around us may offer us various treats and we may find it difficult to refuse them, thinking that if we say 'no' the other person will be upset. Sometimes, even if we manage to say "no", the other person may continue to insist and make us feel under pressure with phrases like "I'll be offended if you don't eat". And we may end up taking in a lot of unnecessary calories during the day because of this. In fact, how we say things to people is more important than what we say. It is important to be prepared for such situations in advance, to prepare some "refusal" sentences that will not offend the other person but will prevent the insistence from continuing, and we can say these when we encounter such situations.
Don't confuse hunger with the desire to eat: If we only ate when we were hungry and stopped when we were full, we would not have a weight problem. Take a look at the times of the day when you eat, how many times do you eat because you are really hungry? What does hunger mean to you? How do you know when you are hungry? What sensations do you feel in your body? Actually, many of us confuse hunger with the desire to eat. And we often eat just because of this desire to eat. If we can understand the difference between hunger and cravings and stop eating just because of cravings, the number of calories we take in during the day will decrease considerably.
Change the definition of "full": The definition of "full" is different for everyone. In people who are thin and can stay thin, the "I'm full" signal appears quickly and the person stops eating at that point. For these people, the definition of "full" may be that most of the feeling of hunger in the stomach has passed. In obese people, the "I'm full" signal occurs much later, because for these people there is a defect in the definition of "I'm full". For example, for these people, the definition of "full" is when the stomach is so full that it is almost pressing on the rib cage and breathing is difficult. The definition of "full" is important as a signal to stop eating, so revising this definition and lowering the threshold will help you stop eating sooner.
Avoidance behaviors: Realizing weight gain is a stimulus that creates negative emotions for almost everyone. In order not to experience these negative emotions, the person tries to avoid situations and environments that will make them realize that they have gained weight, and this is called avoidance behaviors. Typical avoidance behaviors include not getting on the scale, wearing baggy clothes, not going to the pool/sea, not undressing in front of others, not looking in the mirror. Avoidance behaviors are useful for the moment; they prevent us from experiencing negative emotions. However, when we think in the long term, ignoring the problem prevents the problem from disappearing and even causes the behaviors that create the problem to continue. Therefore, recognizing and addressing avoidance behaviors will motivate people to accept the problem and look for solutions.
What are the thoughts that cause weight gain?
Let's call the thoughts that prevent us from dieting and/or being more active sabotaging thoughts . These thoughts prevent us from losing weight or cause us to gain weight quickly. According to cognitive theory, a person's emotional and behavioral response to a situation is not caused by the event itself, but by the interpretations they make about the event. These interpretations are the thoughts that come to the person's mind at that moment. If there are some patterns in these thoughts that are faulty, it causes negative emotions and non-compliant behaviors. If we can find our sabotaging thoughts about dieting and the mistakes we make in these thoughts, we can create more realistic and healthy alternative thoughts and thus get rid of the behaviors that prevent us from losing weight.
Here are some sabotaging thoughts:
All-or-nothing thinking: Evaluating things in only two extreme categories. For example, when you experience the slightest setback in your diet, you may break your diet by saying, "Asink or swim diet".
Negative prediction of the future: Making a single negative prediction about the future, even if this is not the only possible outcome. For example:"I won't be able to resist the desserts at the place I'm going".
Jumping to conclusions: Making an observation and believing that there is only one possible outcome. For example:"If I haven't lost weight this week, it is impossible for me to lose weight".
Self-deception: Telling oneself things that you would not otherwise believe. For example:"I can eat this, it doesn't count".
Setting rules that don't work: Setting rules for oneself or others that do not work, without taking into account environmental factors. For example:"Food cannot be thrown in the garbage ".
Linking unrelated topics: Combining two unrelated concepts. For example: "I am so depressed that I have to eat ".
Where can I apply for weight loss with psychotherapy?
At NPISTANBUL Brain Hospital , "Cognitive Behavioral Therapy in Weight Control" program is applied for people who want to lose weight with psychotherapy. To participate in this program, you need to call the call center of NPISTANBUL Hospital(0216-6330633) and make an appointment at the Cognitive Behavioral Therapy in Weight Control polyclinic. People who apply for this purpose will first be taken to a preliminary evaluation. In this preliminary evaluation, diet and exercise programs, treatments taken for weight loss, eating habits, eating patterns and weight loss motivation will be evaluated by face-to-face interview and questionnaire filling method, and necessary blood tests (hemogram, blood fats, blood sugar, etc.) will be performed. People who are deemed suitable for the program will be taken to individual or group therapy according to the person's request. These therapies will be conducted in weekly 60-minute sessions with a trained and experienced psychiatrist and the program will last for 7 weeks. After the end of the program, follow-up meetings will be held at 1.5, 3 and 6 months.
Each session has an agenda. In the first sessions, the reasons for the vicious cycle that continues throughout life in the form of diet-weight loss-weight gain-diet will be explained.psychoeducation will be provided on topics such as planned eating, environmental organization, learning to say "no" to eating, planned/unplanned exercise, emotional eating. At this stage, participants will be referred to a dietitian to create a regular eating program. In the following sessions, the dysfunctional thoughts that have prevented the person from losing weight so far or that have caused the person to gain the weight back quickly will be identified and techniques to change them will be taught. In the last session, the techniques learned throughout the program will be reviewed and future goals will be set. In the follow-up sessions, what is going well and what is not going well will be identified and problem solving steps will be applied for what is not going well.