Overeating: It’s All In Your Head
The following is an excerpt from the book Three Minute Therapy and focuses on the topic of overeating and how cognitive-behavioral techniques can be used to help a person overcome this concern.
They say that inside every fat person there’s a thin person fighting to get out. In Suzie’s case, the thin person appeared to be losing the struggle. At 5’4″ Suzie felt she ought to be 130 lbs, but was actually closer to 160.
Just about to turn 20, Suzie looked older. She had deep eyes and smooth chestnut hair beneath her floppy leghorn hat, and wore a silk print dress with an enormous string of crystal beads. She had a lively manner and was ready to laugh, but seemed imprisoned by her excess fat. She was disheartened. “I’ve tried dozens of diets over the last five years, and I work out four times a week, but I can’t seem to lose weight consistently, and I’m heavier now than I was a year ago.”
When Suzie told me her exercise regimen, I felt exhausted just listening to it. She was at the gym never less than four evenings a week; for the first 30 minutes she vigorously pedaled an exercise bike, followed by an even more demanding 60-minute aerobics class. Yet she remained overweight.
The Solution to Suzie’s Weight Puzzle
Suzie was sincerely mystified as to why she “could not” manage to reduce. On one level, the answer was obvious: She was absorbing enough excess calories to outweigh the effects of her exercise. Suzie immediately confirmed that she often yielded to impulsive temptations to drink too much alcohol and to snack on high-calorie foods. So the real puzzle was: How can someone with the drive and determination to stick to a grueling exercise program fail to control her eating and drinking habits? The answer is that addictions arise from addictive thinking.
On her first visit I gave Suzie a personality questionnaire, which confirmed my immediate guess. The test involved circling one of the three words “OFTEN,” “SOMETIMES,” or “SELDOM” after each of 50 statements. Suzie indicated “OFTEN” for these statements:
- I feel upset when things proceed slowly and can’t be settled quickly
- I feel upset about life’s inconveniences or frustrations
- I feel quite angry when someone keeps me waiting
- I feel very sorry for myself when things are rough
- I feel unable to persist at things I start, especially when the going gets hard
- I feel unexcited and bored about most things
Low Frustration Tolerance
Suzie was suffering from Low Frustration Tolerance, a very common type of “musty” thinking, which lies at the root of the great majority of overeating problems and other addictions.
Low Frustration Tolerance arises from the third “must,” the belief that life MUST be fair, easy, well-ordered, comfortable, exciting, pleasurable, interesting, or hassle-free. In any situation where life does not conform to such demands, the addict compulsively looks for a quick escape from these “unbearable” circumstances.
Suzie told me more about her problems. She was moody and often depressed about weight, friends, and boyfriends. She had broken up with Sammy a year earlier, but continued to see him off and on. (She had a demand about this situation: “I MUST know for sure if it’s on or off with Sammy.”)
The Power Of Negative Thinking
A specific technique has often been found effective in undermining Low Frustration Tolerance and thereby curing addictive thinking. This method is to maintain a clear and constant awareness of the disadvantages of any particular behavior or outlook. I explained the idea to Suzie:
“Whenever you do anything that is under your voluntary control, even getting out of bed in the morning, all the way to getting into bed at night, you make the decision to do it. And every decision largely consists of a weighing of benefits against costs, or advantages against disadvantages.
“When you get up in the morning, you’re demonstrating that at that moment you believe the advantages of arising outweigh the disadvantages (skipping breakfast, rushing to work, arriving late, and so on). If you had decided that the disadvantages of getting out of bed were greater, then you would have stayed in bed. This process–often operating semiautomatically–repeats itself throughout the day in making large and small decisions.
“It’s exactly the same with your eating or overeating. Whenever you choose to eat pizza, or any other high fat food, it’s because you’ve decided, for the moment, that the advantages of doing so outweigh the disadvantages. Just before making such a decision, you might be thinking something like: ‘This pizza is fattening (disadvantage 1), but it tastes so delicious (advantage 1), I’ll feel so good (advantage 2), I HAVE TO have it (advantage 3), and I won’t really gain weight because I’ll diet later (discounting disadvantage 1).’
“If you can convince yourself that the calculation is reasonable and that the advantages outweigh the disadvantages, you will indulge. If we can get you to realize, strongly and clearly in such situations, that the disadvantages outweigh the advantages, then you will reject the pizza.”
Edelstein, M. (2013). Overeating: It’s All In Your Head. Psych Central. Retrieved on August 30, 2015, from http://psychcentral.com/lib/overeating-its-all-in-your-head/