Why you DON’T really want to lose weight!
In today’s podcast, David and Fabrice address two terrific questions submitted by listeners:
- Greg: What’s the difference between Outcome and Process Resistance for dieting and weight loss?
- Gary: How do you deal with motivation and resistance when dealing with habits and addictions, such as overeating, in TEAM-CBT?
David explains that in his workshops, he often asks his audiences, “how many of you would like to lose some weight?” And he asks you that same question now.
In his workshops, 65% of the hands go up. Did your hand go up too?
Then he say, “all of you who raised your hands just made a mistake! You definitely do NOT want to lose weight. You probably DO want to be thin and attractive, and in great physical condition, but you DON’T want to lose weight. Do you know why? There are only two things that you can do to lose weight–diet and exercise. And they both suck!”
David describes two new, powerful techniques he has created for resolving this dilemma–the Double Paradox and Devil’s Advocate Technique. David and Fabrice bring these techniques to life for you. If you are interested in losing weight, make sure you do the two exercises on paper while listening to this podcast. In fact, take a moment, but the podcast on pause, and get a piece of paper and a pen or pencil right now.
Here’s how they work:
- Double Paradox: First, you draw a line down the middle of a blank sheet of paper, from top to bottom. Label the left-hand column “Advantages” (or ADV) and the right-hand column “Disadvantages” (or DIS). Now, in the left-hand column, list all the Advantages of eating as much as want of whatever you want, whenever you want. As you will see when listening, there are many! Then, in the right-hand column, list all the disadvantages of diet and exercise. As you will see, there are also many!
David asks, “given all of the tremendous benefits of eating as much as you want whenever you want, and all the overwhelming disadvantages and hassles of dieting and exercising, why in the world would you want to change?”
He explains why this paradoxical strategy can be so powerful and helpful. In essence, the therapist becomes the voice of the patient’s subconscious resistance instead of trying to “help” or persuade the patient to change.
Research and clinical experience confirms that trying to “help” people lose weight is usually doomed to failure. In fact, if you review the world literature on the treatment of habits and addictions, you will discover that practically ALL diets and weight loss programs have limited success AT BEST.
- Devil’s Advocate: This is a powerful and fun role-playing technique. First, you list all the positive thoughts that tempt you to give in when you are tempted and craving your favorite food–such as pasta, chocolate, ice cream, donuts, or whatever your weakness is. Then you ask a friend or therapist to play the role of the tempting devil who will try to tempt and seduce you into giving in.Your job is to fight back and defeat the devil. You can record the interactions on your cell phone. if you defeat the devil, you can listen to the recording whenever you are tempted!
David also describes a third, time-honored technique that can be important in dieting (or in overcoming any negative habit or addiction):
- Stimulus Control: Instead of constantly struggling with temptations, you simply avoid them.
David and Fabrice discuss paradoxical vs. straightforward treatment strategies for habits and addictions, and also raise the question of whether there is some “superior” type of diet or exercise, or whether most, if not all, of the action is in the motivation.
David and Fabrice also discuss strategies for maintenance of weight loss once you have achieved your initial goal.
David and Fabrice love your questions so keep them coming!
Fabrice and I hope you enjoy our Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!
At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.
Good morning dear Dr. Burn
Such an amazing presentation that open my eyes on presenting to the patient/ client the resistance and not the desire to help. It is a beautiful idea of play role to defent the devil that can help the client ready understand if they are strongly motivated to changes or not.
Looking forward to wisdom and to learn from you
Thanks for the kind words! david
Hi David, I really love your podcast. Thank you for taking the time to share your thoughts and experience with the world. I have listened to almost every podcast and have learned so much.
I do disagree with you on some of the things presented in this podcast, however.
You mention at the beginning of this podcast that the evidence shows that diets and weight loss strategies don’t work. Yes, this is true and what the evidence clearly and overwhelmingly shows. But then at the end of the podcast you said something completely contrary when you said “you can make any diet or weight loss strategy work if you stick to it. If you have the motivation you can make any diet work.” People don’t “fail at diets” because of a lack of motivation. It’s not because they have cookies in their cabinet or don’t have cookies in their cabinet. It’s much deeper than that.
You said that you have done this work with people on retreats and hikes, and when you employ these double paradox and devil’s advocate techniques that people finally say “Ah! I’m ready to go on my diet now!” I have no doubt that those techniques convince people that they are “ready to diet”. They are very convincing techniques. I do doubt, however, that this is the first time people have had this type of “revelation” and I question as to whether this one is different than the ones that came before or will come after. I work with people who have yo-yo dieted their whole life – 40-50 years some of them. They have had many moments like the one you describe, where they are convinced to start dieting for one reason or another – and many of the reasons make a lot of sense to them. They can even be “good” and “motivated” for several years. They are “successful”, but then gain all plus more back.
This is where we can go wrong with working with people around issues of food. Don’t we want to help people to have normal relationships with food rather than obsessive thoughts and disorded eating? It is my belief that any kind of diet where we have to continually monitor what we eat, where we label food as “good” and “bad”, count calories, have certain days where we are “allowed” to eat certain foods – so any diet –
can be a path to disordered eating.
You fail to mention the middle ground between “eating whatever you want whenever you want” and “dieting”? I believe it is having a normal relationship with food where you eat a variety of foods and don’t label foods good or bad. It is where you remove the morality from food. It is where you learn to listen to your body’s cues of hunger and satisfaction. It is where you allow yourself to eat something you enjoy without guilt or shame, and stop when it is no longer satisfying. Thin people are allowed to eat whatever they want, whenever they want and we don’t make them feel guilty about it. We do, however, have a cultural message that says it is wrong to have a large-body, or be fat. That it is a moral failing that must be rectified.
When you created the list of advantages and disadvantages around “eating whatever you want whenever you want” I heard things that do not ring true for many of my clients’ experiences. My clients who have abnormal relationships with food (due to so many reasons – many of them cultural) often do not find great pleasure in food anymore. There is something compulsive about eating for many of them, but it is not enjoyable. They are afraid of the next diet looming around the corner and the real or perceived deprivation that will cause. There is a lot of shame, fear, ambivalence, anger, and sadness. If they binge eat, or “overeat”, they do not do it because it tastes so great, or brings them comfort. And they certainly don’t do it in public, so it’s not a social thing. They do it around a perceived or real sense of deprivation, often caused by a yo-yo cycle of dieting and a culture who tells them that being a larger-bodied person is unacceptable and unattractive. Dieting has failed them and caused them to have a very abnormal relationship with food. Food should be nourishing and pleasurable. Emotional eating is not a bad thing! We all emotional eat when we eat birthday cake, for example. There is no nutritional value to birthday cake, but it is so pleasurable because of the taste and the meaning behind it, and normally it is enjoyed with friends and family . But people with larger-bodies are not allowed to emotionally eat in public without feeling intense shame and judgement. We do not do that to thinner-bodied people.
Also, there is a large emphasis on weight in our culture rather than health. We say we are concerned about people’s health, but we focus mainly on weight loss. Many of us who are “active” are only active 30-60 minutes a day at most, and spend the rest of our time sitting in front of a computer screen or TV. Evidence is starting to come out that the problem of a sedentary culture is not solved by exercising in small periods a few times a week, but that we need to move our bodies more in general. We all need to do this, not just people who are perceived as being overweight.
Thank you for reading! I am obviously very passionate about this topic and have done a lot of reading and researching to address the cultural issues around weight and food. I welcome any dialogue on this topic! I am nervous to put this out there, because I respect you and Fabrice very much. But, I feel very strongly about these things and wanted to share them – thank you!
Cristina
Hi Cristina, You ARE an expert and thank so much for sharing your expertise and enhancing the dialogue about our podcasts! Fabrice and I both appreciate the many listeners who not only support us, but also ask great questions and add your own thinking and assessments. There are no “real experts,” probably, but if we work together we can share our little bits of expertise and together come up with some good stuff! All the best, david
Thank you, David! I completely agree. I look forward to your future podcasts!
P.S. I recommend the work of Linda Bacon, PhD, and her books “Health At Every Size” and “Body Respect” as well as http://www.thebodypositive.com.
Thanks! Appreciate your comment! all the best, david
Hello Dr Burns. Is it possible to do the “devil’s advocate” technique on your own, for example by recording yourself reading the tempting statements and playing it back? Or would that not work as well?
That’s a sluser great idea, actually! Let me know how it works for you! Make sure you do the Triple Paradox first so you can highlight the powerful forces driving our habit/addiction. d