Making Changes

Hi, I am Deacon Shoenberger, a licensed clinical psychologist. I’ll be writing some brief articles over the next several months about topics that may be of interest to those of you currently pursuing or thinking about engaging in medically supervised weight loss. As many of you know, making significant changes in your own personal behavior is very difficult to do, especially when considering a shift that involves as many factors as losing weight.
Increasing attention to what, when, and how much you eat, exercising more, becoming more aware of your emotional responses, maintaining motivation, dealing with cravings – these are all aspects of the weight loss challenge that can sometimes feel overwhelming when you begin reading or talking about weight loss, or even when you enter a weight loss program. And further, the factors that drive the decision to make the change can sometimes be considered a crisis. “My wife is going to leave me,” “the doctor says I’m going to die,” “I just found out I have a marker for diabetes” – these are some of the reasons people give for wanting to improve their health. As a result, sometimes the basics can get lost in the shuffle, which is unfortunate because the basics are often the most necessary aspects of successful behavior change.
Returning to the basics has been presented in many different ways and has always been expressed as a critical step to be taken prior to attempting to address more complicated problems. Maslow in his hierarch of needs identified physiological needs (food, water, sex, sleep, etc) as the base layer of needs to be met for human emotional health. Without attention to the basics, there is no way to pay attention to anything else. Or, as an emergency room assessment specialist once told me, “how am I really going to know if someone is homicidal if they are hungry, thirsty, cold, in pain, or tired?”
Self-help groups and addictions treatment programs in the 90’s espoused the acronym HALT – Hungry, Angry, Lonely, Tired – as a way to quickly assess your readiness to make effective decisions and to highlight the importance of taking care of your basic needs before making complicated or important decisions. “If you are hungry, angry, lonely, or tired it’s probably not the best time to think about leaving your husband.”
Current behavior therapies have combined the acronym and hierarchy of needs ideas as skills for reducing emotional vulnerabilities and increasing your ability to regulate your emotions and make better decisions. Treating physical illness, eating regularly, avoiding altering drugs, balancing your sleep, and exercise make up the skills practiced in this type of therapy. Again, the fundamental idea is that the foundation for effectively making a lifestyle change is to make sure the basics are covered first.
In sum, trying to effectively lose weight is tough and will involve much more than just eating less and exercising more. And with all of the anticipation about what you will learn and how it will turn out and what everyone will think, sometimes it may feel like a roller coaster. At these times, not only is it useful to remember the basics, it can be critical. So if you are getting ready to engage in this process or even if you are already on the road, get good at the basics – sleep enough, eat enough, exercise, kiss your wife, cut down the booze, and get to the doctor if you are sick. None of us do these as well as we ideally could, but the better you get at them, the higher your likelihood of success at changing any behavior.
Good luck until next time when we’ll talk about the different aspects of behavior change and some of the problem with traditional dieting.

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