Thinking Thin: A Cognitive-Therapy Approach Most weight-loss diets work, as long as you stick to them. But studies show that most of us can't make ourselves stay with a diet long-term. Now, a growing focus on behavioral tricks may help people change the way they think about food and eating.
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Thinking Thin: A Cognitive-Therapy Approach

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Thinking Thin: A Cognitive-Therapy Approach

Thinking Thin: A Cognitive-Therapy Approach

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Today in Your Health, when it comes to losing weight, what you think about you bring about.

Here's NPR's Allison Aubrey.

ALLISON AUBREY: Forty-five-year-old Lori Maslin lives near the Chesapeake Bay, and is passionate about food. She likes to cook, loves to eat, and has never been one to say no to a rich, chocolaty dessert. So imagine how she must have felt before her annual beach weekend with friends, knowing that she wanted to stick with her diet.

Ms. LORI MASLIN (Resident, Chesapeake Bay): On the way down there, we always stopped at this restaurant - the Southern BBQ place, and they have the most killer chocolate cake. And I love chocolate cake.

AUBREY: Maslin's approach to dieting these days has a lot to do with planning. So days before her trip, she decided she'd hold back on the ribs and the coleslaw, and leave room for that cake.

Ms. MASLIN: Which was just as good as I knew it was going to be. And I didn't feel guilty about it.

AUBREY: Maslin has taken off 35 pounds over the past year and a half. Weight watchers taught her how much of what sorts of food she should be eating. But how does she keep it off? To find out, we met her at a diner along with her diet coach, psychologist Judith Beck.

Ms. JUDITH BECK (Diet Coach/Psychologist): So what's important to realize is that behind every behavior change, there's a lot of thinking change.

AUBREY: Beck's father, Dr. Aaron Beck, pioneered a treatment called Cognitive Therapy back in the 1960s. Instead of reaching back to childhood for the source of your emotional problems, the Beck approach is to change the way you think about them.

For dieters, this means catching yourself whenever you have a sabotaging thought. Things like, oh, I'll never be thin, so why not just tear into this bag of chips. When these sorts of thoughts take hold, dieters cave, and then convince themselves they have no willpower at all, which Beck says usually isn't true.

Ms. BECK: Dieters do have a will power. Most dieters have lost weight before. They've just gained it all back. So their will power is a little bit inconsistent.

AUBREY: Beck got lots of tricks to help. Lori Maslin has adopted one of them, almost as a mantra. Everyday, she repeats to herself - no choice - which means she got no choice about sticking with the just the foods she's planned out for the day. Even when she's ordering lunch off a three-page menu.

Ms. MASLIN: This is easy for me to look at. I just ignore most of it. As much as I would love, like, a Jewish hoagie I don't even look there.

AUBREY: Today, it's a veggie wrapped with an apple. Maslin says, in all her years of dieting, choosing a skimpy wrap over a meaty hoagie used to make her feel deprived.

But now she distracts herself by focusing on what she is gaining. Beck gave her this tip: make a list of eight things that are great about losing weight. Maslin now carries the list in her wallet. Number one: better self-image.

Ms. MASLIN: Second one is better clothing collection.

AUBREY: And the list goes on with entries like, no more feeling the need to stand behind somebody in a photo. Carrying a list like this may sound goofy, but Maslin says it's something to hang on to, to help stay in control.

Dr. MARTIN BINKS (Director of Behavioral Health, Duke University Diet and Fitness Program): That is the key to making a lasting change.

AUBREY: Dr. Martin Binks oversees Duke University's Diet and Fitness Program. He says these tricks borrowed from cognitive therapy can be the missing piece for dieters. To get it just right, Binks says, it takes time and a personalized approach.

Dr. BINKS: What seems like the best possible tool to one person might seem kind of silly to another.

AUBREY: If carrying around a food journal or a list of benefits doesn't work for you, it's worth trying group support or scheduling weigh-ins with a doctor. At the end of the day, Binks says, it's important for diet gurus to be honest.

Dr. BINKS: And to admit to people that weight control is difficult. It takes sustained effort and concentration on making a lot of small changes that can last.

AUBREY: Not everyone will be successful and no one can stick to their plan 100 percent at a time. Lorie Maslin says every once in a while she reverts to eating big handfuls of popcorn drenched in butter, while watching late-night TV.

Ms. MASLIN: And sometimes I do. I'll catch myself and I'll have to slow down.

AUBREY: When the going gets tough, she thinks ahead to Sunday morning when she meets friends for breakfast.

Ms. MASLIN: To have them say, you know, how much have you lost now? You look really good. No, you don't want to lose any more weight.

AUBREY: Vows she could go in, Maslin says, for at least another week.

Allison Aubrey, NPR News.

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