The Emergency Weight-Loss Technique: Enjoy Yourself!

Charles Holton, LCSW (Click to return to main page)

I’ve noticed recently that blending mindfulness and hypnotic approaches can have powerful clinical benefits in a variety of contexts. In one case, a colleague referred a client to me for adjunct hypnotic work because she urgently needed to lose weight and had experienced so me success with hypnosis several years earlier. She had developed obstructive cardio-pulmonary disease, the disease her husband had recently died of, making her excessive weight not an aesthetic concern but a medical emergency.

I asked her about her previous treatment, expecting to be able to build on that foundation, and was stunned to learn of the aversive technique employed: the client had been asked to imagine her five favorite foods and then associate them with the smells of vomit and defecation. The only nod to compassion in this treatment had been the suggestion to inhibit gagging and vomiting. I quickly reassured her this was not the direction our work would take, internally noting that if she had expected this was what our work would entail, then her motivation must be even higher than I had assume. Besides being pointlessly cruel and unpleasant, these aversive therapies don’t hold up well, as Alexander Levitan explained at the NCSCH Spring Conference in April: once the negative association begins to fade, as is inevitably will, the intervention has lost its power to inhibit the unwanted response.

I wanted to invoke the Second Law of Hypnosis – when will and imagination are in conflict, imagination always wins – and help her develop a compelling vision of her future success that would pull her into it. Rather than try to fight against the enjoyment of life by mobilizing fear and pain avoidance, I asked her to pursue a different strategy.

“I want you to eat every one of your favorite foods this week, and to enjoy them thoroughly. Most overeating is mindless eating, but to really enjoy your food you have to pay close attention to every detail of every precious moment. Let me tell you a story about my friend who developed food allergies to dairy foods and pepper, two of her favorite flavors. We were at a restaurant with some friends when I commented on how delicious my creamy, peppery soup was, and then felt terrible for reminding her of flavors she couldn’t enjoy. She asked to try just one spoonful, and then proceeded to thoroughly enjoy that spoonful of soup for a full minute. Her eyes closed, she smiled, savored the warmth, the flavors. I believe she got more enjoyment out of that one spoonful than I got out of the entire bowl! She was fully aware of the pleasure of every moment that soup was in her mouth, and she suffered not one symptom of food allergy afterward. It takes some energy to be that mindful of experiences, but it pays off in unexpected and important ways.”

Later in the session when I led her in a standard imagery exercise, she developed and deeply enjoyed her safe place. I repeated the suggestion that she would thoroughly enjoy all the foods she wanted to enjoy in the coming week, would enjoy the experience of nourishment entering her body, and would enjoy the experience of caring for her body in many ways. Enjoyment and tender caring for herself were stressed repeatedly, replacing the brutal negative associations used in her previous hypnotic experience.

When she returned a week later, she updated me on her progress. She had lost four pounds already, had purchased clothes in the next smaller size that she anticipated enjoying wearing and hung them in a prominent place in her bedroom. She had eaten bites of cheeseburgers, pizza, and fried chicken with relish, spontaneously controlling portion sizes and putting her silverware down between each bite, and was well pleased with her progress, pleasure, and sense of control of the process, which was amplifying in positive effect rather than eroding.

She said she could feel her husband rooting for her, and planned to go the jewelry store and buy a ring he had wanted her to have when she reached her goal weight. That way she would feel him with her every day. I was powerfully moved by how she had integrated my simple suggestions into specific behavioral changes as well as the deep fabric of her life, awakening and anticipating a positive future, transforming the grief for her husband into a sense of his supportive presence, taking joy from each step toward her goal.

She and I both know losing weight is easier than keeping it off and there will be temptations and hard work ahead, but from this experience I am heartened that compassionate approaches to habit change are as effective than brutal ones in the short run, and more effective in the long run.