Brain-Powered Weight Loss Read online

  To Tom, who is always pushing me to do and be my best.

  To all of the Wellspring families we’ve served over the years, your courage is inspiring. I hope this offers you some wisdom and support on your journey.

  CONTENTS

  Foreword: Food, Behavior, Addiction, and Overweight by Mark S. Gold, MD

  Why I Wrote This Book

  Introduction: Why Diets Fail . . . Every. Single. Time. (And This Plan Doesn’t).

  Step 1: Cultivate a Weight Loss State of Mind

  Step 2: Face Your Biological Truth

  Step 3: Identify Your Thinking Errors and Food Triggers

  Step 4: Find Your Wise Mind through Mindfulness

  Step 5: Learn Your Dealing Skills—Then Use Them

  Step 6: Adopt a New Lifestyle of Healthy Eating

  Step 7: Make Room for More Movement in Your Life

  Step 8: Set SMART Goals and Plans

  Step 9: Prevent a Lapse from Becoming a Relapse

  Step 10: Outsmart High-Risk Situations

  Step 11: Cross the Bridge to Healthy Obsession

  Acknowledgments

  Selected References

  FOREWORD

  Food, Behavior, Addiction, and Overweight

  I have worked for more than 40 years trying to understand how food, sugar, and drugs of abuse hijack the brain, insinuate themselves into the users’ thoughts, stimulate their own taking, and cause addictions. During this time, neuroscientists have made great progress in understanding where each drug of abuse goes in the brain and body and the changes that occur during intoxication and withdrawal. We can now pinpoint where in the brain the effects are taking place. This has opened new horizons, enabling us to approach the treatment of obesity in promising new ways.

  A lot of progress has been made in our understanding of obesity since the days when we began to focus on the conditions associated with obesity, such as diabetes, heart disease, kidney disease, cancer, and joint problems, like we focused on the emphysema, bronchitis, cancers, and osteoporosis associated with smoking. We now have a new understanding for how bariatric surgery and pharmacological treatments work, and have seen the approval of new medications for obesity based on the addictive nature of certain foods. Still, these treatments are not cures, are incomplete, and work best in the context of a life-changing program. Putting research into clinical practice is quite complicated and is always a work in progress. It requires that someone take a concept or concepts, weave them into the matrix of a caring program, test outcomes, and adjust—while still helping to move the field forward.

  I consider Eliza Kingsford a national leader in weight management. The reason: What the rest of us have discovered in academia, laboratory, and clinical settings, this pioneer has actually put into practice. The culmination of all her knowledge and successful hands-on experience in helping people find the solution to their weight-loss issues is the book you have in your hands.

  Kingsford, a licensed psychotherapist, is the leader of Wellspring, the largest, oldest, and most-respected noninstitutional weight-loss program in the world. What she has achieved in her 10-year tenure, including two years as executive director, is nothing short of extraordinary. Rarely is an expert so grounded in science and the actual delivery of overweight and obesity treatment. Kingsford has learned by working with national and international experts, listening, and applying these insights in an open-air camp setting. She has worked with thousands of young people who have serious issues with food, including the stigma, shame, and trauma that often are part of it all. She knows and studies the literature and applies it in the field, ferreting out what doesn’t work (or doesn’t work very well), and polishing and improving what benefits people and helps them come to terms with their own food addictions and behaviors that drive their urge to overeat.

  I have worked to understand food-brain reward and its relationship to drugs of abuse and addictions since the early 1980s. I am lucky to have worked with leading obesity and food addiction experts: the late Bart Hoebel, PhD, formerly of Princeton University; and Kelly D. Brownell, PhD, of Duke University and formerly of Yale; as well as other top food and addiction experts, including Nicole Avena, PhD; Ashley Gearhardt, PhD; Samuel Klein, MD; Louis J. Aronne, MD; Robert H. Lustig, MD; Gene-Jack Wang, MD; and Marc N. Potenza, MD. Yes, we have really found that, for many people, eating is an addiction as powerful as cigarettes, recreational drugs, gambling, and sex.

  Failed diets and attempts to control overeating, preoccupation with food and eating, and the shame, anger, and guilt that follow look and respond like traditional addictions. It is common for people to overeat beyond fullness for the same brain reward that drives people to smoke, take recreation drugs, gamble, and engage in unhealthy sexual practices. These experts and I have been instrumental in helping Kingsford translate and advance our laboratory science into Wellspring’s treatment program and the first-of-its kind do-it-yourself plan she created called Brain-Powered Weight Loss. Just as we use behavioral therapies to overcome these addictions, Kingsford uses the same and similar therapies to help people overcome the grip that food has on their day-to-day lives. It’s the link that is missing from all other weight-related programs.

  Eliza Kingsford gets it. She understands that the reason overweight and obese people behave in unhealthy ways around food, in spite of the potentially devastating consequences, is because they have a dysfunctional relationship with food. This is the reason why achieving permanent weight loss is so difficult. She also knows that it is possible to address the trauma, shame, stigma, and the effects of food, especially highly palatable food, on the brain. The most novel part of her plan is the tools she uses, which have little to do with what someone should or should not eat in order to lose weight. Her tools are all powered by the brain—self-implementing techniques, based on proven cognitive therapies, that help people change the way they think and behave around food.

  What is more striking and impresses me the most about her successful approach is her goal to steer people toward better physical and mental health, balance, well-being, and wellness. I believe in her program—it will evolve as science and evidence change. It offers the most promise to people who are trying to overcome their struggle with overweight and obesity on their own.

  Kingsford brings an innovative and unique approach to achieving long-term weight-loss success in a way that’s almost unheard of: by teaching overeaters how to change long-ingrained habits that drive an unhealthy relationship with food. Once you read this book, you’ll find, as others have, that it is possible to calmly and assuredly be in control of your relationship with food instead of the other way around.

  Mark S. Gold, MD

  17th Distinguished Alumni Professor, University of Florida;

  Adjunct Professor of Psychiatry, Washington University, St. Louis;

  Chair, Scientific Advisory Boards for RiverMend Health, a national provider of addiction, eating disorders, and obesity evaluation and treatment

  WHY I WROTE THIS BOOK

  For more than a decade, I have been helping people overcome their weight-loss issues. They usually end up in my office unhappy with their relationship with food and their bodies, and are ready to make a change.

  What I’ve observed on a regular basis is a problem at the intersection of theory and practice. By that I mean people are buoyed when the newest diet book (theory) comes out, only to find themselves disappointed in the eventual outcome (practice). They know what they should do, what the latest science suggests, and what the latest research supports, yet they struggle with why they can’t seem to make it work.

  I’ve found that the key to success must involve both theory and practice. There is a need for both. We need to know what the s
cience of weight loss is teaching us, but more so, we need to understand human behavior. Somehow, after reading all the latest diet books—many written by incredibly knowledgeable and talented doctors and scientists—people lose weight, only to go back to engaging in the same behaviors they had before the diet began. You know where that leads!

  I am not saying that going on this or that plan can’t work. Many diets out there can and do work temporarily, but it’s not enough. They’re too short-lived. That missing link called human behavior—our old habits and their relationship with our food choices—is the downfall of even the very best diets.

  This is not to criticize the worth of healthy weight-loss plans and the intention of the people who create them. I am not a doctor or a scientist or a researcher as many of these experts are. I am a licensed therapist who specializes in weight loss. I have an immense amount of respect for the science that goes into writing these diet books. Some of the scientists, doctors, and researchers who author them are my mentors, my heroes, and certainly the people who guide my own work. I feel there is a need for everyone who is overweight to understand the science behind weight loss—what’s good, what’s not so good, what initiates weight gain, what promotes fat burn, and so on. There are thousands of studies and books supporting these theories, all valid aids that could probably solve most anyone’s weight dilemma.

  However, there is still that missing link. We need to get a grasp on the human behavior that drives weight gain. There is a need to understand the complex everyday emotions that drive our decisions around food, which have nothing to do with what we know about weight loss and everything to do with how we feel and think about food. This is the reason why this book came to be.

  You will find Brain-Powered Weight Loss different from any diet you’ve ever tried or any diet book you’ve ever read. For starters, it is not a “diet” in the traditional sense. Yes, I do map out the food choices you’ll want to make in order to promote weight loss and maintain a healthy weight, and I offer the science to back it up. Exercise is in here, too. However, I don’t take up much space telling you what to eat and not eat and why you should exercise. And, though they are essential to personal success, it’s not where I expect you to spend the majority of your effort, either.

  Where you will be spending most of your time is examining the complex phenomenon known as human behavior and its unique relationship with food. Examining the way you as an individual think and feel about food and changing the ingrained habits that drive your food decisions is the soul of Brain-Powered Weight Loss. You won’t be hearing much about theory; this is all about practice—a totally new and different approach to losing weight and making it stick. Not only is it designed to change your relationship with food, but the new practices you will develop are transferrable to other aspects of life as well. Try the exercises, techniques, and worksheets. I believe you will be more than pleasantly surprised at the change they inspire. You might find them transforming.

  I recognize that humans are complex individuals with different needs and different emotions. You may find some practices I recommend irrelevant to your life, but you’ll find many more that will strike a chord and become life-changing. If this book helps you make one meaningful change that impacts your life and reverses your personal battle with your weight, then I feel I’ve done my job.

  Eliza Kingsford

  INTRODUCTION

  Why Diets Fail . . . Every. Single. Time. (And This Plan Doesn’t)

  I am a licensed psychotherapist specializing in weight management, food addiction, body image, and eating disorders. I am also the executive director of Wellspring Camps, a total immersion weight-loss program for children and young adults up to age 26 that has the distinction of having one of the highest success rates in the world of people who lose weight and—here’s the clincher—keep it off. I spend every day in the trenches with people who struggle with their weight. I know what their diet demons are, and I know how to get rid of them. I am also a member of the RiverMend Health (corporate owner of Wellspring as well as several addiction centers) Scientific Advisory Board, a panel of the world’s best minds in weight loss and addiction, and am aware of all the research on what works best and doesn’t work at all.

  Brain-Powered Weight Loss is the culmination of all this knowledge. It is a how-to interactive workbook that will encourage you to approach weight loss in a refreshing new way using the most sophisticated tool in existence: your brain. It is not something you’ll read once and put on a shelf. It’s something you’ll want to come back to time and time again. It is a tool of practice—and power.

  It’s no secret that there’s an obesity epidemic in America. While the reasons are many and somewhat complex, here’s a major one and it concerns me the most: We are an obesogenic society. As a society, we talk a good talk, but we don’t walk the talk. There are hundreds of books touting healthy eating and the latest trends in foods that are better for us nutritionally, but as a population we continue to gain more weight. Although there is a perception among some that we are eating healthier, our actions say something different. Americans spend $50 billion a year on products advertised to help promote weight loss, yet an estimated 70 percent of American adults are overweight or obese, and the rate is projected to rise to 85 percent by 2030. Think, for a moment, what this is telling us: If you are at a healthy weight, you are in the minority! The statistics are even scarier for children. The rate of overweight and obesity among them is an unprecedented one in three, and it’s only expected to get worse.

  Fifty billion dollars? Clearly, we are desperate to lose weight, and I’m here to tell you that the reason it’s not happening cannot be blamed on us as individuals. There are just too many forces working against us that are out of our control.

  First, as you’ve undoubtedly noticed, our food industry in the past 60 years has changed dramatically. We’ve seen the emergence of packaged foods, frozen foods, ready-made foods, low-fat and fat-free foods, and 100-calorie-pack easy-to-grab foods. In order for these types of “convenience” foods to exist safely on our shelves, they have to be processed, engineered, and chemically enhanced in more ways than we care to know about. Like it once was with cigarettes, I believe that we didn’t realize the impact these “convenience” foods would have on our bodies. But we are seeing it now through our surging obesity epidemic. Many of these so-called foods shouldn’t even be called food because we can’t recognize a single ingredient on their labels. As far as I’m concerned, they should carry a warning label, just like cigarettes now do!

  For instance, take the low-fat, no-fat, “lite” trend that’s been all the rage for the past few decades. When you take the fat out of a product, you have to replace it with something else to retain a favorable taste, and that replacement is almost always refined sugars and/or artificial chemicals. When natural food is manipulated to such a degree, it falls into the category of “highly processed,” which has created another phenomenon: food addiction. That’s right, science has confirmed we can get addicted to certain foods, something you’ll hear more about as you read through this book.

  Even many packaged foods advertised as healthy really aren’t, because our bodies weren’t built to identify these added chemicals as fuel, so we end up storing what we’re eating as fat. They also spike our insulin level and contribute to inflammation, a marker for many chronic conditions. Check the labels on so-called fat-free cookies, crackers, and snacks and see how many ingredients you are able to identify. I bet you won’t find many.

  In addition, marketers are spending billions of dollars every year pushing unhealthy, unnecessarily fatty and processed foods in front of our faces. They’d probably push them down our throats if they could. This is not unintentional; they know exactly what they are doing. Magazines and newspapers are flooded with stories about how to get the “perfect” body, ways to exercise more, and tricks to lose weight. Yet, tucked between those pages and plastered all over television are advertisements promoting the most caloric, f
at- and/or sugar-laden products you can find. When you think it can’t get any worse—1,100-calorie fast-food burgers, 850-calorie “salads,” 300-calorie candy bars disguised as “health food,” for example—it does. Really, do we need a pepperoni and cheese deep-deep dish pizza wrapped in 3½ feet of bacon, or deep-fried pickles to go with our double cheeseburgers? I can’t imagine anyone thinks we do, even the people who come up with these concoctions.

  If you’re thinking, “But I don’t eat any of those things, and I’m still gaining weight,” consider this: Sensationalized messaging only serves to nudge our perception of what’s normal or healthy in the wrong direction. If bacon-wrapped deep-deep dish pizza is over the top, it only makes a sausage and pepperoni pizza seem normal. I mean, really? This in itself is a problem because the more we sensationalize the extreme, the more extreme normal becomes.

  Another reason we have an obesity epidemic in this country and in other parts of the industrialized world is because our modern society so easily fosters the problem. Sure, the fact that we drive everywhere instead of walk, and spend hours a day inertly staring at computers and social media instead of being active is part of it. At least these are things we can work on changing. The bigger problem is something we as individuals can do little, if nothing, about: the unapologetic marketing messages that are continually trying to tempt us with mouthwatering-looking food filled with nutrient-deficient empty calories. And marketers are doing it around the clock. We exist in an environment that is working against us. Trying to eat healthy day in and day out, from one meal to the next, is like continually swimming upstream. It takes a lot of effort!

  For example, portions in a lot of restaurants, particularly popular chains, have gotten way out of control, and the fact that most chains must post the nutritional counts of their dishes isn’t having much of an impact. They just reinvent the definition of a portion size as “meant to share,” even when it all arrives on a plate for one. It’s a blatant invitation to overeat. These days when dining out, you can be sure of these three things at a lot of restaurants: Portion sizes are too big; salt, sugar, and fat are generously added to accentuate flavor; and the quality of food has been compromised to account for costs. Trust me, I’m not doggin’ on restaurants, as I’m a huge foodie. But I make it my business to pay attention to these three things when I eat out.