Behavior Modification and Lifestyle Change
Principle 1
Don't start eating until you have reached a level three stage of hunger.
Level 1: You have started to think about food.
Level 2: You feel a little bit hungry.
Level 3: You are good and hungry, enough that you know exactly
what you want to eat. If you are not able to have a meal
at this time, then use a "hunger saver", such as a small
handful of peanuts to save the hunger until a meal is
available. Reaching a level three causes the body to use stored fat.
Level 4: No-no. Here you get so hungry that you will eat anything in
sight, and twice as much as you need.
Principle 2
Learn to take twenty minutes for mealtime. After twenty minutes, rest from eating for five
minutes. Then if you are still hungry, eat for five more minutes. Keep a diary of everything
you eat.
Eat slowly.
Start eating a moment after the others.
Chew slowly. Dissolve the food in your mouth before swallowing.
Taste your food, as if you were a child. Move it around in your mouth for maximum taste.
Be picky about your bites of food. Start with the food that looks most inviting to you. Then
take the portion of that serving that looks most appetizing and pleasing to you.
Try to take bites after the other person that you are eating with.
Put your fork down on your plate between bites.
Try to be the last one through.
Leave a little food on your plate to practice finishing a meal when the hunger is gone.
Leave the table after eating.
Store or dispose of uneaten food.
"Which garbage do you want it to go into?"
Ans: The disposal, the commode or your own fat cell!
Principle 3
Do not do anything while eating, except to socialize with others.
No TV, reading, mail, or radio.
Eat only in a certain room in the house.
Eat only at the table.
If you want to eat while you are cooking, put the food on a plate, and sit down at the table.
Make sure that food is in the kitchen, not in the bedroom, office or living room.
Use your own place mat, dishes, silver.
Use a small plate or dish in proportion to your meal. © Nancy Carter, LCSW
Principle 4
Because you were very hungry before you started eating,
and because you are eating slowly, you can notice when
active hunger is no longer present.
It might feel like "a little sigh" of contentment.
Stop eating at this point.
Do not eat until you are full. That will prevent weight loss.
Principle 5
Let other people control their own eating habits.
Do not purchase problem foods.
Let others purchase their own, if they can't live without them.
Make other people in the family get their own sweets and
other problem foods.
Shop only after a meal.
Principle 6
Take a three week sabbatical from sugar.
It takes 21 days to heal an addiction, or to change a habit. After that time, you will be able
to have one nice sweet food per week, or a small sweet serving per day.
Principle 7
Reward yourself for each 5 pounds lost,
or for every 350 points earned on your work sheets.
Principle 8
Science, Method and Miscellaneous Hints.
Do not skip meals.
You will feel "indebted to self" and overeat.
Try to save some food from a meal for snacks.
Save food choices ahead for special occasions, but do not borrow ahead.
Decide on food strategies for times when you are excessively hungry. Foods like raw
vegetables take a long time to eat. Beans fill you up. Sauerkraut takes forever to eat. Sour
pickles cut the wish for sweets. The smell of cinnamon makes us our brain think that we
already ate.
Cravings. Write down the craving, then promise yourself exactly when
you will eat this food, possibly as a reward. Remember: Now is not forever.
Learn about yourself. Are you a salt eater, a carbohydrate junkie, or is fat your foe?
Weigh yourself regularly, either each day or once each week. Keep a graph of
weight lost per week. The graph will help you see how well you have done
during three week periods of stalemate.
Water Retention. The body burns fat for energy. The combustion produces byproducts of
water and heat for energy. Sometime the body collects the water for as long as three weeks.
You are still burning fat, but your weight stays the same. Then suddenly you will lose about
three pounds of water. In a nine month dieting period, these three week stalemates will
occur at least three times, so expect them. Sometimes a change in diet, such as increased
fruit, or even some beef, will trigger the body to let go of its water reservoirs. Drink plenty
of fluid to prevent this occurrence as much as possible. Give yourself a reward after
maintaining your diet throughout a 3-week plateau.
DON'T GET TIRED IN THE SECOND WEEK. Your body has not begun
to use fat stores yet, as it takes about three weeks. So far, you have lost
mostly water. Your metabolism is slowing down, trying to prevent weight
loss during a condition of famine. This is a good time to increase metabolism
through exercise, vitamin B, milk products and fruits. After the third week,
your body will begin to use stored fat on a regular basis. Your energy will be
regular and stabilized, especially if your are correctly following the American Diabetic Food
Choices plan. You will eventually say that you have never had better energy, and that will
be true. The body doesn't have to wait for a meal for energy once it starts to use fat supplies.
Weight loss is not about will power. If everyone had as much will power
as fat people do, the world would be a better place. Fat people have a
genetic defect in knowing when they have had enough. So they typically
use will power to stop eating; normal people know when they have had
enough because their brain tells them that they don't want any more.
Lucky them! Fat people have to use intelligence and planning to deal
with their problem.
Eating really does help. That's why we do it. A small piece of hard candy is enough to
increase the brain's use of the chemical seratonin, which causes a relaxation response. A
small piece of chocolate increases endorphins in the brain, which is a natural painkiller. It
works. But overeaters take more of it than they need.
If you subtract, then you must add. Whenever you subtract something from your life, you
must replace it with something else. If you reduce food intake, then you must increase other
sensory pleasures, physical activity and social satisfaction. See handout on stress reduction
for other ways to please the five senses.
To stop doing one thing, then do another in its place. For instance, if you have a habit of
eating in a particular situation, then change your actions in that situation. Much cognitive
and behavior therapy is about developing skills for handling situations directly and
effectively. Then you will not have to resort to food. Think about Jesus parable about the
house filled with demons.
Study what foods made you fat. Delete these from your diet, but use them for rewards.
Keep track of verbal exchanges pertaining to food.
Who does it most of the time?
Equipment needed: small scales for weighing food choices, a scale for weighing yourself, a
notebook for the program and work sheets, possibly a blender for milkshakes, possibly a
tape recorder for creating meditations. © Nancy Carter, LCSW
Principle 9
Exercise and Physical Health
For weight loss, use exercises such as walking, dancing
and weight lifting. Use stretch exercises to help your
flexibility. Use other exercises to maintain skin tone.
When exercising, feel the body from inside out.
Use a tape measure to get your measurements before you start losing.
You will lose about an inch off your hips and waist for every 10 pounds lost, depending on
your size at the outset of the lifestyle change.
Have a doctor's check-up. After weight loss you will have to monitor thyroid, blood sugar
and estrogen. Your doctor should have numbers prior to weight loss to compare to the
numbers you will have within two years after weight loss.
Keep a record of when you feel particularly tired. Is there a particular time of day when low
spirits and discouragement are most likely? These are times we are more likely to eat. What
are the causes of the fatigue? Poor scheduling? Stress beyond your control? What can you
do during times you are tired to recover without eating? Have you tried good music,
conversation with friends or meditation?
Make a list of physical activities you would do if you were smaller.
Begin to observe physical pain that is caused by fatness.
How do you handle sleep problems?
Principle 10
Body Image
Look at yourself regularly in a full length mirror,
including nude. Exercise in front of a mirror. This
is necessary in order for you to learn to love yourself
as you are, and to be able to see body changes as you
lose weight.
Draw a picture of yourself now, and as you will be
after you lose weight.
Fantasize yourself 10 pounds lighter (not all the way down). When you can no longer see
yourself smaller, you will stop losing weight. Think about what you will look like, what
will be different about your life, what will you be able to do that you can't do now?
Take pictures of yourself before weight loss, and every twenty pounds thereafter.
If you can, display a picture of yourself as you will be when you are 10 pounds lighter .
Begin to observe the times that fat seems to protect you.
After the fat is gone, how will you protect yourself then?
© Nancy Carter, LCSW
Principle 11
Self-Discovery
Why do you want to lose weight? Make a complete list.
Facts about your weight problem.
When did you become overweight?
Was there a time of being normal?
What is goal weight?
What sports, other forms of exercise did you formerly like?
What hobbies or interests do you have? Have you given any of these up?
Are any other family members overweight?
What do you tend to eat the most of and when?
What conditions cause you to overeat?
How have you effectively dieted in the past?
Study how many pounds per year you have tended to gain. It is probably about twenty
pounds. So if you lose that many pounds per year your body will not produce the yo-yo
syndrome, and force you to gain the weight back. It is when you lose more than that in a
year that your body rebels. To counter this, stay away from sugar products for about 2 years
until your body stabilizes and your weight loss is secured.
What kinds of things make you feel frustrated and irritable?
Make a list.
How do you handle guilt? Or disappointment when you do not do well enough on your
lifestyle change?
What makes you angry or resentful? Anxious or afraid? Sad or lonely?
How do you handle these feelings and situations?
Do you know how to handle grief? In yourself and in others?
How do you handle the wrong-doing of other people?
Do you know how to make decisions? And do you make them often? Do you refuse to let
other people make your decisions for you? Or do you try instead to "rescue" others by
attempting to decide for them what feelings they should have and actions they should take?
Do you always keep your agreements? Remember that decisions make us human and real,
and agreements are simply joint decisions. They are important to your recovery from misuse
of food and fat.
Do you have good communication skills? Do you know how to talk to people, and to talk
about the right things at the right time?
How do you handle time?
© Nancy Carter, LCSW
Principle 12
Self Image
We cannot say no to ourselves if we never learned to say no to others.
We cannot say yes to others if we cannot say yes to ourselves.
We cannot say yes if we never learned how to say no.
We cannot say no if we never learned how to say yes.
List of assets and deficits.
What do you like best about yourself? Least?
Decide how to strengthen assets, and overcome deficits.
Do you think you are pretty? Sexy? Fun to be with? Lovable? Attractive to others?
Let others compliment you. Seek out the company of those who are encouraging and avoid
those who are not. But don't forget to pay attention to others and give encouragement to
them as well!
Would you like new friends? What kind of person would you like to be friends with? What
kind of person would they seek for friendship? What makes a friend? And what makes
people choose one person over another for friendship?
In what ways are you healing, encouraging, and refreshing to others.
Do you use your energy well, or do you send negative energy to others?
What are your basic rights as a person?
Who are you? What is your life about? How does it feel to be you?
Who do you wish you were? What would make you feel at peace with yourself, and
"comfortable in your own skin"?
What do you believe? About yourself, about others, about morality, about God?
What makes you feel competent, successful, useful and important?
How do you solve problems? Learn how to: research the facts, look at options, choose one
option, act on it, the evaluate the results. If the problem is not solved, then begin again and
use a different option for action.
What do you value the most? What are the least important things?
What principles do you live your life by? How do you define wrong-doing?
What do you want to do with your life? How do you set goals, and what are they?
What is your place in God's Kingdom?
What do you want people to remember the most about you after you die.
© Nancy Carter, LCSW
Principle 1
Don't start eating until you have reached a level three stage of hunger.
Level 1: You have started to think about food.
Level 2: You feel a little bit hungry.
Level 3: You are good and hungry, enough that you know exactly
what you want to eat. If you are not able to have a meal
at this time, then use a "hunger saver", such as a small
handful of peanuts to save the hunger until a meal is
available. Reaching a level three causes the body to use stored fat.
Level 4: No-no. Here you get so hungry that you will eat anything in
sight, and twice as much as you need.
Principle 2
Learn to take twenty minutes for mealtime. After twenty minutes, rest from eating for five
minutes. Then if you are still hungry, eat for five more minutes. Keep a diary of everything
you eat.
Eat slowly.
Start eating a moment after the others.
Chew slowly. Dissolve the food in your mouth before swallowing.
Taste your food, as if you were a child. Move it around in your mouth for maximum taste.
Be picky about your bites of food. Start with the food that looks most inviting to you. Then
take the portion of that serving that looks most appetizing and pleasing to you.
Try to take bites after the other person that you are eating with.
Put your fork down on your plate between bites.
Try to be the last one through.
Leave a little food on your plate to practice finishing a meal when the hunger is gone.
Leave the table after eating.
Store or dispose of uneaten food.
"Which garbage do you want it to go into?"
Ans: The disposal, the commode or your own fat cell!
Principle 3
Do not do anything while eating, except to socialize with others.
No TV, reading, mail, or radio.
Eat only in a certain room in the house.
Eat only at the table.
If you want to eat while you are cooking, put the food on a plate, and sit down at the table.
Make sure that food is in the kitchen, not in the bedroom, office or living room.
Use your own place mat, dishes, silver.
Use a small plate or dish in proportion to your meal. © Nancy Carter, LCSW
Principle 4
Because you were very hungry before you started eating,
and because you are eating slowly, you can notice when
active hunger is no longer present.
It might feel like "a little sigh" of contentment.
Stop eating at this point.
Do not eat until you are full. That will prevent weight loss.
Principle 5
Let other people control their own eating habits.
Do not purchase problem foods.
Let others purchase their own, if they can't live without them.
Make other people in the family get their own sweets and
other problem foods.
Shop only after a meal.
Principle 6
Take a three week sabbatical from sugar.
It takes 21 days to heal an addiction, or to change a habit. After that time, you will be able
to have one nice sweet food per week, or a small sweet serving per day.
Principle 7
Reward yourself for each 5 pounds lost,
or for every 350 points earned on your work sheets.
Principle 8
Science, Method and Miscellaneous Hints.
Do not skip meals.
You will feel "indebted to self" and overeat.
Try to save some food from a meal for snacks.
Save food choices ahead for special occasions, but do not borrow ahead.
Decide on food strategies for times when you are excessively hungry. Foods like raw
vegetables take a long time to eat. Beans fill you up. Sauerkraut takes forever to eat. Sour
pickles cut the wish for sweets. The smell of cinnamon makes us our brain think that we
already ate.
Cravings. Write down the craving, then promise yourself exactly when
you will eat this food, possibly as a reward. Remember: Now is not forever.
Learn about yourself. Are you a salt eater, a carbohydrate junkie, or is fat your foe?
Weigh yourself regularly, either each day or once each week. Keep a graph of
weight lost per week. The graph will help you see how well you have done
during three week periods of stalemate.
Water Retention. The body burns fat for energy. The combustion produces byproducts of
water and heat for energy. Sometime the body collects the water for as long as three weeks.
You are still burning fat, but your weight stays the same. Then suddenly you will lose about
three pounds of water. In a nine month dieting period, these three week stalemates will
occur at least three times, so expect them. Sometimes a change in diet, such as increased
fruit, or even some beef, will trigger the body to let go of its water reservoirs. Drink plenty
of fluid to prevent this occurrence as much as possible. Give yourself a reward after
maintaining your diet throughout a 3-week plateau.
DON'T GET TIRED IN THE SECOND WEEK. Your body has not begun
to use fat stores yet, as it takes about three weeks. So far, you have lost
mostly water. Your metabolism is slowing down, trying to prevent weight
loss during a condition of famine. This is a good time to increase metabolism
through exercise, vitamin B, milk products and fruits. After the third week,
your body will begin to use stored fat on a regular basis. Your energy will be
regular and stabilized, especially if your are correctly following the American Diabetic Food
Choices plan. You will eventually say that you have never had better energy, and that will
be true. The body doesn't have to wait for a meal for energy once it starts to use fat supplies.
Weight loss is not about will power. If everyone had as much will power
as fat people do, the world would be a better place. Fat people have a
genetic defect in knowing when they have had enough. So they typically
use will power to stop eating; normal people know when they have had
enough because their brain tells them that they don't want any more.
Lucky them! Fat people have to use intelligence and planning to deal
with their problem.
Eating really does help. That's why we do it. A small piece of hard candy is enough to
increase the brain's use of the chemical seratonin, which causes a relaxation response. A
small piece of chocolate increases endorphins in the brain, which is a natural painkiller. It
works. But overeaters take more of it than they need.
If you subtract, then you must add. Whenever you subtract something from your life, you
must replace it with something else. If you reduce food intake, then you must increase other
sensory pleasures, physical activity and social satisfaction. See handout on stress reduction
for other ways to please the five senses.
To stop doing one thing, then do another in its place. For instance, if you have a habit of
eating in a particular situation, then change your actions in that situation. Much cognitive
and behavior therapy is about developing skills for handling situations directly and
effectively. Then you will not have to resort to food. Think about Jesus parable about the
house filled with demons.
Study what foods made you fat. Delete these from your diet, but use them for rewards.
Keep track of verbal exchanges pertaining to food.
Who does it most of the time?
Equipment needed: small scales for weighing food choices, a scale for weighing yourself, a
notebook for the program and work sheets, possibly a blender for milkshakes, possibly a
tape recorder for creating meditations. © Nancy Carter, LCSW
Principle 9
Exercise and Physical Health
For weight loss, use exercises such as walking, dancing
and weight lifting. Use stretch exercises to help your
flexibility. Use other exercises to maintain skin tone.
When exercising, feel the body from inside out.
Use a tape measure to get your measurements before you start losing.
You will lose about an inch off your hips and waist for every 10 pounds lost, depending on
your size at the outset of the lifestyle change.
Have a doctor's check-up. After weight loss you will have to monitor thyroid, blood sugar
and estrogen. Your doctor should have numbers prior to weight loss to compare to the
numbers you will have within two years after weight loss.
Keep a record of when you feel particularly tired. Is there a particular time of day when low
spirits and discouragement are most likely? These are times we are more likely to eat. What
are the causes of the fatigue? Poor scheduling? Stress beyond your control? What can you
do during times you are tired to recover without eating? Have you tried good music,
conversation with friends or meditation?
Make a list of physical activities you would do if you were smaller.
Begin to observe physical pain that is caused by fatness.
How do you handle sleep problems?
Principle 10
Body Image
Look at yourself regularly in a full length mirror,
including nude. Exercise in front of a mirror. This
is necessary in order for you to learn to love yourself
as you are, and to be able to see body changes as you
lose weight.
Draw a picture of yourself now, and as you will be
after you lose weight.
Fantasize yourself 10 pounds lighter (not all the way down). When you can no longer see
yourself smaller, you will stop losing weight. Think about what you will look like, what
will be different about your life, what will you be able to do that you can't do now?
Take pictures of yourself before weight loss, and every twenty pounds thereafter.
If you can, display a picture of yourself as you will be when you are 10 pounds lighter .
Begin to observe the times that fat seems to protect you.
After the fat is gone, how will you protect yourself then?
© Nancy Carter, LCSW
Principle 11
Self-Discovery
Why do you want to lose weight? Make a complete list.
Facts about your weight problem.
When did you become overweight?
Was there a time of being normal?
What is goal weight?
What sports, other forms of exercise did you formerly like?
What hobbies or interests do you have? Have you given any of these up?
Are any other family members overweight?
What do you tend to eat the most of and when?
What conditions cause you to overeat?
How have you effectively dieted in the past?
Study how many pounds per year you have tended to gain. It is probably about twenty
pounds. So if you lose that many pounds per year your body will not produce the yo-yo
syndrome, and force you to gain the weight back. It is when you lose more than that in a
year that your body rebels. To counter this, stay away from sugar products for about 2 years
until your body stabilizes and your weight loss is secured.
What kinds of things make you feel frustrated and irritable?
Make a list.
How do you handle guilt? Or disappointment when you do not do well enough on your
lifestyle change?
What makes you angry or resentful? Anxious or afraid? Sad or lonely?
How do you handle these feelings and situations?
Do you know how to handle grief? In yourself and in others?
How do you handle the wrong-doing of other people?
Do you know how to make decisions? And do you make them often? Do you refuse to let
other people make your decisions for you? Or do you try instead to "rescue" others by
attempting to decide for them what feelings they should have and actions they should take?
Do you always keep your agreements? Remember that decisions make us human and real,
and agreements are simply joint decisions. They are important to your recovery from misuse
of food and fat.
Do you have good communication skills? Do you know how to talk to people, and to talk
about the right things at the right time?
How do you handle time?
© Nancy Carter, LCSW
Principle 12
Self Image
We cannot say no to ourselves if we never learned to say no to others.
We cannot say yes to others if we cannot say yes to ourselves.
We cannot say yes if we never learned how to say no.
We cannot say no if we never learned how to say yes.
List of assets and deficits.
What do you like best about yourself? Least?
Decide how to strengthen assets, and overcome deficits.
Do you think you are pretty? Sexy? Fun to be with? Lovable? Attractive to others?
Let others compliment you. Seek out the company of those who are encouraging and avoid
those who are not. But don't forget to pay attention to others and give encouragement to
them as well!
Would you like new friends? What kind of person would you like to be friends with? What
kind of person would they seek for friendship? What makes a friend? And what makes
people choose one person over another for friendship?
In what ways are you healing, encouraging, and refreshing to others.
Do you use your energy well, or do you send negative energy to others?
What are your basic rights as a person?
Who are you? What is your life about? How does it feel to be you?
Who do you wish you were? What would make you feel at peace with yourself, and
"comfortable in your own skin"?
What do you believe? About yourself, about others, about morality, about God?
What makes you feel competent, successful, useful and important?
How do you solve problems? Learn how to: research the facts, look at options, choose one
option, act on it, the evaluate the results. If the problem is not solved, then begin again and
use a different option for action.
What do you value the most? What are the least important things?
What principles do you live your life by? How do you define wrong-doing?
What do you want to do with your life? How do you set goals, and what are they?
What is your place in God's Kingdom?
What do you want people to remember the most about you after you die.
© Nancy Carter, LCSW
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