Weight loss

Postby Louise McDermott » Mon Sep 08, 2003 3:44 pm

I would like to know a little about how to treat weight loss and smoking.

The questions I've been thinking of are:

1. What's the best approach when a person says they've gone down to a certain weight many times, only to find they put it back on again? WHat is it that's not letting them maintain that weight?

It seems like some pattern interruption could be in order - I can only think of the Ericksonian 'get her to put weight on instead of trying to lose it' thing, but I'm not brave enough to try that! What would any of you experienced people do?!

2. I've heard a few people say that they put on weight after giving up smoking. I reckon it's a simple case of people changing their eating habits when they stop smoking (if that could be clarified that would be great!).

I'm thinking that could be examined in therapy, and strategies/info given on how to eat sensibly, etc. I guess the actual question here is, would you tackle the smoking first usually, and ask them to put the strategy in place and see what happens? I suppose they don't know what their natural appetite is like until they've stopped, nor their natural weight.

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#1

Postby Mark Roberts » Fri Sep 12, 2003 11:40 pm

Hi Louise,

In answer to the second question, smoking tends to suppress the appetite. Therefore, there is a tendency for the appetite to increase once the smoker has stopped.

You can also add two other factors to this. Firstly, the sense of taste and smell become improved after the first 48 hours of smoking cessation. This will obviously increase the urge to eat. Secondly, nibbling seems to be an ideal substitute for the "what shall I do with my hands" syndrome.

There are a couple of ways to deal with this problem. You can obviously offer suggestions of various substitutes or suppression of appetite during the hypnotherapy. However, we prefer to offer Instant Substitutes that the client can turn to should they require them. These can range from the habit of drinking a glass of ice cold water, keeping a bowl of fruit and vegetables handy or chewing gum to suppress any pangs of hunger.

As for the "what shall I do with my hands?" syndrome. We suggest carrying a pen around the they can twiddle in their fingers. Short stubby ones work the best as they mimic the feel of the cigarette. Alternatively, chewing sesame sticks can also help as well as suppressing the hunger pangs.

Hope this helps. As I specialise in smoking cessation, if you require any further tips, please let me know.
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#2

Postby Roger Elliott » Sat Sep 13, 2003 1:24 am

Mark's post (welcome to the forums Mark!) has reminded me of a trick that I heard oil rig workers use when giving up smoking. Whenever they feel the urge for a ciggie, they roll a piece of paper into a ball between their fingers.

A good way of dealing with the habitual 'I've got to do something with my hands' element of smoking.

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#3

Postby Louise McDermott » Thu Sep 18, 2003 4:02 pm

Hi Mark,

Thanks for those tips on how to replace the habits around smoking - very useful.

Yes, it does seem to be wise to keep in mind that smoking affects the appetite.

I wonder what's happening though, with those who stop smoking and don't put weight on, or change their eating habits.

It is so helpful to look at those who are naturally getting it right.

Also, a few of the clients I've seen have just assumed that they will put weight on, simply because it's become a well known fact that smoking suppresses the appetite. I think maybe weight gain becomes an issue because at first it's a reason that allows the person to keep smoking. Then perhaps it does become a real fear once the person realises that either way, they really must give up smoking.

I'm sure it's not like that for everyone of course, but it seems to be a trend I'm picking up on in my experience to date.

I read an interesting fact too, about a person needing to put on about 45lbs before the risk to health was anywhere near that of smoking. It's a nice little fact to throw in, I've found. However, I think clients' concerns about weight gain are more to do with appearance/self esteem than actual threat to health . . .

Louise
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#4

Postby Sylvia » Wed Oct 08, 2003 4:25 pm

Hi,

Would it work to simply state: that many people don't put on weight, so there is no reason to expect that they would, but, if they did, would a few pounds be worse than smoking? If you're worried about it preplan your strategies. And then give them tips.

And also I agree with the water, fruit, gum suggestion, too. That's all built right in with my script.

I would also tell them that hypnosis reduces the cravings, etc. so again many people do not experience these side effects.

- and isn't this just another part of the addiction theory we learn about from the media.

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#5

Postby Roger Elliott » Wed Oct 08, 2003 7:13 pm

It's such a clear illustration of both the smoker's optimistic distortion, and our vanity-ridden society that people consider a few pounds extra weight more important than the life-shortening, health ruining effects of smoking. But then, that's what we have to work with, so it's no use me complaining! ;)
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#6

Postby guyb » Wed Oct 08, 2003 7:39 pm

I believe that weight gain on stopping smoking is mainly due to substitution. The smoker feels they have given something up and they therefore fill the hole left by cigarettes.

This is where cognitive therapy is important. If you can move the client from seeing stopping as a sacrifice (I will never be able to smoke again) to a liberation (I will never have to smoke again) then they will not feel deprived. Not only does this stop cravings (which are entirely driven by a fear of being deprived) but it should stop substitution with sweets and food. It usually does with my clients.

If you set substitutes I think you are reinforcing the idea of a sacrifice. The same goes for setting rewards (other than the natural ones of health, energy etc.)

Likewise, if you give them ideas of how to deal with cravings, you are reinforcing the myth of cravings perpetuated by the drugs companies: "when your cravings get really bad, slap on a patch" etc. I would help them through cravings if and when they experience them not set up expectations beforehand.

Also, cravings might feel like hunger, but they are in fact the opposite: the longer cravings go on the easier it gets where the opposite is true of hunger.

Louise, you are right that many smokers use the weight gain thing as a reason to carry on. Another self-deception. As Roger says, what vanity can anyone who smokes actually have?


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#7

Postby Mark Tyrrell » Wed Oct 08, 2003 7:43 pm

Hi, I always remind people about to stop smoking that because blood and oxygen will now have free access around their body's once again they'll have more energy to move and exercise thus raising basal metabolic rate and burning more fat! Stopping smoking makes you healthier-therefore fitter and so trimmer. This is the frame I use anyway. :wink:

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#8

Postby Roger Elliott » Wed Oct 08, 2003 7:57 pm

Great stuff guy, some important insights there. And a very warm and belated welcome to the forums. Good to see you here.

Roger
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