Clinical psychologist Brenda Temblador works with patients preparing for weight-loss surgery at Baystate Medical Center, but notes some of the counseling she does can be applied to anyone looking to better manage their weight.
“Mindset is probably the most important part of losing weight and trying to be healthy and live healthy,” Temblador said.
“We talk about mindfulness all the time in this program. We think about what am I doing, what am I eating? Is this portion of food the right amount for me?”
She adds, “We encourage people to think about this not on an anxious, obsessive level but to really pay attention.”
“Am I hungry? Am I not hungry? Am I full,” said Temblador who is clinical supervisor in the hospital’s adult outpatient behavioral health department.
Additionally, she said it is also “important for people to assess why they want to lose weight and give themselves a clear vision of what goals they have and what are the difficulties going to be in trying to achieve them.”
“It is important to pay attention to all of these things before embarking on some kind of eating plan and is really vital for success,” said Temblador who holds a doctorate in her field and has worked at Baystate for more than two decades.
She said she talks “a lot about emotional eating” with her patients.
“How much of what they are eating and the choices of what they are eating have to do with more emotional motivations rather than I am hungry and I need to eat something,” Temblador said.
She said it is good to be aware and to apply mindfulness if “whenever I am having some sort of uncomfortable emotion and I am trying to get rid of it, I find food and the food makes that emotion go away.”
“For example, I am having a really bad day at work and I am leaving and I think I will have some chocolate. The idea of eating chocolate is going to make me feel better. We all do that to a certain extent and that is not problematic,” Temblador said.
“But when I regularly deal with anxiety or depression or sadness by eating then it becomes a habit and difficult to change and that is where mindfulness comes in."
She added, “Am I eating just to feel better? Am I having a craving that has nothing to do with being hungry and time for a meal?”
“It is important to pay attention and guard against that because the more I do that the more I engage in emotional eating and the easier it will be to engage in emotional eating,” Temblador said.
“Trying to resist that is going to be hard but necessary to stop this emotional eating habit.”
Temblador helps patients address this habit by teaching them “mindfulness exercises.”
“We can do this very intensely by doing things like eating slowly, chewing your food and tasting it as you are eating,” Temblador said.
“Also, preparing a meal and looking at it. Making decisions on what is the right amount of protein, the right amount of vegetables on my plate. Being very thoughtful about it. Paying attention.”
Temblador said she sometimes asks “people to plan what you are going to eat.”
“So, when are having a bad day the plan is there that you will eat a healthy salad,” Temblador said.
“It is more likely you will eat the healthy salad that is on the plan then if there is no plan and you are just going to try to fulfill that craving quickly and easily.”
She also cautions her patients that “being very negative or punishing or beating yourself up – all of those kinds of things – is not at all helpful.”
“The people I see have berated themselves all of the time or been berated for failing,” Temblador said.
“Every time they do something wrong, they get on the scale and it goes in the wrong direction and they feel like a failure. It is important to push that aside and figure out what has happened.”
Temblador added, "Don’t berate yourself for doing something you feel is not a good thing, but say, ‘OK, I can start right now to change,’ and be again in this moment to move forward and not wait until Monday.”
She cited the example of someone having one slice of cake and at least “feeling good about that” as opposed to their past behavior of “eating much more than that.”
Temblador said people have different motivations for wanting to lose weight. She said a health scare can be the “biggest motivator,” but does not always sustain motivation especially if it resolves.
“People needing to lose weight in order to have bariatric surgery may also be motivated by the desire to move better, play with their children, get on the rides at Six Flags, and embarrassing events that have been very crushing to them,” Temblador said.
“Some of these things can be motivating enough to get them started and maintain their motivation.”
She added, “Getting started and keeping motivated is the hardest thing ever for everyone.”
“I focus with everyone on what are the things that are going to keep you motivated when, for example, you are at Thanksgiving dinner and all of the stuff you are not supposed to be eating is right in front of your face,” Temblador said.
“Or, mom comes and says, ‘I made this for you,’ and you realize that is not something you should eat. We work on what is going to motivate you through those situations.”
She termed “preparing, planning ahead, keeping yourself focused on what you are doing” as “all of those things that can help people.”
She also said that family support can be a “make or break kind of thing for a lot of people” trying to lose or manage weight.
“Sometimes I have conversations with folks, asking how does your family feel about you wanting to have weight-loss surgery,” Temblador said.
“I go into great detail, saying what will it mean to them if you go to the Christmas dinner and don’t eat their dish. Would it make more sense to talk to them ahead of time and say this is what I am doing so I am going to have to give up certain things or change things, and can you help me with this and support me with this?”
She said she encourages her patients “to get family support and that way they can really be helpful.”
“Families sometimes have a hard time maintaining good healthy habits too, but if they are aware and they are part of the plan, there is a better chance they will stick with supporting the person,” Temblador said.
“Just being open and honest a good amount is vital.”
She said she sees varied strategies among her patients in terms of social events around food.
“Some people will say I just decided to try a little bit of everything and that might be satisfying,” Temblador said.
“I have had other people bring a dish to the meal that they can contribute and they will have that rather than the other things. I have had people avoid going to these situations because it will be too hard not to have the foods that are there or avoid having large quantities of it.”
She added, “A lot of people I see have had problems with weight for a long time, and have not been able to get it under control and have maybe tried all sorts of different things.”
“Some work temporarily but usually none work forever,” said Temblador of different diet trends.
“For them weight-loss surgery may be the answer."
What does Temblador suggest in general to people trying to better manage their weight?
Here are some of her tips:
"Start with small goals.
To say I want to lose 100 pounds is probably not sustainable.
Don’t go to extreme with an eating plan.
Do one where you can maintain the level of eating.
Eating healthy is a main goal for me, though my patients have other goals and this is where I say, ‘What is doable for the rest of your life?’
If having a protein shake twice a day is not your thing, then sustaining that is probably not the tactic you should use.
If eating three meals a day with reasonable portions is something you can sustain, then that is what you should try to do and not worry about how much weight you are going to lose or losing a lot quickly.
It is about what is sustainable, what you can maintain over the rest of your life."
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