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Week 10

Welcome to the tenth week of the BTF weight loss and wellbeing programme.

To read the advice, tips and suggestions from our experts please follow the links to this week’s articles below. The other resources you can use are:

  • Expert advice - learn more about thyroid disease and weight management from our medical experts
  • Patient stories – find out about how other thyroid patients have managed to successfully lose weight and improve their wellbeing
  • Community - share your weight loss journey with other people who are taking part in this programme by joining our closed Facebook group

Thinking styles and weight loss

When making important changes in our lives, like losing weight, it is likely that we will have the odd lapse (returning to old habits for a short period of time) or relapse (returning to old habits for longer period of time). At times like these we may experience unhelpful thoughts like the ones below:

"I've cheated. I might as well have some chocolate."

"I should give up now - no point continuing."

"Why do I bother? All my hard work is ruined."

Unhelpful thoughts

These unhelpful thoughts can affect how we deal with lapses as they can get in the way of our efforts to get back on track and our long-term progress.

Examples of some of the unhelpful thoughts we can sometimes have are:

  • Negatives and no positives: Thinking of the negatives in every situation and ignoring the positives. Not giving yourself credit for your achievements.
  • Catastrophising: tending to view the situation as terrible or dreadful. This is linked with negative automatic thinking and the feeling that when something doesn’t go well it is ‘the end of the world’.
  • Black and white thinking: Thinking in all or nothing terms, for example, ’I’m going to follow this strict diet 100% and nothing less.’ With this type of thinking you are either right or wrong, good or bad, there are no in-betweens, no shades of grey, and no middle ground. It is very easy to have negative emotions as a result of thinking this way, particularly when you feel like you have done something that is not ‘good.’ For long term weight loss success we need to find the shades of grey.
  • Jumping to conclusions: mind reading and predictive thinking are the different ways in which someone can jump to a conclusion. Decisions are based on little factual evidence and assumptions can be made which are not always true.
  • Should and must thinking: making unreasonable demands or pressure on self or others, e.g. ‘I should go to the gym three times a week’ ‘I must stick to my healthy eating regime at all times’.

By identifying the unhelpful thinking style you can start to look at the situation differently and in a more positive and balanced light. This might be an opportunity to look back at a time you have had a lapse and how you responded. If you can’t think of one, use this example:

"I had a takeway when I didn't want to. I can't stick to my diet so now I've blown it. I might was well not bother for the rest of the weekend and I'll get back to my diet on Monday."

This black and white (all or nothing) thinking can lead us to feeling that we have in some way failed. As described, reframing our way of thinking can help us to find the middle ground. Could you say to yourself instead: 'I did have a little blip when I had that takeaway. But I am making good progress overall and if I stick with it should be able to stay on track.'

Trying to reframe unhelpful thoughts is not easy. If at times you struggle with unhelpful thoughts and you are struggling to find these 'middle of the ground' thoughts, it can sometimes help to imagine what you would say to support a friend and apply this to yourself. Having good support from family, friends and peers really does help and assists in creating the right environment for you to succeed.

Unhelpful thoughts can often lead to distressing/negative emotions. When we are feeling low in mood, anxious or stressed we may experience these more frequently and we get trapped in these thought patterns. At the end of this article there is a short video that discusses thinking traps.

These thinking traps can lead to unhealthy coping mechanisms to soothe the negative emotions that we feel. Examples of some unhealthy coping mechanisms include food, alcohol and drugs. So, we want to get out of these thought traps. But for some they struggle, and they get stuck, experiencing a lifetime of yo-yo dieting, losing weight, regaining weight and moving from one diet to the next hoping that will solve their issues. With the right support we can break this cycle and develop healthier coping mechanisms. These will help us make healthy lifestyle changes, lose weight and improve our quality of life.

Relaxation

Unhelpful thoughts and distressing emotions/feelings like stress can increase our cortisol and adrenalin levels. When we feel constantly under attack, the fight-or-flight reaction stays turned on that little bit higher than is healthy. Over exposure to stress hormones can lead to problems with anxiety and depression, headaches and poor sleep, weight gain, concentration and memory.

Relaxation is allowing physical and/or mental tension to be released and is a healthier coping mechanism than turning to food. Tension is the body's natural response to threat, part of the body's alarm or survival mechanism. It can be a very useful response, but a lot of the time, we don't need this tension, so it's okay to learn to let it go, and learn some relaxation skills.

Healthy living is a matter of balance. Relaxation is part of the balancing process alongside other aspects of your lifestyle such as what you eat, your physical activity and how you handle stress. Learning to relax takes practice, as with learning any new skill.

  • Reduces tiredness when you can manage everyday life without excessive tension.
  • Improves performance in work, sport or music through self-awareness and control of tension.
  • Reduces pain which can occur as a result of tension e.g. headaches and backache. Relaxation can help you to cope by raising your pain threshold and reducing the amount of pain.
  • Coping with stress. Relaxation helps you to reduce the effects of stress and to breathe effectively.
  • Improves sleep by allowing you to be calm and peaceful.
  • Improves self-confidence by increasing your self-awareness and ability to cope with daily life.
  • Improves personal relationships. It is easier to relate well to other people when you are relaxed and self-confident.

Finding the time for relaxation is an important part of self-care. It ensures we have some time for ourselves, are being kind to ourselves, and allows us to control the things which make us feel better within ourselves.

References

What are Thinking Traps
https://www.youtube.com/watch?v=rfrvrNekzLE

Unhelpful thinking styles
https://www.cci.health.wa.gov.au/-/media/CCI/Mental-Health-Professionals/Unhelpful-Thinking-Styles/Unhelpful-Thinking-Styles---11---Challenging-unhelpful-thinking-styles.pdf

Challenging unhelpful thinking styles
https://www.cci.health.wa.gov.au/~/media/CCI/Consumer-Modules/Back-from-The-Bluez/Back-from-the-Bluez---05---Unhelpful-Thinking-Styles.pdf

Self-help resources
http://www.getselfhelp.co.uk/

Emotional eating
50 Ways to Soothe Yourself Without Food: Susan Albers (2009)

Depression/Low mood:
Mind Over Mood: Christine Padesky and Dennis Greenberger (1995)
Overcoming Depression: Paul Gilbert (2009)

Self-esteem:
Overcoming Low Self-Esteem: Melanie Fennel (2009)

Compassion / mindfulness / values-based approaches:
The Compassionate Mind: Paul Gilbert (2010)
The Happiness Trap: Russ Harris (2008)
Get Out of Your Mind and into Your Life: Steven Hayes and Spencer Smith (2005)

Second hand or electronic copies of these books may be available at a lower price. Public libraries are usually another good source and some GP practices have ‘book prescribing’ or ‘healthy reading’ schemes.

How being active improves weight management and health

Being more physically active means that we are activating our muscles to use more energy either through sport, exercise or reduced sedentary time. Every day we consume calories through carbohydrates, fat, and protein. We use carbohydrates as our main source of fuel and fat is our secondary source of fuel. We rarely use protein as energy even though proteins have many calories.

When we become more active, we use more of the energy that goes into our bodies. This means that if we already eat too much energy (in the form of calories) or do not move enough, this could contribute to weight gain. Changing our behaviour in both areas helps us to manage our weight much better.

By eating a healthier diet with less energy, and by using up more of that energy through physical activity, we can lose weight healthily in the long-term. This is known as energy balance. If we eat less energy than we use in daily activity, we will use stored fat instead. This results in weight loss. If we eat more energy than we need for daily activity, any spare energy is stored as fat. This, in turn, leads to weight gain and the associated risks.

Reducing sedentary behaviour

Two of the biggest contributors to obesity or being overweight are lack of physical activity and sitting for too long. Sedentary behaviour is bad for our health. It often makes us feel even more tired and less likely to exercise.

If we spend too much time sitting down, we are more likely to be overweight and have higher blood pressure. The body will also be less able to use fat as energy as efficiently. This can contribute to higher ‘bad’ cholesterol (or low-density lipoprotein (LDL)) which can increase the risk of heart disease and stroke. Higher cholesterol is also common among those with uncontrolled hypothyroidism. So, this gives us even more reason to do what we can to be active.

When we sit too often, the ability of ‘good’ cholesterol’ (or high-density lipoprotein (HDL)) to clear up the level of ‘bad’ cholesterol that is circulating in your bloodstream is reduced. By sitting less, we can flush ‘bad’ cholesterol from our system leading to reduced risk of heart disease and stroke.

Sedentary behaviour results in deconditioning, which is the opposite to fitness. Our heart will not be as strong. This means it must work harder to pump blood around the body, often resulting in high blood pressure. Our muscles will also be weaker and more likely to get injured in everyday activity, which can lead to further inactivity. Generally, if we are deconditioned, everyday life becomes harder, and we will feel out of breath doing simple activities. Our quality of life becomes reduced as a result.

Keeping our thyroid function within the reference ranges can help us to become less sedentary as our energy levels often start to increase. This is particularly the case if our TSH has crept up and is above the normal reference range. And remember, even if you find you struggle some days, making small changes to your levels of physical activity can help you the feel the benefits of improved energy levels, metabolism and overall quality of life.

Watch

Dr Sue Jackson, shares tips about the importance of language, including:

  • How to manage when you’re feeling overwhelmed
  • Reframing how we describe the things we would like to do can be helpful
Week 9 info Week 11 info