Can cognitive behavioral therapy help with weight loss?

If you’re struggling to lose weight, you may benefit from trying cognitive behavioral therapy (CBT). This therapy approach emphasizes the influence of your thinking over your mood and behavior. It involves identifying your self-defeating thoughts and challenging them with more effective beliefs.

The power of your thoughts for weight loss

It’s not what happens to us that determines how we react; rather, it’s how we think about or interpret the events around us that determines how we react.

For example, if you believe, “I’m not good at nutrition,” then you won’t feel much hope to improve your nutrition.

But a belief such as, “I can decrease nighttime stress eating by eating a mindful dinner (without screens) at least once a week,” gives you more hope you can change.

How cognitive behavioral therapy works for weight loss

In CBT, you and your therapist work together to identify core beliefs and the validity of those beliefs, then question unrealistic beliefs to work toward more effective self-talk and behavior.

Individuals who have dieted a lot tend to have all-or-nothing thoughts, like, “Either I eat perfectly or the whole day’s shot,” or “I shouldn’t eat any cookies, but I caved and ate one – might as well eat the whole box now. I have zero self-discipline.”

After questioning how helpful or realistic all-or-nothing beliefs are, you might find the middle ground by practicing beliefs such as, “Every meal or snack is an opportunity to follow my meal plan – nobody eats perfectly.”

The therapist might team with a dietitian to help you follow a meal plan with one serving of cookies, instead of zero or the whole box.

Change your self-talk, change your behavior

We know that positive reinforcement is more effective than punishment for behavior change. However, we often forget this fact when it comes to weight loss.

We punish ourselves by thinking, “I’m fat and disgusting – I need to buckle down,” when beliefs like, “All I can do is my best,” or “Keep going – one tiny change at a time,” are more effective to motivate behavior change.

When using CBT, therapists will help you set challenging but realistic goals. It’s important to remember that extreme weight-loss goals are often unrealistic.

Is cognitive behavioral therapy right for you?

If you prefer more structured approaches and are willing to practice outside of session, you will likely benefit from CBT.

For individuals with eating disorders, CBT may be part of a treatment plan that will be more involved. Eating disorder treatment is a specialty involving psychological, nutritional and medical care.

Some people prefer acceptance-based approaches like mindfulness or another form of counseling called acceptance and commitment therapy (ACT) over CBT. These approaches emphasize noticing thoughts and feelings without reacting to them, instead of changing thoughts.

How long does it take for cognitive behavioral therapy to lead to weight loss?

CBT is one of the most empirically validated treatments for behavior change. But change is hard, requiring persistence and effort.

Clients need to engage in therapy and complete homework assignments to help them challenge beliefs. CBT tends to be briefer than other treatments, but treatment frequency and length depend on how severe and complex your symptoms are, as well as on your treatment goals.