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Think you can't lose weight? Maybe you don't know your own strength, says hypnotherapist Jean Fain, whose blend of attitude adjustment and practical advice works wonders for her clients (and will for you, too).
As if reading from a script, dieters who settle onto my couch start their story virtually the same way: "I've tried everything. Nothing works. I can't lose weight—keep it off—get off this plateau—." With each failed diet, each pound lost and regained, they've grown more desperate. Baggy clothes and crossed arms can't hide their shame. Defeated dieters live with the delusion that no matter what they do, they can't lose weight.

If all goes well, after a number of sessions clients change their tune. "I can't" becomes "Maybe I can," which finally shifts to "I can." En route to their desired weight, determined dieters develop a firm belief in their abilities. I've witnessed this shifting-to-I-can phenomenon many times among long-term weight loss successes.

How do you make that vital change?

New clients often expect me to transform their attitude and figure instantly and effortlessly with hypnotic suggestions. That's fantasy. A good hypnotherapist can help bring about that transformation-by first focusing the client's attention, then offering tailor-made suggestions and images to the receptive unconscious mind-but not without time and effort on the dieter's part. Whether the shift happens in a momentary aha or a gradual dawning, it's unmistakable. Clients at my Concord, Massachusetts, practice and the Harvard Medical School hospital where I teach have literally exclaimed, "I can do this!"

To get clients started, I take a detailed diet history, listening particularly for what has helped and what has hindered their weight loss in the past. Most people who come to me see themselves as total failures; they don't realize they've done some things right. I tell them stories of the dieters I know who are winning the battle of the bulge and describe their individual strategies-which methods they've made use of, which they've tossed. Hearing others' stories gives people an idea of how they might succeed. I watch for the glimmer of hope in their eyes, the momentary identification that could inspire a shifting process in them. The shape-up strategy that arouses the most genuine hope has the best chance.

Learning to get to "I can" is not unlike learning to have an orgasm. You hear your friends' experiences, ask about technique, and explore your own body. Through trial and error, you figure out what turns you on, what turns you off, what satisfies you when you've got ample time or next to none.

Sometimes getting started requires nothing more than sitting back and listening to someone else's story. Here are four different weight loss successes, four women who took their own routes to "I can." So take a deep breath and a leap of faith, and give yourself permission to feel out whether any one of their paths resonates for you.

Next: Putting yourself first
Tending to parents, children, and work, members of the sandwich generation can feel hopelessly overburdened. Billie, a 49-year-old working mother who wanted to lose 35 pounds, was no exception. What was exceptional, given how helpless Billie felt, was that she'd found my couch.

"I don't care enough about myself to care what I eat," this worn-out ad exec confessed. Or to care when she ate, or if she ever got a minute alone. Putting herself last was as automatic to Billie as making coffee. Incessant demands from her business partner, her teenage daughter, and her elderly mother had convinced Billie she didn't have time to peel an orange, let alone leave her desk to eat. Like the Super Size Me filmmaker, she kept eating junk food despite the weight gain and the toll on her health. If she was going to get serious about slimming down and going off blood pressure medication, Billie would have to start putting herself first. Dieting would feel too depriving, she realized, unless she stopped depriving herself of alone time. At first she could find only 15 minutes a day to listen to a personalized hypnosis tape or a Jon Kabat-Zinn mindfulness meditation CD (from (Early studies indicate that mindfulness training significantly reduces compulsive overeating.) But she began setting up regular dates with a masseuse and made it a priority to relax at night with a tape or a book. Recharging her batteries in these small but significant ways allowed Billie to make other positive changes (packing a healthy lunch instead of grabbing fast food, rejoining the gym), and she began losing weight at a most unlikely time-between Thanksgiving and New Year's.

"I am not at my goal yet," she recently e-mailed, 20 pounds lighter. "But I know I will succeed."

There's no shortage of reasons to put yourself last, but promoting yourself to first even a few hours a week makes shifting to "I can" possible. You're taking an important first step out of helplessness, taking charge in the smallest but most powerful way. You're valuing yourself-and giving your mind enough quiet space to think. When you can think, you can begin to see possibilities of what might work for you.

Next: Taking care of business
In a youth-oriented culture, age is notorious for adding the injury of declining health to the insult of increasing invisibility. Whether what's hurting is psychological, physical, or a package deal, managing weight may need to take a backseat to pain management.

Judy, a 56-year-old globe-trotting CEO whose mother had told the young Judy how beautiful she'd be if she were thin and gave her amphetamines at age 14, was too busy to deal effectively with her arthritic knees and debilitating depression. Her ostrich style of managing distress-burying her head in potato chips-had only increased her burden by 50 pounds. It was getting harder to ignore her orthopedist's concern. He wanted to schedule a second knee replacement. Harder still was her husband's indifference to her (since her apple shape had rounded to grapefruit, she feared he'd leave her for a younger woman).

She knew she needed to lose weight, but her knees ruled out running, the only slimming strategy that had ever worked for her. She started hypnotherapy expecting me to tell her what to do. Instead I told her about a depressed client who'd lost 60 pounds while on antidepressants. (Antidepressants have a generally good track record of decreasing binge eating as they alleviate depression.)

"Not another pill!" she told me. Her pillbox was already brimming with joint and heart medications. If the physical pain let up, she was sure the emotional distress would, too. If only she could find nonsurgical relief. That hopeful thought led to a second opinion from a more conservative doctor who was able to treat her pain without an operation and, as anticipated, lift her spirits. Just as helpful were cognitive-behavioral pain management techniques, including recognizing feelings and situations that exacerbate pain and then trigger bingeing. (The same behavior modification techniques helped Judy curb her potato chip consumption.)

Successfully managing her pain left Judy feeling much more capable, allowing her to take care of other pressing business. With a little help from Jenny Craig's home delivery service, she dropped two sizes.

Until you realize that addressing life issues is addressing weight loss, shifting to "I can" is impossible.

Next: Getting what you need
Kim, a 335-pound binge eater, could exercise, but she couldn't stick to a diet. (The keys to lasting weight loss, according to researchers at the National Weight Control Registry, a database of more than 4,000 people who've kept off 30-plus pounds at least one year, include lowering dietary fat to a quarter of daily calories and working up to moderate physical activity-brisk walking, bicycling-60 to 90 minutes a day.) Years earlier, weight lifting had started this 30-year-old teen counselor losing weight, though how much she lost she couldn't say; standard scales don't accommodate people of Kim's size.

For Kim pumping iron was easy compared with counting calories. She could only follow a diet for a while until she ended up bingeing on Twinkies or other high-fat treats. Kim's eyes brightened when I told her about Breaking Out of Food Jail, Jean Antonello's antidiet book that urges readers to eat until they feel satisfied. This all-you-can-comfortably-eat approach to weight loss isn't for everyone, but it worked for Kim. She started shifting to "I can" shortly after reading the paperback and investing in a lunch bag and healthy snacks (dried figs, oat bran pretzels). Other standard weight loss techniques helped, especially keeping a food journal. But whenever she needed a motivational boost, she'd reread Food Jail.

Twenty pounds lighter, Kim never expected to revisit "I can't." But life circumstances change, for better or worse, and sometimes the allure of old habits proves irresistible. For Kim it was the double stress of getting married and buying a house that brought back bingeing and ten pounds. She realized she needed group support. Not any group (she'd found Overeaters Anonymous restrictive and judgmental), but something flexible and supportive. Kim discovered just the group at her neighborhood health center and quickly got back to "I can." Six months after joining this weight loss program, she's lost another 50 pounds.

Next: Rediscovering passion
Tapping into a creative passion can be an exhilarating back road to "I can." It was for Jill, who'd always fantasized quitting her day job to write novels. Never could this 49-year-old single accountant have imagined she would write her way to a healthy weight.

Jill had learned to keep her expectations low traveling the superhighway to thin, from Atkins to the Zone. The 275-pound veteran dieter excelled at losing weight; keeping it off was the problem.

After dropping 30 pounds the first 30 weeks of hypnotherapy, which included suggestions for eating more slowly with more enjoyment as well as images of her active ideal self at a comfortable weight, predictably Jill plateaued. She couldn't imagine exercising more or eating less; her regimen was tough enough already. She could imagine the alternate route I suggested: indulging her fantasy of writing by using her struggle with weight as something to write about. Turning her unwelcome dieting way station into a creative opportunity helped Jill get in touch with her real feelings and gave her a new confidence. Writing didn't replace exercising and dieting, but it allowed Jill to reach two elusive goals: to maintain significant weight loss (53 pounds for three years) and be published (at age 50).

"When I get rid of the self-pity and do the math," she wrote, "I'm left with the ineluctable truth that if I take in fewer calories than I burn, I will lose the weight."

Each of these women found a different route in getting to "I can". Asking for directions can help. But the surest way to get there from here is to consult the diet expert who knows you best: you.

Jean Fain is a hypnotherapist who specializes in eating issues. She practices in Concord, Massachusetts.

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