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Yvonne Dolan

ABSTRACT: This article illustrates through a personal case example

how Solution-Focused Brief Therapy concepts can help people lose
weight and keep it off.
KEY WORDS: Solution-Focused Brief Therapy; weight loss.

One out of every three Americans is overweight. Obesity is currently the most common nutritional disorder in the western world
and is occurring with increasing frequency in developing countries as
well (Simopulous, Victor, & Jacobson, 1993). Diets usually fail. According to recent statistics, 95 percent of people who diet regain the
weight they have lost (Gullo, 1995). Many then gain additional weight.
The remaining five percent of dieters who succeed made me curious
about how Solution-focused concepts (Berg 1990, 1994; de Shazer,
1982, 1985, 1991; de Shazer, Berg, Lipchik, Nunally, Molnar, Gingerich, & Weiner-Davis, 1986, Lipchik, 1988; Lipchik & de Shazer,
1986; O'Hanlon & Weiner-Davis, 1989) might be applied to weight
loss and maintenance. After all, no one overeats all the time.
This article will illustrate (through a personal case example) how
Solution-focused concepts such as imagining a miracle (Berg, 1990; de
Shazer 1988), identifying exceptions (de Shazer et al., 1986), scaling
(Berg, 1990) can be utilized to help people succeed at losing weight
and then keeping it off. Included is a Solution-focused Weight MainteYvonne Dolan, MA, The Solution Group, 27866 Meadowlark Drive, Golden, CO
Contemporary Family Therapy, 19(1), March 1997
1997 Human Sciences Press, Inc.



nance Success Scale designed to prevent regaining after the loss has
been achieved.


Among the after Christmas bills came a packet of photographs
including photos containing an image of a person I had known for a
long time. I was dismayed to notice that she had put on a considerable amount of weight. She was me.
Twice earlier that year I had attempted unsuccessfully to diet.
I had celebrated my 40th birthday five years before by losing 15
pounds, but I had not kept it off. In fact, I had gained an additional
five pounds. Then, after a delectable December visit to Belgium
where I stayed at the home of a renowned chef, and indulged in the
world's best chocolate, I had added a couple of pounds more.
As the January snows settled, the problem of my excess poundage
seemed very heavy indeed, and I began to feel depressed. For weeks I
had been telling myself that I would start a diet "tomorrow." Tomorrow had come and gone many times. I felt hopeless.


As a therapist trained in Solution-focused therapy, I knew what I
should do. I had better ask myself the Miracle Question. The relentless optimism that usually colors my beliefs about clients was nowhere to be found when I forced myself to describe my own Miracle.
In fact I felt cynical, jaded, more than just depressed, resistant to
defining what the damned miracle would be.
Internalized Solution-Focused Therapist (ISFT):
If a Miracle happened in the middle of the night while you
were sleeping, and when you awakened your weight problem
had been solved, what would be different?
What would be the first thing you would notice?
ME: Yeah, right. Well, the first thing would be that my clothes
would fit. My jeans wouldn't be leaving bruises on me anymore.
ISFT: Hold on. That doesn't sound to me like the first thing you'd
notice. We're looking for a little sign here, not a huge one.
What would be the first and smallest sign?


ME: Okay, okay. I'd wake up in the morning and I would be in a

good mood.
ISFT: How would that show up?
ME: Well, I would feel active. I would want to do something physical.
ISFT: What would be the smallest thing you could do?
ME: Take a walk or lift weights since I have them in the house. But
dammit, I've done that before, for a year in fact, and I didn't
lose any weight. I just became a more athletic fat person.
ISFT: In the interest of solutions, I'm going to ignore both your sarcasm and your foul language. What would be the next small
thing you would notice the day you woke up after the miracle
had happened?
ME: Well, I guess I would make a point to eat breakfast. I always
skip it.
ISFT: And what kind of breakfast would you have after the miracle?
ME: Something nutritious, light, healthy.
ISFT: And what difference would that make?
ME: I would feel a little bit encouraged, a little bit proud of myself
as I started my day.
ISFT: And what difference would that make?
ME: Oh, shut up. Okay, I admit I would be less depressed.
ISFT: Moving along here, what would be the next small sign?
ME: Well, obviously I would eat a sensible lunch, but since you are
me, you know that once I get past breakfast, the caloric trouble
begins for me.
ISFT: You mean you've never in your whole life ever eaten a sensible,
healthy, weight reducing sort of lunch?
ME: I take it you're looking for an exception, a time, even once,
when I was in control, and you want to know how that happened, and what was different about that time?
ISFT: Yeah. So what was different?
ME: I planned what I was going to eat ahead of time. That made a
ISFT: What else?
ME: Well, when I was thin, I never ate carbohydrates for lunch. If I
eat carbs, I practically always eat too many of them. I've seen
myself do it.



ISFT: Let's get back to the exception here, what did you eat instead
of carbohydrates?
ME: Anything healthy: fruit, vegetables, protein, you know. People
don't get fat because they don't know what is fattening. I know
what I should be eating.

ISFT: So how confident are you that if you set your mind to it, you could
eat the kind of lunch you just described? On a scale of 1-10, just
how much faith do you have that you could do it tomorrow?
ME: Not much. I mean look at my track record.
ISFT: Okay, I know, but pick a number. Just pick one. Be honest.
ME: I'm somewhere between a 1 and a 2. I mean, what comes to
mind, is why bother, it won't make a difference anyway?
ISFT: So what would have to happen in order to raise it to a 3?
ME: Well, if I told someone I was trying to do this, my self respect
would be involved, my credibility as a person.
ISFT: Who might you tell?
ME: My husband.
ISFT: Would that make it a 3?
ME: Yeah.
ISFT: What would raise it more?
ME: If I told some other people as well, a couple of good friends, and
maybe my sister.
ISFT: If you told each of those people, how much would that raise the
ME: It would be a 5.
ISFT: Is that high enough that you would succeed in getting through
ME: No, probably not. This is getting hard.
ISFT: Hey, I'm just asking you the same kinds of questions you ask
your clients and you expect them to answer. What would raise
the number a little more?
ME: If I threw out all the foods that I tend to overeat. Not everything in the house, but the stuff that triggers me to overindulge. It's stuff that isn't healthy for the rest of my household,
ISFT: How much would that raise it?
ME: It would be up to an 8.



ISFT: What would make it a 9?

ME: In order for it to be a 9, I would have to have a few days of
sensible, weight reducing lunches under my belt, so to speak.
ISFT: And then, what would bring it to a 10?
ME: After I had lost the weight and had kept it off for a few
months, then, only then would it be a 10. Back off!
ISFT: We're not done with the Miracle yet. So after lunch, what
would be the next small sign you or someone who cares about
you would notice?
ME: Okay, I would eat a light, healthy dinner, I wouldn't snack.
These things are not news to me. If I could do them, I wouldn't
be fat and miserable.
ISFT: Have you ever managed to eat a light, healthy dinner and not
snack afterwards?
ME: Well, yes, but not in a long time.
ISFT: What was different about those times from a long time ago?
ME: Well, I was busy, or I was distracted from eating, or I was, I
suppose, too sick to eat.
ISFT: When you were busy, what sorts of things were you doing?
ME: Lots of things: work, sewing, seeing friends, cleaning, all kinds
of things.
ISFT: Are any of those things you could do now?
ME: Yes, I guess.
ISFT: After the Miracle, what things might you notice, or another
person notice you doing at night instead of eating? What would
be the first and smallest thing?
ME: Probably taking a walk. I used to love to take a walk after
ISFT: How confident are you that you could do that? On a scale of 1-10?
ME: Oh, God, you're not going to ask me to scale this, too, are you?
ISFT. Yep.
ME: Okay. 5.
ISFT: What would make it a 6?
ME: If I set up a time to go walking with another person after dinner.
ISFT: And what would raise it a little more?
ME: If I had other things planned as well, if I made a list of them
and did at least one each night after dinner.


ISFT: And how much would that raise it?

ME: 8. And that is high enough. Get off my back!
ISFT: We're not done, yet. Are you willing to do the things you identified for the next week?
ME: I don't know.
ISFT: Well, what difference would you imagine it would make if you
did that for one week?
ME: I would feel better. I'd probably have lost a little weight.
ISFT: How confident are you that you could do that this week if you
ME: Well, if I "chose," I could certainly do it.
ISFT: How motivated are you on a Scale of 1-10?
ME: Well, maybe a 3.
ISFT: What would raise it?
ME: If I looked in the mirror.
ISFT: Okay, if you imagine looking in the mirror how much would
that raise it?
ME: Well it depends what I imagine seeing when I look in the mirror.
ISFT: Well, what do you want to imagine?
ME: Myself thin, of course.
ISFT: Hmmm.
ME: Okay, okay? I'll do it. Just the thought of looking in a mirror
right now terrorizes me. I'm an 8. No. When I really think
about those pictures, I'm an 11!
ISFT: The motivation scale I gave you was 1-10. You were supposed
to scale it somewhere between 1 and 10.
ME: Now I'm off the scale, my motivation is off the scale! Are you
ISFT: I think you have now managed to become a weight loss customer rather than just an overweight complainant.
ME: What was that about?
ISFT: I thought I would compliment you. It's part of the approach.
ME: Well, thanks, I guess.
ISFT: I'll be seeing you.
ME: You will?
ISFT: You bet. Later tonight when you walk over to that refrigerator,
I'll be there, inviting you to scale your motivation. And tomorrow when you go by the bakery. And Saturday when you go to
that Italian restaurant. And then next week . . .
At the end of the first week, I had lost three pounds. I steadily
lost approximately one pound a week for the next four months. Every



day and at the end of each week I used scaling to assess my motivation and confidence that I could succeed in the goal of becoming thin.
If I had a slip-up in terms of sensible eating, immediately afterwards,
I used scaling to rate both my motivation and confidence that I could
succeed, identifying the specific behaviors needed to raise both my
motivation and confidence to a 10.
To address the statistical likelihood of regaining the lost weight, I
have invented daily and weekly versions of a Solution-focused Weight
Maintenance Success Scale based on the behaviors I identified as exceptions to overeating. This scale could be altered as needed for different people to include individual behaviors associated with successful
weight control.


Today I remained within a healthy range of caloric intake

Today I scaled my food control confidence level before each meal
Today I ate sensibly
I did not give into the urge to overindulge in trigger" foods
I have exercised within the last 24 hours
I spent some time relaxing unrelated to food
I spent some time today exploring creative interests unrelated
to cooking or food


My weight is within normal range

I exercised at least four times this week
I scaled my food control confidence level before each meal
I avoided trigger foods
I relaxed each day in some way unrelated to food
I spent some time this week exploring creative interests unrelated to cooking or food
I voiced my intention to remain in control of my weight to a
person whose opinion of me I value

So far (five months later), the weight has stayed off. While research is needed to further substantiate this, my experience suggests



that a Solution-focused approach is a potentially valuable resource for

people seeking support and assistance with weight loss and weight

Berg, I. K. (1990). A solution-focused approach to family based services. Milwaukee, WI:
Brief Family Therapy Center.
de Shazer, S. (1982). Patterns of brief family therapy. New York: Guilford.
de Shazer, S. (1985). Keys to solutions in brief family therapy. New York: Norton.
de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar, A. Gingerich, W., &
Wiener-Davis, M. (1986). Brief therapy: Solution-focused development. Family Process, 25, 207-222 .
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton.
de Shazer, S. (1991). Putting differences to work. New York: Norton.
Gullo, S. B., (1995). Thin tastes better. New York: Dell.
Lipchik, E., & de Shazer, S. (1986). The purposeful interview. Journal of Strategic and
Systemic Therapies, 5 (1-2), 88-89.
Lipchik, E. (1988). Purposeful sequences for beginning the solution-focused interview.
In E. Lipchik (Ed.), Interviewing (pp. 105-117). Rockville, MD: Aspen.
OTJanlon, W., & Weiner-Davis, M. (1989). In search of solutions. New York: Norton.
Simopoulos, A. P., Victor, H., & Jacobson, B. (1993). Genetic nutrition: Designing a diet
based on your family medical history. New York: Macmillan.