There’s that old joke about a person asking a passerby in New York City, “How do you get to Carnegie Hall?” And the passerby answers, “Practice, practice, practice”.

Well, the direction to take if you need help losing weight is monitor, monitor, monitor.

Why monitor? Because any form of self-regulation requires accurate monitoring to evaluate how you’re doing and to make decisions about how to get from where you are to where you want to be.

When you are trying to shed pounds, there is a lot to monitor. There’s pounds lost. There’s the food you eat—kind and quantity. There’s hunger. Is it for real? Can I wait until dinner? There’s your perseverance. Why can’t I keep this up? There’s willpower. Motivation. Feelings. Difficult daily situations. I’m too tired. The kids are really annoying me today.

Yes, there’s lots to monitor.

What if you wrote out a set of test questions having to do with your problems losing weight? Wouldn’t this be one way to monitor yourself?

Make up the test questions. “Why can’t I keep this up?”— your dieting motivation, for example.

Then put in the answer to the question: “When I have a bad day, I stop dieting and then can’t stop eating.

Next, put what the right answer should be. For example: “when I have a bad day and I want to stop dieting, I can ______________________ “(you fill in the blank).

Remember, evaluating how you’re doing and what you need to do in order to get there are the essentials for good self-monitoring. And good self-monitoring is the sine qua non for successful weight loss.

All is lost!

This is the painful cry of the woman who, after all she lost (pounds, that is), found herself back in the old condition of gaining back weight—and she just lost it (hope, that is).

Oh, she might, as time goes by, go on another diet, and another, and another. But for the time being, now that all is lost (hope, that is), she says to herself, “what’s the difference. I have nothing more to lose” (hope, that is), and she eats up a storm, putting on even more of what she lost (pounds, that is).

If this is you, please don’t believe all is lost (hope, that is). When all that was lost (pounds, that is) comes back, all is not lost (hope, that is)—or at least it doesn’t have to be. It depends on what you believe.

Reminder: it’s only a setback, and if you can think of it this way, then you haven’t really lost it all (hope, that is).

So, see if you can set your mind—not to mind setbacks—at least not to the point of crying “all is lost”. Use what you've gained (hope, that is), and put it toward all you have left to lose (pounds, that is).

Would it help you to have a set of guidelines for losing some weight?

If so, try these on for size.

• Specify realistic weight-loss goals — not just number of pounds to lose, but also the changes you will have to make in the way you eat, think, plan, react, keep motivated, etc

• List the possible positive outcomes and use these as motivation

• Identify what will get in your way of achieving your goals, and think of ways to overcome them

• Plan out the actions you will take to avoid the old triggers

• Practice your new behaviors (attitude, thinking, feeling, ways of coping) each day

• Monitor your practices and keep a diary of how you did

• After a week, review how you did and revise your plans and practices accordingly, making sure you note and work on anything that is still getting in the way

• Review all of this openly and honestly with a trusted confidant

• Keep this up, week after week until you’ve reached your goals

Maria remembered the time when her good friend Wendy dispensed with all the small talk. She was calling Maria back then to talk about her weight. So there was none of the usual chitchat about the mundane and the politically mundane, Wendy got straight to the point. She was alarmed because she had started to gain some of her old weight back. Maria picked right up on this and asked if there was something eating at her. Get that? Eating at her. Wendy said that’s why she was calling Maria. She learned from her struggles with weight, from knowing Maria, and from reading Escape to Thin that emotions and emotional patterns were heavily involved in weight control. So Wendy and Maria made a date to talk more about this.

When they met a week or so later at Wendy’s house, Wendy took Maria into the den, where the two women settled themselves, Wendy on the couch and Maria in an overstuffed rocker close to Wendy. At first, Wendy rooted around for an answer to her weight gain. Maria asked her friend, “Has there been anything different going on in her life?”

“No,” Wendy said. “Not that I can think of.”

Maria followed up by asking Wendy to “Try to name, guess at if you need to, any changes in your life since you started putting on weight.”

Wendy couldn’t think of any changes, and Maria encouraged her to work at it some more. “Try,” Maria exhorted her friend.

Wendy ran through all the usual things in her life. Her children were fine, her marriage was okay, work was work, her parents were healthy. “No,” she said. “Nothing out of the ordinary.”

Maria took a chance at being a pain and tried to get Wendy to narrow down her observations, to think more specifically. Maria knew there had to be something that happened. But Wendy couldn’t get to anything else. She said to Maria that she was back on her old diet, the one that worked so well for her before. So, for the time being, Maria knew that she had to leave it like that. She had learned that people can’t be pushed. Pushing at them wasn’t a form of help. And it spoiled the possibility of helping at a future time.

Once, OK. Twice, understandable. Three times, six times—getting pretty frustrated. More than this—you have a chronic problem. Whatever you do, you just can’t lose unwanted weight.

Diagnosis: Treatment refractory weight loss

In other words, you failed to respond to the usual forms of treatment—dieting, cutting portion size, practice not eating so much, using more willpower, following doctor’s orders, being part of a support group.

Looks like nothing can be done about it, because of all that you tried, and all the times you failed.

Helping someone in your shoes to have successful weight loss is going to require a transformation—from someone who can’t to someone who can take charge of her eating and weight.

This will call for careful attention to what’s been going wrong psychologically for you. Repeated failure is an indication that something needs to be brought to your attention, so you can see it for what it is and then learn to work on it so it’s not in the way.

Try doing it this way and see what you come up with. If you would like professional help, set up an appointment with a mental health professional.