© 2001-Present Cookie Rosenblum, M.A

© 2001-Present Cookie Rosenblum, M.A. | RealWeightLossRealWomen.com

Essential Worksheets

Table of Contents

Lesson One: Miracle Question (Think) 1

Lesson One: Creating Your End Game (Think) 2

Lesson Two: Physical Hunger Scale (Eat) 3

Lesson Two: Before I Eat (Eat) 4

Lesson Two: Food Journal (Eat) 5

Lesson Three: CTFAR (Think) 6

Lesson Three: Top 3 Daily Feelings (Think) 7

Lesson Three: 4 Steps to Change Your Habit & Rewire Your Brain (Think) 8

Lesson Four: Start Here with Whatever You Weigh (Think) 10

Lesson Four: Ideas for My Self-Care (Love) 12

Lesson Five: Sensations vs. Emotions (Think) 13

Lesson Six: How DO You Recover from a Slip? (Eat) 14

Lesson Six: Leave Perfectionism at the Doorstop (Think) 15

Lesson Seven: Evaluate Your Food (Eat) 17

Lesson Seven: My Helpful and Unhelpful Foods (Eat) 18

Lesson Eight: Recognize Your Stress (Think) 20

Lesson Eight: Handling Stress Differently (Think) 21

Lesson Nine: My Reasons for Losing Weight (Think) 23

Lesson Nine: Do More of This and Less of That for Your Ideal Self (Think) 24

The Five D’s of Busting an Urge to Binge or Overeat (Think) 26

Daily Check-In (Think) 28

EAT - THINK – LOVE: Putting It All Together (Think) 29

Figure Out Your Slip (Eat) 30

Changing Your Habits for Good – The If / Then Tool (Think) 31

How to Create Self-Care in Your Life Right Now (Love) 32

Stop Eating When You Are Lightly Satisfied (Eat) 35

The FREEDOM Group | Essential Worksheets Page | 1


Lesson One: Miracle Question (Think)

When you are trying to envision a future without emotional eating and the

extra weight it brings, it can be hard to see past your situation right now.

Imagine that you go to bed tonight. And while you are sleeping, a miracle

occurs. The eating problem and the extra weight that you struggle with are

gone. You are at your natural weight.

1. You wake up and get out of bed, washing up and getting dressed. How are things

different? What’s it like looking in the mirror? How do you move? Feel? What does your

body look like?

2. You move through your day. What happens when you sit down and eat breakfast? How

are things at work? What is your demeanor like? How do people respond to you?

What’s different?

3. What happens when you go to lunch? Are you acting differently? How about when you

choose what to order in a restaurant?

4. You leave work and stop at the grocery store before coming home to cook dinner…

what’s different for you being in the store? How are you thinking about dinner? What

are you cooking?

5. It’s the end of your day. Are you feeling a different level of energy than you usually feel?

What are your plans for dinner? For the evening? How is this different than what is

typical for you?

6. Looking at your day, overall, what feels the same and what feels different if this miracle

had occurred and your weight was no longer an issue?

7. If zero (0) represented the worst feeling, and the best feeling was rated at a 10, what

number were you after the miracle occurred? And in your real life, what number are

you at now? What would have to happen to move you up the number scale one notch

higher, right now?



Lesson One: Creating Your End Game (Think)

1. When I get to my ideal weight range, how will I feel? 2. What kind of clothes will I wear? 3. How will I act at work, with friends, in relationships? 4. Will I treat myself differently than I do now? What will that look like? 5. How do I imagine people treating me? 6. What would I love to do that I don’t do now? 7. To sum up, what is my vision of how my life will be transformed when I am

in my ideal weight range? (Hint: focus on the feelings.)



Lesson Two: Physical Hunger Scale (Eat)

-10 -8 -6 -4 -2 0 +2 +4 +6 +8 +10 -10 Starved! Will definitely overeat

-8 Too hungry to make good choices. Will overeat

-6 Seriously hungry

-4 Strong hunger

-2 Slightly hungry

0 Neutral, not full, not hungry

+2 Comfortable, satisfied

+4 Ate a little too much

+6 Uncomfortable, sluggish

+8 Stuffed, stomach may hurt

+10 In pain! Beyond Thanksgiving stuffed

Your goal is to eat when you are a little hungry and stop when you are comfortably satisfied (from -2 to +2).

This is basically how naturally slender people eat… not people on a diet, just people who eat when they are hungry and stop when they’ve had enough.

We call this “eating between the 2s” for short. ☺



Lesson Two: Before I Eat (Eat)

Before you eat, use this worksheet to ask yourself important questions and learn more about what your body really needs.

1. Am I hungry? If yes, at what level?

2. If hungry, what food do I want?

3. How do I want to feel after I eat? Will eating this food give me that

feeling when I’m done?

4. If I am not hungry, what am I feeling?

5. What is the thought that is causing that feeling?

6. What do I really need?

7. Do I need to ask for support?

8. What’s my plan?



Lesson Two: Food Journal (Eat)

Today’s Date: My Weight:

Meal 1 Time I Ate:

Hunger Level Before Eating: ______ Hunger Level After Eating: ______

What I Ate:

Meal 2 Time I Ate:


What I Ate:

Meal 3 Time I Ate:


What I Ate:

Meal 4 Time I Ate:


What I Ate:

Meal 5 Time I Ate:


What I Ate:



Lesson Three: CTFAR (Think)

Use the right two columns to take notes or write out examples.

C ircumstance: • External and objective • Something that happens in the

world • In the moment, you have no

control over the circumstance

T hought: • A story you create in your mind • A sentence about the

circumstance • How you would describe the

situation

F eeling: • An emotion you experience

which is caused by a thought • Can be expressed in a single

word

A ction: • A step you take based on your

feeling

R esult: • End product of the action • The result may be desirable or

undesirable



Lesson Three: Top 3 Daily Feelings (Think)

On a daily basis, what are your most common feelings?

1. 2. 3.

Why do you think you have these feelings on a daily basis?

What do you think this says about you and your life?

Are you content with these feelings on a regular basis?

What would need to happen for you to change these feelings?

What would you like your top three feelings to be?

1. 2. 3.

How do you believe your life would be different if you lived from the feelings you want instead of the feelings you have?



Lesson Three: 4 Steps to Change Your Habit & Rewire Your Brain (Think)

Reprinted with permission from the author, Dr. Amy Johnson (DrAmyJohnson.com)

#1. View your urges as “neurological junk” (Re-label)

Stop believing the urges signal a real physical or emotional need and stop assigning them any value or significance.

View them as automatic brain messages generated in your Lower Brain that deserve no attention. They are coming from a programmed machine—no different than your alarm clock or screensaver.

#2. Separate your Higher (human) Brain from your urges (Reframe)

Realize the urges aren't really you; your true self is much more than the animal, Lower Brain. Your Higher (human) Brain gives you the ability to ignore the urges.

Your urges are powerless to make you act. Your Higher Brain, not your Lower Brain, has complete control over your voluntary actions.

The urges are no longer threatening because you are “above” them, metaphorically and in terms of brain structure.



#3. Stop reacting to your urges (Revalue)

Stop letting your urges affect you emotionally. Simply let them come and go without getting wrapped up in them. This makes the urges tolerable and rather easy to resist.

Fear, frustration, fighting against them, talking back to them, and trying to reason with or figure them out has made them stronger over time.

They aren’t you; they can’t hurt you without your input, and they aren’t personal. It is safe to ignore them.

#4. Stop acting on your urges (Refocus)

When you stop obeying the urges, your brain rewires around a new normal of not acting on the urges.

Your urges will taper off quickly once you stop acting on them.



Lesson Four: Start Here with Whatever You Weigh (Think)

Ah, the dreaded scale.

Our goal here is to take away the bad feelings we get when we get on the scale

and see a number that we don’t like. First, know that all numbers on the

scale are neutral. There is no such thing as a bad number. When you get

on the scale, the number you see means, ‘this is my starting place’… and if you

get any bad feelings when you are on the scale, it’s simply because of what

you’re telling yourself.

So, I’d like you to weigh yourself three days in a row.

Look at the number on the scale, record it, and then write out your responses

to the prompts below. No matter what the number is, you are not allowed

to beat yourself! Seriously, in order to move forward, I want you to see what

comes up (your thoughts) when you see your number. Notice it and see if you

can think of the number on the scale in a more neutral way.

Here’s an example:

Number on the Scale: 187

Initial Thought: I’m so fat! What’s wrong with me?

New Thought: 187, that’s a great place to start. Or: 187 is okay, I’m in the process of getting to a lower weight.

Now it’s your turn! Choose three days in a row to complete this exercise. Use the next page of this worksheet to record your answers.



Day 1

Number on the Scale: _________

Initial Thought: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

New Thought: ___________________________________________________________________

___________________________________________________________________ ___________________________________________________________________ Day 2


Initial Thought: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

New Thought: ___________________________________________________________________

___________________________________________________________________ ___________________________________________________________________ Day 3


Initial Thought: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

New Thought: ___________________________________________________________________

___________________________________________________________________ ___________________________________________________________________



Lesson Four: Ideas for My Self-Care (Love)

Now it’s your turn to start your own list of self-care choices.

Add some of the ideas from the previous page that appeal to you. Add others that you’re already doing or have always wanted to do. Get creative! Have fun with it. And remember, self-care doesn’t have to cost money or take up a lot of time. Some ideas on your list might be luxurious and extravagant. Others will be very simple, inexpensive, and/or take very little time.

As long as it makes YOU feel good, it’s worth it.

The FREEDOM Group | Top Worksheets Page | 13


Lesson Five: Sensations vs. Emotions (Think)

Use this worksheet to learn how to recognize and separate your physical

sensations like hunger from your emotions.

Describe the physical sensation of hunger:

Describe the feelings that might make you think you’re hungry:

Example: My stomach feels empty and makes noises

Anger: I want to use food to stuff down my fury

Example: My mouth gets wet Loneliness: I am comforted by warm, yummy food when alone



Lesson Six: How DO You Recover from a Slip? (Eat)

Use this worksheet to help you realize that a slip is not the end of the road.

You can recover from it and here’s how:

Recovering from a Slip Step-by-Step:

1. Acknowledge What

Happened

2. Define It

3. Play Detective

4. Contain It

5. End It

6. Get Clear

7. No Drama

8. Make a plan



Lesson Six: Leave Perfectionism at the Doorstop (Think)

Use this worksheet to help you leave perfectionism at the doorstep.

Your goal is to begin to take actions and aim for a ‘B’ instead of an ‘A+’.

This is not to say that you shouldn’t do your best in any endeavor. But if you

fall short, it’s really important not to negate the progress you’ve already made.

And when you let perfectionism be your guide that is exactly what happens.

You take actions that aren’t perfect, so you give up and add to the damage and

then beat yourself up.

Don’t stop. Just see where you are. Keep going.

And know that sometimes your life grade might be a B. And that’s okay.

Imagine this: you plan what you’re going to eat for the day, but a friend surprises you and brings over a bag full of your favorite candy. You indulge and eat some of it.

A. Old way – You eat it and say, ‘what the heck, I’ve blown it!’ finish all the candy plus more and overeat until you go to bed… ready to start over tomorrow.

B. New way – you see where you are and make a mental note, without judgment of what you did. Notice your thoughts leading up to it.

C. You let go – of this eating incident and stay on your path for the rest of the day.

D. You continue – on track with a small bump in the road, instead of a complete roadblock. No starting over. No self-beating. No saying ‘what the heck!’



Now it’s your turn:

Imagine that you are on your path, living your life and trying to stop

eating without hunger. But something happens to derail you. Let’s walk

through the process of planning out some possible ways you might

handle this using the model on the previous page.

Describe the situation:

1. Old way – What would you have done in the past?

2. New way – Evaluate where you are now.

3. Let go – How can you let go and move on, while staying on your path?

4. You continue – How will you continue for the rest of the day?



Lesson Seven: Evaluate Your Food (Eat)

Name of food you are evaluating: _______________________________________________

1. Is it nourishing by your standards? Why or why not?

2. Does it satisfy you for long enough? Does it hold you at least 2 hours

when you eat it at a -2 to start?

If your answer is no for this food, do you know why it isn’t satisfying

you for at least 2 hours? (quantity, quality, processed, etc.)

3. Does it give you energy? Or does it make you lethargic?

4. Is it easy to stop eating at a +2? Or does it trigger compulsive eating

before, during or after eating it?

5. Do you gain, lose or maintain weight when you eat it regularly?



Lesson Seven: My Helpful and Unhelpful Foods (Eat)

It’s time to begin noticing which foods are helpful and which are not so helpful to you. Pay attention to foods as you eat them and make a note about how they make you feel, how your body reacts, and what the overall end results are when you eat them. Use the previous worksheet “Evaluate Your Food” to guide you when making notes.

My Personalized List

My Helpful Foods My Observations



My Personalized List

My Unhelpful Foods My Observations



Lesson Eight: Recognize Your Stress (Think)

Take notice of what you are thinking and feeling when you experience stress. Begin a list of how stress shows up in your life, your body, and your mind so that you can be more aware of it. The sooner you recognize stress the easier it will be to make a different choice for how you handle it.

My Physical Symptoms Most Common Thoughts

Most Common Feelings Actions I Usually Take

Actions I Usually Avoid My Common Patterns



Lesson Eight: Handling Stress Differently (Think)

Now that you recognize how stress shows up in your life, you can choose to handle it in ways that will serve you instead of ways that are ultimately unhelpful.

Actions I usually avoid that I could choose to take because they would be helpful to me during stressful times: (For example, going to bed early)

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Alternatives to unhelpful actions that I could take instead:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Self-care options that I can practice when feeling stressed instead of eating:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________



How can I remind myself that food is not helpful when stressed? Write a note here to myself that I can read when feeling like I want to eat in response to stress:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

What is my “Stress Plan”? I know I’m stressed because ________________________ ________________________

________________________ ________________________ ________________________

________________________ ________________________ ________________________

And when I _________________________ I normally do this: _________________________

_________________________ _________________________

_________________________ _________________________

_________________________ _________________________

Instead, when I notice that I’m stressed I will do this:

____________________________ ____________________________ ____________________________

____________________________ ____________________________ ____________________________

____________________________ ____________________________ ____________________________



Lesson Nine: My Reasons for Losing Weight (Think)

List all the reasons you want to lose weight. ALL of them. Then determine

what type of motivator each reason is (internal, external, big picture, or

instant gratification).

All the Reasons I Want to Lose Weight:

What Type of Motivator Is This Reason?

Internal External Instant

Gratification Big

Picture



Lesson Nine: Do More of This and Less of That for Your Ideal Self (Think)

To refresh your motivation, you need to keep your Big Why front and center AND you need to create reminders of the small things you can do more of or less of at any time in order to keep yourself moving forward. Think back to a time when you felt you were at your personal best. (We’re not talking about perfection here.) This is a time when you were at your best, happiest, and most proud. Perhaps you achieved something or simply felt peaceful. Imagine this time as a snapshot of yourself. What were you doing? Who were you with? What other details can you fill in? Write about your personal best here: Why is this particular vision of yourself at your personal best meaningful? What does it symbolize about how you want to live your life? How does it represent your ideal self?



Now let’s create a list of small steps you can take that will bring you closer to your personal best and refresh your motivation for your weight loss goal. Keep these ideas handy so they’re readily available. Use them when you feel less-than-motivated or you need a quick and easy way to see that small steps will make a difference. This is one way to easily refresh your motivation when it seems to be evaporating. What do I want? What is my goal? ______________________________________________ What do I need to do more of in order to get what I want, reach my goal, and be my personal best? (Thoughts, feelings, actions)

What do I need to start doing that I’m not currently doing in order to get what I want, reach my goal, and be my personal best? (Thoughts, feelings, actions) What do I need to do less of in order to get what I want, reach my goal, and be my personal best? (Thoughts, feelings, actions) What do I need to stop doing that I’m currently doing in order to get what I want, reach my goal, and be my personal best? (Thoughts, feelings, actions)



Bonus Worksheets

The Five D’s of Busting an Urge to Binge or Overeat (Think)

1. Distract – Have a distraction rule or plan: list some things you can do to buy time before you start to eat. Think of things you can do at home, out, with people and alone. Be creative and use all your senses. You aren’t avoiding the urge; you are weakening the urge by allowing it to come up and not responding to it. The idea is that you are helping yourself pause and remember what you really want. Be prepared with ideas of what you can do so you are ready when the time comes.

2. Delay – Set a timer on your cell phone, alarm clock or computer for 8 or 11 or 13 minutes. Actually, do this, don’t just guess. You are going to allow time to pass while you sit with the urge. Notice the thoughts and feelings that come up. Create space between the urge and you, so you can wake up the front part of your brain, see the big picture, and not respond to the urge. Doing this helps you quiet down the lower brain, so you can see what is happening objectively.



3. Distance – Create a physical space between you and the object of your desire. Remove yourself from the scene of the crime. Get out of the kitchen. Get away from the food to create the pause so you can see what is happening. This will take away the visual trigger of the food and allow you to think more clearly. Go to the restroom if you have no other options. Remind yourself what’s important.

4. Download – Sit down and write. What are you thinking? What are you feeling? Ask yourself: Is this true? No judgments, just a download to help you get clear and see your thoughts written out. Get them out of your head and onto paper.

5. Decide – Consciously decide if you are going to eat, and if so, what and how much. Nothing just happens; we always decide. Use the higher part of your brain and make a conscious decision. Own it and say it out loud. “I know I’m not hungry, but I’m going to eat this. I know there will be a result and I’m going to contain it.” Keep this separate from all other eating decisions. If you do decide to eat when you’re not hungry, then wait to be hungry to eat again. Not to punish yourself, just to get back on track and wait until you are hungry again.



Daily Check-In (Think)

• How am I feeling today?

• What thoughts are causing those feelings?

• How do I want to feel?

• What can I think to feel that way?

Eating Plan for today:

Movement plan for today:

Rewards/Breaks/Play for today:

If/Then:

Mantra for the Day:

Brag:

Grateful:



EAT - THINK – LOVE: Putting It All Together (Think)

EAT THINK LOVE

MO

N

TU

ES

WE

D

TH

UR

FR

I

SAT

SUN



Figure Out Your Slip (Eat)

Use this worksheet each time you slip so you can fail forward and learn from the slip. The goal is to learn and not give up. 1. What was I trying to do? 2. What went well? 3. What didn’t go well? 4. What would I do differently?



Changing Your Habits for Good – The If / Then Tool (Think)

Heidi Grant Halvorson, Ph.D. created a tool that is wonderful for use in changing our habits. The ‘If / Then Tool’ lets you plan in advance, what you will do if one of your habit triggers happens. For example, let’s say you are trying to watch the quality of the food you eat. And you know that when your co-workers order pizza, you usually cave and have more than you need. That may be because you don’t have a plan in place, and you may have exhausted your willpower during the course of your day. So, when the pizza is in front of you, you don’t have the mental energy to even think about it. And the next thing you know you’re eating it. The point is not that you shouldn’t have pizza, but that you get to decide if, when and how much you have. So ahead of time, plan for it. “If the gang orders pizza, I will have one slice and the salad I brought.” This will let you make a quick decision that will send you in the direction you want to go, and you’ll feel good about it. No willpower required. It’s like programming your brain. Here is some practice for planning ahead using the if/then tool: 1. Situation coming up:

2. My usual behavior when this happens:

3. How I’d like it to be different:

4. If ______________________ happens, I will _____________________.

5. The outcome I can picture happening is __________________________.



How to Create Self-Care in Your Life Right Now (Love)

1. What are you doing now that might be considered self-care?

2. Do you recognize a lack, a place where you need to insert some care?

3. What do you do that’s just for you?

4. What makes you feel good at the end of a day?

5. What do you hunger for most?

6. If your biggest wish could come true, related to how you live your life,

what would it include that you don’t do now?

7. What did you love doing as a child that you don’t have time for now?



8. What are some mantras you could adopt that would instantly make you

feel better?

9. Do you plan for how to feed yourself? How can you start doing this AND

make it easier and even possibly fun?

10. What is your strategy to claim 10 – 15 minutes a day for yourself, if for

no other reason than to have time to think?

11. What do you do that involves multitasking? What are you willing to stop

doing?

12. When you find yourself eating emotionally, consider it a signal that you

are out of balance. Next time you do it, figure out what it means.

13. How can you bring more laughter into your life?



14. What is one tiny change to your eating you might try?

15. Would you make time for music? When? Where? Which music?

16. Help someone else and see how good you feel.

17. What do you need help with? Who can you ask?

18. Allow yourself to figure this out imperfectly. Why is it okay to not be

perfect?

19. How can you be more compassionate with yourself?

20. What physical goodies can you give yourself? Here is where you can do

that warm bath, a mani or pedi, a facial, a massage, and light those

candles!



Stop Eating When You Are Lightly Satisfied (Eat)

In order to learn how to stop eating when your body is physically satisfied, it will be helpful to practice stopping, and see what thoughts come up for you. Print out several of these worksheets and fill out one for each meal whenever you want to practice this skill. Here are your directions:

1. Decide that you will stop eating when your body is at a +2.

2. Start your meal and note your hunger level when you start:

3. Midway through your meal, pause and assess your hunger level:

4. If you are at +2 or above, stop eating.

5. What thoughts come up?

6. If you are below +2, continue eating.

7. Three-quarters through your meal, pause again and assess your hunger

level:

8. If you are at a +2 or above, stop eating.

9. What thoughts come up?

10. At the end of your meal, pause and assess your hunger/fullness level.

11. What are your thoughts?



12. If you have thoughts that urge you to keep eating without physical

hunger, what are some options for how you look at these thoughts?

13. Is this thought absolutely true?

14. Will following this urge to eat without hunger take you closer to or

further from your goals?

15. Is this urge to overeat simply a brain habit? If you are no longer hungry,

can you consider that you are just used to thinking, feeling and acting

like continuing to eat is your best option?

16. What do you choose to do? What will take you toward the woman you

wish to be? What choice will make you proud?

17. Your end result:

18. How your result makes you feel:

19. What you’d like to do, if anything, differently next time:

Documents

© 2001-Present Cookie Rosenblum, M.A