I’ve heard it many times before “Brian, in my life, I’ve literally lost 1,000 pounds, but I’ve put on about 1,400” Or “I’m losing/maintaining weight, and I’m every second of every day I am shitless that it’s all going to come back” I’ve now come to the very distressing conclusion that people’s previous weight rebounds are a form of trauma that impact – and even impede - people’s ability to manage their relationship with food and body in a healthy way.
A lot of this is due to “diets”. I know that many of my readers know that “diets” (e.g. Atkins, Paleo, Intermittent Fasting, Keto) are inherently bad, so I don’t need to explain in detail why this is the case. However, many “diets” do indeed work – you eliminate a food, adjust your eating – and with willpower weight does tend to come-off. However, there is an axiom in weight loss that says “what you do to lose the weight is what you need to keep doing for the rest of your life to keep it off.” So if you have lost weight by standing on one foot, whilst only eating pure organic salmon skin with juice from a GMO-free, organic, free-range grown lemon followed by greenhouse-produced celery flown-in by Canadian Geese from a fourth generation farm in Buttpoke, Idaho, you will have to continue doing this for the rest of your life. Once you reach your goal weight, you can’t go back to eating bread and cupcakes. To keep the weight off, it’s salmon skin for life baby.
What’s worse is that diets can actually create or perpetuate full-blown eating disorders in people. People begin to treat their bodies are things to be controlled, starved, managed and pigeon-holed into the passing flotsam and jetsam of Instagram fashion. This often begins a very serious cycle of restricting and purging that can indeed become rapidly out of control.
And it is this being out of control that causes the panic, trauma, anxiety, guilt, shame and embarrassment that fuels eating disorders and huge weight cycling. When people binge, they are out of control. When people restrict and starve themselves, many people (but not everyone) knows that deep down there is something wrong with their behaviour, since they know that the hunger they feel will never go away and needs to be satisfied. However, more broadly, people just feel hopeless and helpless when it comes to their weight, their self-esteem and their relationships with their bodies. That is why I hear people telling me that they feel getting their relationship with food, weight, body and self-esteem back seems impossible.
My main goal in therapy, and I tell clients this, is to restore people’s relationship with all of
these things. Below are the main points that I try to tell clients as they make this transition:
Psychologically, it is critical to reduce people’s anxiety about weight fluctuations. People arguably work with me so that they no longer have to feel the minute-by-minute anxiety and shame that comes from weight cycling throughout their entire lives. I work to stop the feelings of worthlessness and being out of control with my clients.
The main way I accomplish the above is I tell people to take their eating changes very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, very, slowly. Oh, did I mention that I tell people to take their weight changes very, very, very, very, very, very, very, very, very, very, very, very, very, very, very slowly? I work with clients to understand the rush for losing weight and determine if that rush is caused by anxiety or other psychopathology that would interfere with a healthy relationship with food and or body. Note too, that I will determine if clients have medical issues that impact either their food intake or the speed with which they need to lose weight, and will always defer to medical advice in this area.
The reason for this is simple – I want people to restore their relationships with food and body before they make any changes to their weight. Sometimes people actually say that once this happens their weight loss goals change, and I am thrilled because they are now looking at themselves with fresh perspective and are in a position to make better choices about their weight and food and what they want from life.
Food is meant to be enjoyed as much as it is meant to be for fuel. Sometimes people can choose to eat to fuel themselves during the day, and at other times they can use food for comfort. It can and should be both. Typically, clients who weight cycle have only used food for weight control, and that is just simply a recipe for disaster.
Finally, I want people to make lasting change, not quick change.
Sometimes I spend almost a year with clients helping them get ready for their weight loss. This time is hardly spent sitting on our hands. We are discussing trauma, addiction, past relationships with food, reasons for quick changes, etc… Life these days, quite frankly, is full of enough shit and stress for many of us. Given that we have to eat multiple times a day, food and weight should not be a “stress” that we should have to manage on top of everything else. It should come naturally to us. Like most anything, we will screw-up with it, our weights will change, what we eat will change, our need to lose weight will change and so on. Going up and going down in weight only adds to our stress – and it shouldn’t. Slow, sustainable changes that support one’s proper relationship with food and body image are the only real ways to make sustainable changes in our lives. In the short term, this will cause an immense amount of anxiety, but it will break patterns of weight cycling.