I get asked about weight loss a lot by clients struggling with binge eating. They’re not only tired of feeling out of control with their food, but they want to be a svelte, younger version of themselves too. I tell them, “Absolutely, we can help you with weight management, but weight loss is not a goal we believe in.” That’s where I lose them.
What’s the difference between weight loss and weight management? Weight loss is a goal driven by the medical field and by society’s thin-obsessed ideal that has little, if anything, to do with health. Most doctors promote weight loss as a cure-all, lessening your risk of heart disease, stroke, cancer, and the like. The media says you’ll love yourself and succeed professionally and personally if you can attain the thin, athletic look of the models and stars of Hollywood’s elite. But that’s just not true.
Let’s take the first issue of health. Weight does not equal health. Diabetes, cancer, heart disease, and the like all exist across the weight spectrum. An unhealthy lifestyle does lead to increased weight for many, and that’s why the obsession with the correlation between weight and health. But can a heavy person be healthy? Of course! People live in larger bodies all around the world, but it’s only when they fall victim to truly sedentary lifestyles and poor nutrition that their health becomes an issue. It has nothing to do with their weight.
The converse is true as well. Losing weight does not mean you will be healthy. Weight loss for most people comes in the form of restriction and compulsive exercise. It’s just a pendulum swing in the other direction leading to malnutrition and injury. The body reacts for most with a compulsive drive to eat, taxing a person’s ability to control their impulses and eventually landing in a binge and subsequent blame and self-loathing. Our bodies are not meant to diet, proven by research dating back to the ’50s with the Ancel Keys study and re-proven time and again for decades. The vast majority of folks regain their weight plus added pounds in short order. But what’s worse, it creates a sense of personal failure and many just give up on self-care as a result.
Ah, but weight management is a different story. I describe this as part of a way to measure success in ending the binge eating and diet cycling phenomenon. When I got into recovery from my eating disorder, my dietitian knew I was still fixated on weight loss. She helped me take the pressure off to eat perfectly by weighing me with my back to the scale. If my weight changed more than 5 pounds, she would tell me, but the goal was to eliminate the binges and restrictions. I was to control what I could control, which was one meal at a time and working on following my body’s cues. If I was hungry, I was to eat. If I was full, I was to stop. If I didn’t like the food, I could say no thanks. If I loved the food, I would really focus on the flavors and textures and take my time.
In the end, without dieting, I found my weight did go down. But more so, I , and focused on other numbers like my heart rate, blood pressure, cholesterol levels, etc. I remained overweight, but worked on accepting that my body was a big body and would be the rest of my life. But it was healthier, and I could sustain that for the rest of my life.
Now that last part, that my body would be a big body forever and ever, was an ongoing battle to accept because of how much I was indoctrinated into the thin-obsessed culture from TV, internet, magazines, movies, and my own family. Everyone I know, outside of the eating disorders world, still speak as if thinness would bring peace and prosperity to their lives. It never does, and they all acknowledge it. But it’s just so stuck in our brains.
It takes real work to find what really makes us happy. Most find it in our connection to others. We want to be accepted and loved. To do that, we have to make peace with ourselves, find our own internal pride, and there are several areas of focus that can get us there. When my clients work on increasing their self-care behaviors in physical/emotional/spiritual health, connect with friends and family, achieve at work, find time for personal development, joy, and adventure, and can find balance with it all, their body image and shape have little impact on their happiness. That’s the goal of the complex work we do in our treatment program.
I know this all very hard to do. It took me years, with support from my wife, my son, friends, and professionals, to get there. But it all started with giving up the weight loss goal, stopping the eating disorder behaviors, and switching to weight management as a tool to measure progress. I learned trying to achieve a small body made for small happiness. Living a big life in my big body led to big joy. Interestingly, I feel lighter because of it.
By Andrew Walen, LCSW-C - Founder, Executive Director, Psychotherapist at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 443-602-6515 or email firstname.lastname@example.org.