- Hall KD, Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity Med Clin N Am 102 (2018) 183–197 https://doi.org/10.1016/j.mcna.2017.08.012
- Berthoud HR at el. Blaming the Brain for Obesity: Integration of Hedonic and Homeostatic Mechanisms, Gastroenterology 2017;152:1728–1738
- Hall KD et al. Dynamic Interplay Among Homeostatic, Hedonic, and Cognitive Feedback Circuits Regulating Body Weight. Am J Public Health. 2014; 104:1169–1175.
- Freedhoff Y; S AM. Best Weight: a Practical Guide to Office-Based Obesity Management. Canadian Obesity Network; 2010.
The aftermath of a diet: weight is up, self-esteem is down
I am a psychologist, so I like asking the ‘why’ question: Why do we keep falling for these lines (lies)? Well, it turns out that we do this naturally. If we have a problem, we want a solution. The bigger the problem, the more we want a solution. This is natural, it is what we call escape motivation (“Beam me up Scotty” for you original Star Trek fans); we want the pain to end. We want the solution, the cure.
The problem is that we have been approaching weight loss as if it is true that we can lose all the weight we want. Tell me you haven’t thought about reaching your goal weight, or your ideal weight. Science tells us differently. Weight is not a behaviour and it cannot be controlled as a behaviour. Appetite is regulated by complex hormones and brain functions and the body strongly resists weight loss. The science of obesity as a medical condition is telling a story of success that is pretty much the opposite of what we hear in the media and what we have been following for the past forever.
The result of this is two unfortunate consequences. First, people living with excess weight who want to lose their excess weight are heavier now than when they began their efforts at weight loss. How sad is this? Biology has caused the system to backfire. Second, we see that this experience of weight loss failures has had an extremely negative psychological impact. Self-esteem has taken a real beating for most people. The narrative has always been that weight is controllable and all you need is the willpower to eat less and move more. It’s that simple.
So, if you are not successful (which we now know is not a surprise given our genetics, our biology, our environments and our lifestyle) I guess that makes you... There we go, another blow to your self-esteem.
This torture needs to stop. Weight is not a behaviour and body size is not a sin. People come in all kinds of shapes, sizes and colours. One size does not fit all! I think it is very important for all of us, whether medical professionals or citizens, to accept body diversity. If we can promote obesity as a medical condition, not a number on a scale, we can help here.
Obesity is the consequences of excess adipose tissue (fat) that impairs health, function and quality of life. Your weight is not your worth. I find the concept of Best Weight helpful. Best weight is the weight you can achieve and maintain while living the healthiest and the happiest. If you can’t get there, if you can’t stay there, if you need to do something unhealthy to get there, or if getting there makes you miserable this is NOT your best weight.
Imagine a world in which we did not attach a worth value to body weight? That would be a better world. We can still promote healthy weight, and in fact may be more successful at supporting moderate amounts of sustained weight loss.
I think as we move forward it is time to focus on promoting healthy best weight while also promoting positive self-esteem. Because we are social beings what others think of us is and always will be important. But there has to be a limit to this. As we develop as a society, we have the option of re-examining the beliefs that have seeped into our cultures. You are probably too young to remember but the cultural norm for thinness, especially in women, has not always been there.
Haven’t we grown as a society to embrace diversity? Now, as much as ever, we can choose; we don’t have to live our lives according to some other-imposed standard. I really hope that as we develop obesity treatments that are more supportive and evidence based we will also provide a context to promote positive regard for oneself.
What is self-esteem? Well, self-esteem is the esteem that you have
about yourself; sorry if that sounds simple. Hang on, in some ways
maybe it could be simpler. Self-esteem is between you and you. I often
remind people I see in my practice the
• Self-esteem cannot be earned
• Self-esteem cannot be given
• Self-esteem cannot be borrowed
• Self-esteem cannot be downloaded
• Self-esteem cannot be bought
• Self-esteem can ALWAYS be CLAIMED
If we are successful in helping people shift the narrative of obesity management away from the eat less move more myth, we might be more successful in accepting body diversity and respecting others. I encourage you to value the body you were born into, to appreciate the accomplishments you can achieve and to claim the worth and dignity that is inherently yours.
You are leaving Truthaboutweight.global
The site you are entering is not the property of, nor managed by, Novo Nordisk. Novo Nordisk assumes no responsibility for the content of sites not managed by Novo Nordisk. Furthermore, Novo Nordisk is not responsible for, nor does it have control over, the privacy policies of these sites.