
“This experience of weight loss failures has had an extremely negative psychological impact. Self-esteem has taken a real beating for most people.”
By Dr. Michael Vallis, August 2020
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.
“If we have a problem, we want a solution. The bigger the problem, the more we want a solution. The problem is that we have been approaching weight loss as if it is true that we can lose all the weight we want.”
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 experience of weight loss failures has had an extremely negative psychological impact. Self-esteem has taken a real beating for most people.”
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.
“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.”
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.
“It is time to focus on promoting healthy best weight while also promoting positive self-esteem. As we develop as a society, we have the option of re-examining the beliefs that have seeped into our cultures.”
In the 1960s along came a young model, rail thin, by the name of Twiggy (go ahead, look her up). Prior to that the desired female shape was more curvaceous (think of Marilyn Monroe). 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.
“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
following:
• 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
“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.”
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.
Being underweight could be a sign you're not eating enough or that you may be ill. If you're underweight, contact your general practitioner for further evaluation.
The medical community recommends that you keep your weight within this range.
* The term ‘pre-obesity’ was previously classified as ‘overweight’ by the World Health Organization (WHO)
People who fall into this category may be at risk of developing obesity. They might also be at risk of developing other health problems, or that their current health problems may worsen. The recommendation is to consult a healthcare provider trained in obesity management.
There are two recommendations for people who fall into the pre-obesity category, which are recommended by European and American clinical guidelines for obesity management in adults.
The recommendation for people with a BMI of between 25.0 and 29.9 and who do not have weight-related health problems (i.e. high blood pressure or high cholesterol) is to prevent further weight gain through healthy eating and increased physical activity.
For people with a BMI of between 27 and 29.0, and who also have weight-related health problems, the recommendation is to lose weight by combining lifestyle interventions and anti-obesity medications to achieve weight loss and improve health and quality of life.
People who have BMI equal or over 30 may have obesity, which is defined as an abnormal or excessive accumulation of fat that may harm health. Today a number of health organisations recognise obesity as a chronic, but manageable disease.
World Health Organisation and other health organisations distinguish three classes of obesity:
Obesity Classification |
BMI |
Class I | 30.0–34.9 |
Class II | 35.0–39.9 |
Class III | Above 40 |
The BMI ranges are based on the effect excessive body fat has on individual’s health, life expectancy and risk of developing diseases; as BMI increases, so does the risk for some diseases.
It is recommended that people with a BMI equal or above 30 consult a healthcare provider trained in obesity management for diagnosis, risk assessment and treatment of obesity and weight-related health complications.
The goal of managing and treating obesity is not simply to lose weight, but instead to improve health and lower the risks of other health complications. Losing even a modest amount of weight, such as five percent of body weight or more, and maintaining this weight loss, can improve overall wellbeing, while also reducing the risk of weight-related complications.
There is a range of scientifically proven treatment options for obesity that may be recommended depending on individual needs, health status and the presence or absence of weight-related complications. Treatment may include a combination of the following options**:
* Bariatric surgery is generally considered for people with a BMI of over 35 who also have weight-related complications. It is also generally considered for people with a BMI of 40 or above.
** Disclaimer: This information is not a substitute for the advice of a healthcare provider. If you have any questions regarding your health, you should contact your general practitioner or another qualified healthcare provider.
People who have BMI equal or over 30 may have obesity, which is defined as an abnormal or excessive accumulation of fat that may harm health. Today a number of health organisations recognise obesity as a chronic, but manageable disease.
World Health Organisation and other health organisations distinguish three classes of obesity:
Obesity Classification |
BMI |
Class I | 30.0–34.9 |
Class II | 35.0–39.9 |
Class III | Above 40 |
The BMI ranges are based on the effect excessive body fat has on individual’s health, life expectancy and risk of developing diseases; as BMI increases, so does the risk for some diseases.
It is recommended that people with a BMI equal or above 30 consult a healthcare provider trained in obesity management for diagnosis, risk assessment and treatment of obesity and weight-related health complications.
The goal of managing and treating obesity is not simply to lose weight, but instead to improve health and lower the risks of other health complications. Losing even a modest amount of weight, such as five percent of body weight or more, and maintaining this weight loss, can improve overall wellbeing, while also reducing the risk of weight-related complications.
There is a range of scientifically proven treatment options for obesity that may be recommended depending on individual needs, health status and the presence or absence of weight-related complications. Treatment may include a combination of the following options**:
* Bariatric surgery is generally considered for people with a BMI of over 35 who also have weight-related complications. It is also generally considered for people with a BMI of 40 or above.
** Disclaimer: This information is not a substitute for the advice of a healthcare provider. If you have any questions regarding your health, you should contact your general practitioner or another qualified healthcare provider.
People who have BMI equal or over 30 may have obesity, which is defined as an abnormal or excessive accumulation of fat that may harm health. Today a number of health organisations recognise obesity as a chronic, but manageable disease.
World Health Organisation and other health organisations distinguish three classes of obesity:
Obesity Classification |
BMI |
Class I | 30.0–34.9 |
Class II | 35.0–39.9 |
Class III | Above 40 |
The BMI ranges are based on the effect excessive body fat has on individual’s health, life expectancy and risk of developing diseases; as BMI increases, so does the risk for some diseases.
It is recommended that people with a BMI equal or above 30 consult a healthcare provider trained in obesity management for diagnosis, risk assessment and treatment of obesity and weight-related health complications.
The goal of managing and treating obesity is not simply to lose weight, but instead to improve health and lower the risks of other health complications. Losing even a modest amount of weight, such as five percent of body weight or more, and maintaining this weight loss, can improve overall wellbeing, while also reducing the risk of weight-related complications.
There is a range of scientifically proven treatment options for obesity that may be recommended depending on individual needs, health status and the presence or absence of weight-related complications. Treatment may include a combination of the following options**:
* Bariatric surgery is generally considered for people with a BMI of over 35 who also have weight-related complications. It is also generally considered for people with a BMI of 40 or above.
** Disclaimer: This information is not a substitute for the advice of a healthcare provider. If you have any questions regarding your health, you should contact your general practitioner or another qualified healthcare provider.