Weight & empathy

Today I had a client who wanted to lose weight, and she had been assigned to a dietician, a young skinny woman, for help. The dietician gave her some good advice but my client struggled to implement it because she also cooks for a fussy child and a hungry husband, and she has many other things going on in her life, and a long history of weight gain and all the emotional issues that go along with it. When she tried to express to the dietician that she was struggling, the dietician’s response was “well, are you serious about wanting to lose weight or not?” My client did not feel seen or heard, and didn’t go back.

Is it not arrogant and inappropriate for a young, thin person to be giving weight loss advice to an older, non-skinny person? What life experience does she have, what empathy has she developed, has she had to juggle fussy kids and hungry husbands with her own needs? Has she even studied the psychological dangers of yoyo dieting?

Many doctors also take this approach- that any overweight person just needs to lose weight in order to resolve their health issues. This is definitely not evidence-based medicine, or best practice, in this day and age! It is easy to tell people to lose weight, and if you do not have weight issues yourself, it can be hard to empathise.

I watched my mother be dismissed over and over again by medical professionals because of her weight. They could not see past it to the person. They could have done so much more for her- just with kindness, let alone medical support. Instead she felt dismissed and belittled by all but one.

Knowing what you ‘should’ be doing and doing it, are worlds apart for most women. Not through lack of intention, discipline, willpower….but because it’s deeply complex and not easy! If it was easy we wouldn’t have a multi billion $ weight loss industry! It is a fundamentally flawed model.

My experience is that trying to address weight issues without also addressing all the psychological issues that go along with it is futile and at most may have short-term success. I mean common issues such as: disordered eating and outright eating disorders (which are rife), self starvation and binging, self hatred, postponement of life until one has lost weight, loss of being in touch with one’s own natural signals of hunger and satiety, societal expectations of women to look eternally young and thin, the hyper-palatability of modern processed foods, the addictive nature of processed sugar….just to touch the surface!

Food is not like any other addiction where you can just go cold turkey or take medications to withdraw. It is deeply tied in to our sense of nurturing, comfort, wellbeing, and it's meant to be that way. For most of humanity’s history, food was scarce and we needed to eat lots when it was available.

It takes time and lots of self love and patience to unravel the psychological issues, to re-educate the tastebuds, to develop new habits, to get in touch with our bodies, to be really kind to ourselves. And then we all have different constitutions, and those with a tendency to putting on greater amounts of weight are often very sensitive, kind-hearted nurturing people for whom making food for others is a way they show love. This can’t just be dismissed as not being serious about losing weight. For any serious long term weight loss, this all needs to be considered.

There are a zillion ways to easily lose weight- pretty much all diets work- but only in the short term. The body has ancient mechanisms for making sure we do not starve, and if we starve ourselves, they kick in and override our meagre willpower.

I love working with women who struggle with weight and self esteem, and health issues around it all, and one of the first things I do is look at their disordered eating patterns- and make sure they are eating enough! So many overweight people try to starve themselves- for years.

Many women do not feel worthy of joy until they have lost weight. But without joy, there will be no real progress