6 Truths To Accept About Weight
What you need to know on your weight management journey or to support the journey of a loved one
- You are not alone
Living with excess weight or obesity can be an extremely isolating and lonely experience. Loved ones, colleagues, acquaintances and the general public typically do not understand your struggle. Society remains rampant with weight bias and experiencing weight bias can be a very traumatic and marginalizing experience. The medical community has been slow to recognize your challenges and implement guidelines, policies and medical education to address them.
However, please take heart in the fact that things are changing. The obesity epidemic is growing such that it can no longer be ignored. Weight bias is becoming increasingly recognized and brought to the general public’s attention. Medical schools and residency programs are beginning to implement various forms of education in obesity medicine. Organizations like the Canadian Obesity Network have public engagement committees that are led by individuals living with obesity.
There are some really smart and dedicated individuals working on keeping this momentum going. Hang in there and try some of these resources so that you may find a group of caring and supportive peers to help you along your journey.
2. It’s not your fault
The pervasive thinking in society and unfortunately even in the medical community at large is that you’re living with excess weight because you have a poor lifestyle. Basically it’s your fault you’re fat. You’re lazy and you eat too much. This belief is offensive and judgemental. Moreover, it does not add any value to the discussion on how to help move people forward on their health journey. Imagine how it must feel to have struggled with weight your whole life, finally muster the courage to seek advice and then be told you’re doing this to yourself and you need to exercise more and eat less. Gee thanks-it hasn’t dawned on me to diet and exercise! Don’t get me wrong, lifestyle is extremely important but often poor lifestyle decisions are less about conscious choice and are driven by circumstances, lack of opportunity/education and current mental/physical health. For example, paying for a gym membership and cooking from whole ingredients may not be a top priority (or possible) for a single mom working shifts and trying to provide for her children.
Furthermore, the belief it all comes down to eating less and moving more is not scientifically supported. We know now there are numerous contributors to one’s weight (see figure below) and many are unfortunately out of one’s control.
3. Weight loss and maintenance is hard
It’s not news to a person living with excess weight or obesity that losing weight and keeping it off is hard. Researchers are slowly starting to understand why — And it’s not because of lack of effort or discipline! Most individuals living with excess weight have tried numerous times to lose weight. What’s a bigger demonstration of motivation than tackling a problem over and over again despite repeated “failure?” They are trying and trying hard, but failure can be exhausting.
We now know that our bodies defend our body weight (referred to as a set point) and if we lose weight, our bodies respond with changes in metabolic rate (increased efficiency and reduced energy expenditure). At the same time chemical mediators of hunger and satiety change to increase food intake. All this in an effort to get back to the weight your body has decided to defend. A great talk and visual explanation of this by Dr. Arya Sharma can be seen here.
Great, so those living with obesity not only have to battle social stigma, socio-economic barriers and concurrent health conditions to work on their weight but their own bodies are in a sense working against them!
Still not convinced? If you truly believe that weight management is all about discipline and motivation and obesity is a self-created state, I ask you to try to lose 5–10 pounds by simply eating less/exercising more and keep it off. Then, come talk to me.
4. Exercise is great but…
There is no disputing the numerous benefits of exercise. However when it comes to weight loss, exercise alone is not that effective. The amount of exercise (alone) that is required to attain meaningful weight loss is often impractical. As Yoni Freedhoff discusses often on his blog (weightmatters.ca), exercise as an exclusive solution to weight management is often promoted by the food industry to distract us from their unhealthy foods. I often say to my patients that they can eat a muffin from McDonald’s and exercise for an hour to burn it off, or, not eat the muffin.
This does not mean exercise is not important in weight management. I view exercise as a habit from which others flow (a keystone habit as described in this great book). Those who exercise regularly tend to make better food choices. Furthermore, once you have lost weight, exercise is valuable in helping maintain your loss. It’s a very important part of a well-balanced, healthy lifestyle. In isolation however, it is minimally effective at best when it comes to weight loss.
5. If it sounds too good to be true…
It is! Weight loss is a multibillion dollar industry. Those living with excess weight or obesity are constant targets for peddlers of miracle diets, weight loss cleanses or quick fixes. News flash — they don’t work! Breaking news — someone is making money off you! As discussed above, weight loss is hard work and lifelong work. Beware of anyone telling you otherwise. Remember for every person that swears by a new and easy weight loss method, there are countless people for whom it has failed.
6. If you can’t stick to it for life…
Find something else. People do lose weight on commercially available diets. The problem is that as soon as you stop, the weight comes back and you end up where (or often heavier) than where you started. These diets are impossible to sustain and sustenance is the key. This is where the peddlers get you. They can state that their diet works because you lose weight (and money) while you’re on it. Your regain is then blamed on you not sticking with the diet and not the diet-design itself.
So what diet is best for you? The simple answer is the one you can remain on. There are numerous scientific studies promoting one diet over another but, what’s the point if you are miserable on it? Find something that is reasonable for you and involves changes that you feel you can stick to for life. Most importantly, find a diet you can remain happy on. If you’re struggling to stick to a diet and feel you are suffering, you will not stick to it.
Great approaches to weight management are available. In particular I highly recommend The Diet Fix written by Dr. Yoni Freedhoff and The Weight-Loss Prescription by Dr. Ali Zentner. The Canadian Obesity Network or The Obesity Society are also great places to start. Finally, I encourage you look into medically supervised weight management clinics in your area. It may be difficult to distinguish between peddlers and healers. Ask your family doctor, we’re happy to help!
