Question from the AMA box: I want to lose weight. Why can’t I follow through?
Dear AMA person: This might be the hardest question I’ve had to answer so far from the AMA Inbox. I am not trained or educated in nutrition. Furthermore, the research on how to lose and keep off weight is a vast and contradictory subject with more than one person hacking a ‘snake oil potion’ that promises weight loss nirvana to everyone who will buy the product. It is difficult to know whom or what to trust. I am guessing that these are the very reasons you posed the question.
Many people try diet after diet, endless exercise programs, and/or other lifestyle changes with no discernable change in their weight over time. This has created a burgeoning commercial industry but no reduction in overall rates in what is called ‘obesity epidemic’ in North America. Nor has all our science reduced the human suffering that has travelled alongside the many attempts to lose weight.
Willpower is probably not the problem. Obesity is often viewed through the lens of a lack of willpower; if people just tried harder (or tried at all—so say the shaming messages) they would lose weight, right? Eating less and exercising more over a period of time does work for a few people but, overall, willpower does not explain long plateaus where there is no weight loss despite very little caloric intake, set-points that a person can’t push past, or rapid weight gain after being on a diet despite little change in the overall caloric intake. Therefore, follow-through or willpower might be a red herring in our attempts to lose weight.
Insulin management might be the answer. How does insulin affect calorie use and distribution? Good question. It’s a bit radical to consider that we may have been fed misinformation about the role of calories but Dr. Jason Fung is pretty convincing and seems to have the research to support his ideas.
Create a lifestyle that best supports your mental and physical health and wellbeing. Going on a diet/cheating/starving/gaining-losing/repeat is no way to live your best life. So, begin by creating a way of being that, overall, makes you and your body happy and healthy. You will find it easier to stick to something that supports your values and ethics and has a definable purpose.
Stop the shaming-blaming-naming cycle. You are not bad; food is not bad and you are not a… “insert terrible self-appraisal comment here”. I know our culture is perfect-body, celebrity-beauty, and youth-obsessed but you don’t need to hop on this train. Most human beings will never look like that for very long, if at all, so it is really a train going nowhere good.
Therefore, work on silencing the inner critic in your head and break the unrealistic body image spell. Deeply hold the truth that you are not what others say you are. Weight and character are not equivalent. Beauty and character are not equivalent. Live into self-compassion for your whole self and appreciate what your body can do. Gather some people around you for the changes you want to adopt and add a lot of loving presence via your relationships. It is easier to follow through when you have solid social support.
Also, try not to obsess about calories or consuming empty calories/working off every calorie, monitoring the nutritional impact of every calorie, and so on. Is every calorie used up, accessible in the same way, and stored in the same way by your body? Apparently not! This may be another myth that we are so used to hearing about that we believe it to be unequivocally true. Following through on systems that don’t work doesn’t make sense, so make sure you are accessing information and resources that work for you.
Finally, if you really want to do the diet thing, the Mediterranean diet seems to work slightly better than any other diet and is generally considered a more healthy approach to life in general. This program is easier to follow than others so you might find it is easier to do over the long haul.
Disclaimer: As for any health or wellness information presented, it may not be helpful, safe, or appropriate for every person. Always run everything by your doctor or health professional before you make any changes to any health and lifestyle practices.
The current cultural ideal for a desirable body image is pretty rigidly defined and often carries with it psychological pain if you don’t measure up to what is, largely, an unattainable physical shape. This can create deep frustration and disappointment, self-hatred, public shaming, and a long list of everyday fears and trials that are largely subsumed into a diminished life.
On a personal level, weight management has been a big part of my own life experience and has affected many of my clients, friends, and family members as well. Because of this, I have attempted to offer perspectives about weight management that inspire hope, relieve some suffering, and increase the possibilities for individual flourishing. I hope that these goals will manifest in the life of every reader.
Peace to you and your household,