Can the pressure to lose weight keep you from losing it?

Enjoy this guest post by one of our amazing clinical dietitians Narmin Virani, RD, LDN

Today, I want to tell you a story. I have had some very interesting conversations with a few post-op patients that I simply had to share. I met 3-4 post-op patients over the last 2 months or so, all of whom were about 6-24 months post bariatric surgery, starting to regain some weight, struggling with getting back on track. Very similar situations. These were all bright and sensible women, who had each encountered some stress in their lives. One had to pick up extra hours at work due to a coworker of hers getting fired, one had some medical issues that had got worse, one was caring for an elderly parent, while one had had an accident that caused her to take leave from work. Due to these additional demands on their time and energy, or due to not being physically able, all had got off track with exercise. This led to some weight regain for all of them. This weight regain led to feeling depressed and discouraged, which led to low motivation with planning and preparing meals. This led to eating out, not caring about meal planning, which led to guilt. This guilt made the feelings of depression/discouragement worse, which led to “comfort eating”, which caused some more weight gain.

What struck me about each of these women was that they all were feeling terrible about their weight gain, said they almost didn’t attend their follow-ups because of that, were beating up on themselves for having got off track, and were wondering if they could go on a crash diet to lose the weight they had gained. These women had all encountered some very real stressors that life can sometimes throw at us. But instead of being kind and compassionate to themselves during these difficult times, they beat up on themselves for gaining weight, which ironically discouraged them further. It made me realize: the pressure to lose weight can keep you from losing weight! How ironical!

Now, as someone who has been doing weight-loss counseling for 15 years, and as someone who had my share of weight cycling/crash dieting as a teenager/young adult, here are my 2 cents of wisdom I’ve gleaned over the years:

The scale can be a double-edged sword. Yes, having a weight goal can sometimes be motivating, but at other times can lead to discouragement and feelings of failure.
There will come times in your lives, when you will have to put weight loss on hold. Times when you are overwhelmed with extra demands on your time and energy or times when you are sick. At such times, chasing weight loss will only add to your stress, and stress can deplete your motivation.
At such times, focusing on self-care – eating foods that nourish and satisfy you, moving in ways that de-stress and energize you – will actually motivate you and help you lose weight. Thinking that losing the weight you have regained first will motivate you to plan meals and move more is actually a “backwards” way of going about it.
At such times, accepting and respecting your body can lead to nourishing and caring for it, while being critical can lead to body-punishing exercise/diets that are hard to sustain.
At such times, going on a crash diet might leave you hungry, tired, deprived, and miserable for a few weeks, and make you lose a lot of water weight, which would come back on as soon as you added regular foods back in. And you may already know this, but dieting leads to deprivation, deprivation leads to cravings, cravings lead to out-of-control eating.
Satisfaction and Convenience are 2 key ingredients for long term success. You could be on the world’s healthiest diet, but if you are not satisfied, you could end up thinking about and looking for food all the time, because you’re missing something. Similarly, if it takes a lot of time and effort to put together meals daily, it will be hard to keep up during busy periods in your life.
Satisfaction means eating foods that are not only filling, but that also leave you feeling energized, and that please your palate. It’s striking a balance between taste and health, allowing yourself regular indulgences without guilt. Convenience means keeping frozen meals on hand as back-up for busy days, and knowing that it’s perfectly okay to get take-out meals at times, which may include some healthy choices and some not-so-healthy ones that you are craving, without guilt
These times in your lives are BUMPS IN THE ROAD, NOT THE END OF THE ROAD. And the more you focus on self-care vs. weight at these times, the sooner you will lose the weight you have gained. And it’s okay to tell well-meaning family members who instill the fear of relapse in you, that they are not helping.
Maybe you won’t lose 80-100 lbs, but say 30-50 lbs. But what’s the point of losing 80-100 lbs if you’re unsatisfied all the time? Isn’t it better to lose a little and keep it off, than to lose a lot and gain it back? And aren’t health and quality of life more important than weight?
As far as comfort-eating goes – for a person for whom food is the only way they have learnt to soothe their soul, turning to food at stressful times is actually a very smart survival mechanism – without it, they may either jump off a bridge or take to other, more dangerous ways of self-numbing. The problem is not turning to food for comfort – everyone does it at times – the problem is when food is the only source of comfort. The solution? Cultivating other ways to cope and soothe – from building strong support systems, to making time for rest and recreation without guilt, to putting your needs above those of others.

Of course, all this is easier said than done, when you have spent half your life dieting, chasing weight goals, beating up on yourself for your weight, eating by numbers – calories/carbs/etc, and forgotten what true hunger/fullness/satisfaction feel like. It’s natural to keep reverting back to what’s familiar and comfortable, even though we know it doesn’t always serve us. It’s easier to be critical rather than accepting of our bodies in a thinness-obsessed society. It’s harder to give yourself credit for the weight you have lost and kept off, and easier to beat up on yourself for the weight you’ve gained. This is why support groups are helpful. For sharing your struggles, which might not be yours alone. For coming up with ideas for coping with stress. For coming up with ways to practice self-kindness and compassion. For cheering others on who may be struggling. For sharing your stories of what helped you get through the tough times in your life.

Don’t ever give up! Take each day at a time! Eat in ways that satisfy you! Move in ways that give you more energy, help you sleep better, reduce stress/anxiety! Come to your follow-up appointments, we are here to help, not judge you! And oh, take that number on the scale with a grain of salt!

“For both excessive and insufficient exercise destroy one’s strength, and both eating too much or too little destroy health, whereas the right quantity produces, increases and preserves it” – Aristotle

Narmin Virani, RD, LDN

Clinical Dieititan, Weight Center
UMass Memorial Medical Center