by Pamela Tinkham, LCSW, C-IAYT, SEP
What motivates us to lose weight? Sometimes it is the way we perceive people looking at us. Other times our partner or spouse makes a comment that bothers us. It can be as simple as a look or stare that we perceive from someone. For some people, they are motivated once their clothing does not fit or becomes too tight. Yet…some people are never motivated. Why?
There is a defense mechanism called denial and it acts as a protector for many things. Denial is helpful during a traumatic event, for instance. The mind will not fully process the event and will stay in a state of shock until the mind is actually ready to process the event. Some people repress events for their entire life and stay in a state of denial. Some people can live a normal and healthy life that way. Others cannot. Others try to repress situations, traumas, emotions, and events and have a difficult time with this. The emotions come out in other ways such as sickness, ailments, headaches and other somatic symptoms. For some people, the repression of these emotions can cause weight gain and obesity. Others are genetically predisposed to obesity and yet others have a combination of both.
Let us talk about the denial that has to do with denying having to lose 30, 60, or 100+ pounds. This denial is different. It is not acting as a healthy defense to protect the ego. It is actually unhealthy because it is preventing you from taking good care of your body. Part of the issue is that almost everyone these days is 30 pounds overweight. We even think it looks healthier to be 30 pounds overweight than 5 pounds underweight. Did you ever notice when someone you know starts to become too thin? It is our perception they are too thin when in reality they may be at a healthy weight for their age and body type. There have been numerous articles written about this topic and whenever pictures are shown of supposedly healthy people who will live a long life, they appear skinny; even scrawny. When pictures are shown of people who are at risk for heart disease, diabetes, stroke, and so on…they have plump, healthy looking faces and look “healthy” in our American perception and definition of healthy. In actuality, they are not healthy and need to lose a significant amount of body fat, especially around the chest which covers the heart muscle.
Denial can become destructive when we never admit to ourselves that we may have an issue. When it comes to weight control issues, denial can be heard as, “I love myself as I am”, “I am happy as I am”, “I don’t buy into this societal image of having to be thin”, “I am what I am”. It is important to have self love and self worth. You can love and accept yourself overweight, and you truly must realize that if you love your whole self; body, mind, and spirit, then you will treat your body as a sanctuary and nourish it with healthy foods. That is not to say that you will never overindulge if you have self love. It means that with true self love, you will care for yourself in a way that nourishes your body, mind, and soul. Knowing the facts that being 30+ pounds overweight can cause heart disease, high cholesterol, high blood pressure, diabetes, amongst other physical ailments such as arthritis and musculoskeletal injuries…how can we deny the facts? We cannot. We can only deny facing the facts.
What can I do about my weight?
Here is a formula for tackling the issue right now…TODAY!
Ask for help. Get outside interventions immediately. Speak with your primary physician and get a referral for a registered dietician. Hire a trainer and a psychotherapist or someone who does both. (There are only 3 of us in the country that I know of). Make the decision to lose weight and keep your commitment to yourself. Keep a journal all of your feelings and thoughts and all of the food and drink that you consume throughout the day. Have someone who is your coach/trainer/therapist who you are accountable to. Have someone who you have to report to for a weekly weigh in or who you at least have to report your weight to. Find the self motivation to improve your physical health, your mental health, and your quality of life. Pray for the motivation to do this. Even if you do not believe in a higher power, the power of prayer and the intention it creates can move the energy in the right direction to help you attain your goals. Give it a try.
Can I do this on my own?
If you are 10 pounds overweight and have never been more than 10 pounds overweight you have it within your capabilities to lose the weight on your own. You just have to make the decision to take on the challenge. You can do it and you know you can because you have done it in the past. Sometimes we just lose our drive to do it because our lives have become boring and mundane. Add some spice back into your life by joining a class or club that you would enjoy and be passionate about. In this busy lifestyle that we all have to keep up with we lose sight of the things that we are passionate about. Find those things you are passionate about and make the time for them. Make it a priority to do things that you love, not just things that you have to do to maintain your busy lifestyle. It may mean reorganizing your priorities and listing some of the ones you placed at the bottom of your list first. Make a list of all the things you must do throughout the day and find time and space for doing something you love at least once a day. Even if you only have 5 minutes to sing your favorite tune or dance in your living room, do it. It will help you get back to your true self; the self that has a higher purpose than just accomplishing the daily tasks that we all have to do.
What about surgery?
If you are over 10 pounds overweight and reaching 20-70 pounds of excess it may be difficult to lose the weight on your own without outside interventions. If you are 70-100+ pounds overweight you may have tried every fad diet out there and have become so frustrated and discouraged that you may be considering or have already had bariatric surgery. If this is the case you need to be aware that by having your stomach surgically made smaller you will not be able to change your behavior unless you have additional counseling. Some of the hospital bariatric programs have follow up interventions with a dietician and psychotherapist. Many of the programs do not. There exist a number of programs at hospitals that require a psychiatric evaluation prior to surgery and a support group following surgery. This set up is not enough to help you change the behavior that you have had for your entire life. It is recommended that you consider therapy before deciding to let someone operate on you. After a year of therapy, surgery may be the best option. Explore for yourself. Do not look for quick fixes because there aren’t any. Numerous people have had bariatric surgery and have put the pounds back on over time. The same concept applies to liposuction. If fat cells are removed from one part of the body, they can surely come back to another part. If you remove the fat from your thighs, you can gain the fat in your stomach. You cannot remove all the fat with liposuction because you will die. Therefore, you can only remove fat in certain areas. If you do not change your eating behaviors you will gain the fat back in different areas. It is not a pretty picture. You pay all this money to have gorgeous, skinny thighs and a year later you have excess fat in your upper back. Who knew fat could go to your upper back? You certainly did not think of it when you wanted your skinny thighs.
The goal here is not to convince people not to have surgery. There are skillful surgeons who have helped so many people feel better, get motivated and increase their self esteem. People must examine the reasons why they want surgery and explore other possibilities before going to that extreme. In many cases surgery may be the only way to help someone lose the initial 100 pounds that needs to be lost. You must treat the actual problem behavior before you treat the symptom. If you cannot treat the problem behavior and have never been successful at treating the problem after numerous outside interventions, then it may be time to treat the symptom. Only you can decide.
So what is the magic formula for exercise?
Here are the newly revised recommendations for exercise from the American College of Sports Medicine (2007) for adults aged 18 to 65:
Perform 30 minutes of moderate cardiovascular exercise on 5 days of the week or 20 minutes of vigorous cardiovascular exercise on 3 days of the week or a combination of the moderate and vigorous exercise goals.
Perform 2 weekly sessions of strength training (weight training) to maintain muscle strength.
What is the magic formula for eating?
You have seen hundreds if not thousands of fad diets and have maybe tried a few. You have possibly read Oprah’s book that she had written with her trainer. You may have been inspired by your favorite celebrities and have tried to eat the same way they do. You may have just tried to follow your dietician’s recommendations and attempted to eat a healthy, balanced diet following the food guide pyramid. There is so much information out there and it has become so confusing for people. People enter weight loss programs after reading many different books. Most of the diet books have some healthy suggestions and some not so healthy suggestions. Dr. Atkins got so much attention and there was such controversy about his book. The reality is that many people lost the initial 30 pounds because by depleting carbohydrates they lost all their water weight initially. With the loss of water weight it gave many people the motivation to keep going and some people did exceptionally well and others were passing out from dehydration. The Zone had good results and became difficult to maintain for many people because of having to constantly consider portion size and the exact amount of the ratio of protein, fats, and carbohydrates. Other diet books suggested cutting out fat almost completely and people began to have gallbladder issues. All of these diet programs have some good things that they offer and some things that may not work for all people. Every person is unique; therefore every diet program should be structured to meet the individual’s needs. There is not one program that will work for all people. There are too many differences within each individual.
The simplest way to begin to lose weight would be to cut everything you are eating in half. Cut your portions in ½ and do not change anything else. If only it could be this easy! Most people are not getting the nutrition they need and are certainly not getting enough fruits, vegetables, and water with their current regimen. By just cutting your portions in half you will not be adding nutrition.
A sensible diet is recommended. One that is high in nutritious foods such as fruits and vegetables, low in saturated fats such as red meat and cheese, and is moderate to high in whole grains depending on whether or not you are sensitive to carbohydrates. A healthy diet should have a sufficient amount of protein and calcium rich foods, and should not be excessive in any areas. You have to figure out for yourself what makes you gain weight. You will discover if you are sensitive to carbohydrates if you follow the food guide pyramid and gain 5 pounds immediately from all the carbohydrates it recommends. If you exercise every day you need more carbohydrates. This is the reason working with a registered dietician is a great idea. You can have a program set up specifically for you. You can communicate to the dietician that every time you eat carbohydrates with every meal, you gain weight. Your meal suggestions will be structured to meet your needs.
What is the story with Carbohydrates?
One thing that has helped hundreds of people lose weight has been to cut out the carbohydrates at night. Be finished eating your carbohydrates after lunch and your afternoon snack and dinner can be protein and vegetables. This has helped people drop weight immediately. To clarify, there is no scientific evidence why this structure works. Some believe it works because people lose the excess water weight over night and wake up with flatter stomachs. Therefore, it works as a motivator to continue to stay on your exercise and diet program. By the book it should not matter when you eat your carbohydrates because what matters is; what you put into your body will be either used for energy or stored as fat. If you work out and expend a certain amount of calories you will technically burn off the calories and carbohydrates you eat at night and it will not matter if you had carbohydrates at dinner. These are the facts. What many trainers and coaches have found is that people are more motivated when they do not have their carbohydrates at night. Bob Greene’s book that he had written with Oprah encourages people to have the smallest meal of the day at dinner time. The evidence is in the numbers of people that he has trained and put on this regimen. The scientific evidence is not conclusive, yet there are hundreds of clients who have lost weight on this regimen. The hypothesis is that it works because of the water retention loss and the way people wake up in the morning feeling thinner. It is much safer than the Atkin’s diet because you are only depleting your carbohydrates at night. You are not depleting all carbohydrates because you can eat as many vegetables as you wish to at dinner time. It is not easy to do and it leaves you feeling hungry, but if you can get through the hunger pains and just have a lot of water at night, you will see the pounds fading away. Brushing your teeth can help the hunger cravings at night as well. Brush, floss and use mouthwash every time you get a craving. You will have excellent hygiene!
This is too difficult!
These suggestions are a lot to ask and it is a vigorous formula to follow. It is also discouraging to think that it takes this much hard work to lose unwanted pounds. You may be saying, “Where’s the joy in life?” “Where’s the fun in eating”? “How can I wine and dine if I have to be so careful”?, “What if I’m to busy to exercise”? You are right to ask all of these questions. It is not fun to have to monitor everything you do and to be so careful. It is fun to overindulge. If you must, give yourself one cheat day a week to eat the entire fridge (only kidding), to indulge in the decadent things that you love. It can be fried food, pizza, chocolate, etc…but it cannot lead into the next day and the next day and so on. Most people cannot give themselves a cheat day because it throws them off course. Most people will fall off course unless the weight loss is taken as an obsession and a way of life. This is why Dr. Dan Kirschenbaum encourages the Healthy Obsession Program, a program that does not encourage moderation with weight loss programs. He does not allow a cheat day and does not believe in moderation. His program is an excellent program, especially for people who are 100+ pounds overweight. However, it is difficult for people to keep up this healthy obsession for the long term without learning other ways of coping. That is why a cheat day is recommended, if you can get right back on your program. It is not an easy thing to do. In fact most people who are 100+ pounds overweight do not do well with a cheat day. Their cheat day becomes eating anything and everything they can get their hands on and it becomes very difficult to stop the cycle. If you are one of those people who can have one cheat day a week and get right back on the program, consider yourself lucky. If not you will need to be certain to have a trainer/coach/therapist to help you achieve your goals. It will also be helpful to have a registered dietician.
This is too expensive!
This sounds too costly? Once you have your program set up for you, you can certainly check in with these professionals once a month and stay on track if you have the internal motivation. If you cannot motivate yourself you may need professional help at least once a week. A creative way to cut costs could be to have a buddy that you chose to go on a weight loss program with. This will cut the cost in ½ and enable you to have the outside intervention that is needed. If you do an honest inventory and budget you will begin to see how much money you are spending on things you do not actually need (junk food being one of them). You may have more income that you initially thought, once you do a budget. If you have the opposite problem where you actually have less income than you thought and you are in debt and cannot afford anything else in your life, it will be important to prioritize goals. See where you are getting in trouble financially, and possibly work with a therapist covered on your insurance plan to help you prioritize and set realistic goals for yourself. Check in with a professional at least once a month. It is heartbreaking to see clients leave a program and say that they are ready to tackle the issues on their own (after a 60+ pound weight loss) only to gain the weight back within a three month period. Ultimately, they fall back into old patterns and habits and are too ashamed and embarrassed to call and make an appointment with a professional. Do not let that happen. There is no shame here. It took your entire life to develop these poor eating habits. You cannot expect that within 6 months of being on a weight loss program including Cognitive Behavioral Therapy, fitness coaching, fitness training, and working with a Registered Dietician, that you will have changed your bad habits and will be ready to be on your own. You will have learned an enormous amount and will have changed your behavior in the short term, but changing behavior takes years… not months. There is no guarantee that you will be able to do this on your own. It is also not recommended that you become completely dependent on your trainer/coach/therapist for the rest of your life. Give yourself a break and have a little patience with yourself. Forgive yourself if you fall of your program. Even if it has been a year since your therapist or trainer has seen you and all 100 pounds have come back, never be too ashamed to call and ask for help. That is what all helping professionals are there for. They know you cannot handle this alone. They understand that you need help. They went into the careers they are in because they understand this and have a higher purpose in life to help people. They care. Do not be ashamed.
Seek outside intervention
Continue outside intervention for as long as possible at an affordable cost to you
Do not think you are cured and completely stop outside interventions once you have lost the weight you desire to lose (this is especially important during crisis situations where you throw everything out that you have learned).
Lastly, this does not have to be torture. You will find that once you lose the unwanted pounds you will be able to eat many of the foods that you love. You will just have to eat much smaller portions than before. Now it will be satisfying to take just a bite of something you love instead of having to eat the entire plate. Can you do it? The results will be your motivator!