Weight Loss, Body Acceptance, and Healthy Habits

 "The curious paradox is that when I accept myself just as I am, then I change." ~Carl Rogers

I cannot think of many areas in healthcare that are as emotionally charged as the concept of weight loss. Physicians are quick to recommend weight loss to just about every patient that walks though their doors and many people ignore it or take it personally--and how can we blame them for doing so when it's likely that they've been insulted, teased, and harassed throughout their lives for being overweight? However we may feel when receiving such feedback, it doesn't make the recommendation any less valid. Indeed, the social, emotional, and health consequences of obesity are well documented across the various healthcare fields. 

Now add the relatively new-age concepts of body acceptance and body positivity and many people leap to the assumption that those two subjects run counter to traditional concepts of health and wellness and promote unhealthy habits or enable dangerous/irresponsible behavior.

*They don't.* and I'll explain why later.

Doctor: "Would you like to increase mobility, decrease reliance on medication, lengthen your life 10 years, find energy you never knew you had, sleep better, alleviate or prevent chronic pain issues, and manage your blood sugar so that you don't become diabetic?" 

Patient: "Sure! Who wouldn't? Sign me up!"

Doctor: "Then I recommend you start an exercise routine and make healthier choices in your diet by adding fruit and veggies and eating less red meat, starches, and salt." 

Patient: "Yeah, thanks but no thanks, Doc. I work 60 hours a week, have three kids, and an endless honey-do list to tackle. Where should I pick up the prescription?"

It's well-documented that stress--more accurately, cortisol--a stress hormone--promotes weight-gain. People develop habits over time of eating when stressed, bored, lonely, tired, depressed, anxious, etc. (it's all technically "stress", really). We attempt to manage our stress primarily by managing our time and our diets and sleep are the usual sacrifices we make to Kronos, followed by exercise and our social lives. We instinctively reach for the quick and easy meals that fill us up. Each of these meals tend to have half the nutrients we need for a whole day in a single meal--but they taste good and save us time and energy after a long day's work, right?

In the example conversation I gave above, the patient was in agreement with the doctor that the benefits of having a healthy diet and more exercise would be ideal, but they didn't see how it would be possible to live their current life with fewer tools for emotional regulation/stress reduction and less time.

So how do we move forward from here?

Stages of Change

In counseling, we are frequently gauging which stage of change a client is in. It helps us sort of keep a finger on the pulse of what is happening with the client's experience so we can predict more accurately when to gently push and when back up and regroup. The five stages of change comes out of years of research pioneered by Dr. James Prochaska and are as follows:

1. Precontemplation--No intention to change anything at all and unaware of problem
2. Contemplation--No intention to change at this time, but aware of problem
3. Preparation--Intends to change and is gathering information and setting up a plan to do so
4. Action--Currently implementing the plan developed in the preparation stage
5. Maintenance--relapse prevention and solidifying action stage behaviors into habit

Chances are, when you're at the doctor's office getting a physical, you're either in stage 1 or 2 and any advice or directives they give you will likely be pushed aside or later used in the preparation stage--and that isn't your fault! That's the entire point of what annual physicals are for: to identify if there is a problem and to start educating you on it--but there's a difference between stage 2 and 3 and treating someone in the contemplation stage of change as if they're in the preparation stage is pointless and can even make people stay in the contemplation stage longer than they would otherwise. Ever try and tell a friend or loved one to leave a toxic relationship? How did that work out? 

Working with a therapist can help you move through these stages but the catch is that you'll have to want to move through the stage you're in, as the therapist can't make you. We all want things in life that are just out of reach given where we currently are standing. 

Body Acceptance and Body Positivity

As a former Cavalry Scout for the US Army, land navigation was an extremely important task I had to master. Though I no longer have much need for such a skill, one lesson has stuck with me since I left the service that others have found useful when I've shared it with them in therapy: In order to find your path to your destination, you must first know where you currently stand. Look around and take in your surroundings. What do you see? What do you hear? What do you feel? What do you smell? Putting it all together will help you find yourself on that map and from there, you plot your path and move--making sure to find yourself again and again along the way. 

In therapy, "finding yourself" can mean a lot of things to different people, but in relation to weight loss and building healthy habits, it means to raise awareness and acceptance of who you are now. If you're depressed because of you're overweight and you believe that overweight people are somehow inferior or unlovable, then you're likely going to struggle to find yourself on the "map" because you aren't inferior or unlovable! By accepting yourself as you are--and it's okay to want a healthier lifestyle, but by accepting yourself as you are and loving yourself as you are, you'll be much more successful in your endeavor to make your changes--hence the paradox that Carl Rogers described in the opening quote to this article.

And even if you remain overweight for the rest of your life, you'll understand that it has nothing to do with your value as a person. It is better to be overweight and accept yourself than it is to be overweight and miserable. At least then you'll give yourself a fighting-chance to start making healthier choices to nourish the body you love.

A Personal Example

Stage 1: I took my metabolism for granted as a teenager and young adult. No matter what I ate, I was thin and appeared healthy. People would marvel over how much I could eat and still look good--I grew proud of my ability to put away a whole large pizza in one sitting without apparent consequences (thanks to the miracle of lactase tablets). Without those consequences, I easily developed a habit of eating out of boredom or "treating myself" after a stressful day of hard work. Even my annual physicals told me that I wasn't doing anything wrong, despite eating Triple Whoppers several times a week.

 

 

Stage 2: Then my pants started to get uncomfortable. My waist had been a solid 31 inches since high school and I wore a small/regular uniform while in the service. Once my pants started to be a struggle to clasp, button, or zip up, I told myself that I didn't want to spend the money buying new pants if I could just start exercising again and keep the ones I had.

Stage 3: Without really doing much homework, I assumed that if I ran daily around a couple blocks during the summer and early fall one year and went on a diet, I could get my weight down. I planned on weighing myself every day to check my progress and figured that this plan would be good enough.

 

Stage 4: I tried a handful of times to exercise and a fad diet or two, but I was never fully committed to them. They were always seen as temporary alterations to my behavior that I would shed as soon as I was able to get into my clothes comfortably. I felt hungry all the time and was miserable. None of these attempts were focused on being more healthy, rather they were focused purely on losing weight and none of these attempts were successful in the long-run. I'd soon give up trying altogether.

Stage 1: I stopped buttoning the top button of my jeans and started wearing a belt to conceal that fact. Problem solved. I went back to eating and drinking whatever I wanted, whenever I wanted. I felt better and was back to enjoying as much pizza as I could get away with. Again, I wasn't thinking at all about how this was going to impact my overall health.

Stage 2: After an annual physical, my Doctor informed me that my blood pressure was significantly higher than it usually is, but not dangerously high... yet. I also weighed about 180 lbs. I felt concerned about my health, but not concerned enough to make significant changes to my lifestyle--I was convinced that I was too busy running and building my business and couldn't afford to introduce the stress of another fad diet and exercise while working 7 days a week. I gave in and bought larger clothes that fit me better. At the very least, I was comfortable and felt more confident.

 

Stage 3: My wife and I went on vacation to Hawaii. She had been exercising and eating much more healthily for a while in preparation for this trip, while I continued to assume that I was healthy enough to see everything we had planned on seeing. Paradoxically, I was self-conscious about my weight and wore sun-shirts to the beach to hide my body while also protecting my ghostly white complexion from the summer sun. We visited the summit of the Haleakala and went on a two hour hike down into the volcano's crater--without even thinking about how I would be able to climb back out of it. I was exhausted and actually got to the point where I worried that I would need assistance to finish the trek back to the summit. My wife made it out without any issue and I knew that her efforts at her gym and healthy diet had suited her well for the task. When we left Hawaii, I made up my mind that I would join her at her gym and adopt her attitude and commitment toward nutrition and health. If I was going to continue seeing the world with her for as long as I could, I knew I had to make time--as she did--for myself.

Stage 4: I joined the gym that my wife was now coaching others in and I was nervous at first, but soon found that everyone was welcoming and we all encouraged each other. Prior to starting, we were given a class on nutrition with actionable guidelines that was based on science and not somebody's get-rich-quick scheme to sell a repackaged starvation diet to desperate people. I trusted everything I was being told largely because I personally witnessed her increase in energy, strength, mood, and confidence; I knew I just had to follow the program and something would change. 

Everyone had to get their pictures taken at the start of the 10 week introductory course, along with measurements of their chest, stomach, waist, thighs, and arms. We were discouraged from stepping on scales between official measurements because of how discouraging it can be to see the scale move so slowly--or not at all. 

I showed up every day and stuck to the nutrition plan I was taught and within a week or two, I started to see and feel the difference between actively making healthy choices and not. I found more energy throughout the day that I never knew I was missing. I stopped eating my feelings and out of boredom and started eating to fuel my body. I was more mindful of the consequences of my dietary choices. I no longer had to take my nightly antacid tablets that I had been chewing for years to stave off heartburn and indigestion. I ended up winning 2nd place in my class in terms of my transformation!

Toward the end of the 10 week program, I had never considered going back to my old relationship with food and exercise. Then I suffered an injury afterward that kept me off my feet for about 6 months and by the time I was ready to go back to the gym, the COVID-19 pandemic was in full-swing. My dietary habits essentially went back to the way they were prior to joining the gym and I regained all of the weight I lost plus an extra 10 lbs--this was my first real setback in my attempt to live a more healthy lifestyle. I kept telling myself that it was temporary and that I would start my health journey again when I felt that things were safe enough to go back to my daily exercises. 

In October of 2020, I went back to the gym for a few weeks before I ended up getting sick with COVID-19--the nurse weighed me in at 190 lbs. I was heartbroken--not because I was overweight again, but because I allowed myself to lose site of my my goals. Once I recovered from COVID-19, I endeavored to restart my health routine--this time, I worked out at home and recommitted to my nutrition plan.

Stage 5: As of this post, I am 157 lbs and stronger and more healthy than I can remember ever being. I still workout at home 6 days a week and have stuck to my nutrition plan nearly every day (I make exceptions for vacations). I've learned that one doesn't make one decision to commit to being more healthy. Instead, they must choose to make healthy decisions over and over again. My acceptance of my body as it was along with my acceptance of the consequences of my daily habits allowed me to find myself on my map. After that, all that remained was for me to identify where I wanted to be and plot a course. No plan is fool-proof and failure is the part of life that teaches us the most important lessons. I don't plan on having another setback, but I accept that it will happen again. When it does, I can either commit myself to learn from it then or wait until I learn from it later.

I hope this post teaches those who are concerned about their weight to accept themselves as they are and shift their focus to their health. So many factors that we cannot directly control go into what we weigh on a given day, but we CAN control whether or not we make a healthy choice in this moment. You can act healthily all day long and not lose a single pound today--and if you're weight-focused, that may discourage you from trying any further. However, if you're focused on being more healthy, then simply making a healthy choice in any given moment is an achievement in and of itself.