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The psychology of weight loss

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Obesity levels are at an all-time high globally, having nearly tripled since 1975. Alarmingly, most of the world’s population now live in countries where excess weight and obesity kills more people than does malnourishment or being underweight.

The main cause of people becoming overweight or obese is an energy imbalance between calories consumed and calories used. Two main reasons for this is that there has been an increased intake of energy-dense foods that are high in fat; as well as an decrease in physical activity due to the increasingly inactive nature of work, changing modes of transportation, and increasing urbanisation.

There is no doubt that losing weight and reducing obesity has significant health benefits.

In fact, research now shows that losing just 5% of your body weight can lead to substantial improvements in health.

Furthermore, a study which investigated whether gradual weight loss was associated with greater long-term weight reduction than rapid initial loss, found that fast initial weight loss had both short- and long-term advantages over gradual weight loss. People who lost weight faster (greater than or equal to 0,68kg per week) achieved greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers (who lost less than 0.23 kg per week). 

The bottom line is that obesity is preventable. Why then are so many people overweight and obese and not losing weight?

One reason why weight loss attempts fail is that the person’s head is not in the right place. 

Dr Meg Arroll and Louise Atkinson, authors of the book ‘The Shrinkology Solution’, say that any diet is much more likely to work if you have got to the point where you are absolutely ready to lose weight and willing to make some changes to get there.

It’s mind over matter

We asked Johannesburg based clinical psychologist and Cognitive Behavioural Therapy specialist Dr Colinda Linde and Dr Hemant Nowbath, a specialist psychiatrist at Life Mount Edgecombe Hospital in KwaZulu-Natal, to weigh in on the subject of the psychology behind weight loss.

“Commitment is where it begins – make a list of pros or benefits of losing the weight, and be specific,”

says Dr Colinda Linde. Reasons could include having more range of motion in the body when getting up or moving around; clothes feeling more comfortable or being able to go for a walk without getting out of breath.

“Then list the costs of losing weight, as in, it’s an effort, you’ll need new clothes, it may feel strange to not have the ‘protection’ of extra weight around you,” she says and explains that there are certain psychological barriers to losing weight, such as the type of protection served by being overweight which can make a woman feel invisible to the opposite sex.

“For example, what if you lose the weight and you still don’t meet someone? This is one of the most common hidden fears people experience, especially women. Familiarity is also comfortable, whereas change is generally not, so this is a factor too. Finally, effort in the wrong direction can also lead to discouragement, for e.g. going to gym and doing exercise that is too short or not burning fat effectively, or snacking on ‘healthy food’ but in excess. Even healthy food in large enough amounts, will become fat if not used up!” she says.

Breaking bad habits

Dr Hemant Nowbath reiterates that changes in lifestyle such as eating habits, exercise, and substance use are difficult to make. “Habits are hard to break,” he says.

People also set unrealistic expectations and these unrealistic goals may hinder the process.

He adds that people with depression may lack motivation and lack interest. Another factor includes stress, which can distract however good the intention. Importantly, he also says that there still exists ignorance about the dangers associated with obesity.

About food being used for comfort, Dr Linde says that this is very common. “Think about babies – breast or bottle, they must be held while drinking, and so there is a conditioning of nurturing and food. Then when a toddler gets hurt, what do we offer them along with a hug? That’s right, a biscuit. And what do we give each other when there’s a loss, or celebration? Food is the number one choice. So there are many instances throughout our lives of where food and emotion/comfort become linked, and when we are adults it’s small wonder we turn to food for comfort!” she explains.

Setting expectations

As far as being realistic, Dr Linde suggests getting advice from a professional as to your fat content, and what the realistic range is for your body and age. She says people should not only rely on a BMI calculation which does not take bone density into account.

“Break it into small, weekly goals, which are small enough to be realistic as well as achievable, with moderate effort. Rather set goals within reasonable limits, than get over zealous and give up due to not achieving them or running out of steam,” she suggests.

Dr Nowbath believes that the approach to the treatment of obesity must be holistic and tailored to individual patients. “A ‘one-size-fits-all’ approach is bound to fail,” he says. “An assessment by a dietitian is essential. A dietitian will structure a specific, suitable diet for an individual patient. The secret lies in getting patients sufficiently motivated to adhere to the diet,” he says.

Avoid fads and quick fixes

Dr Nowbath warns people to be wary of the quick fixes which can be detrimental to one’s health. He adds that psychotherapy, such as supportive therapy or cognitive therapy, can be an important component of treatment. “Group therapy can connect patients with others who have similar problems, creates cohesion and provides valuable support,” he says6.

Dr Linde says that the focus should be on a change in lifestyle, incorporating the new eating habits into one’s daily living, instead of crash diets. Dr Linde’s new eBook called Healthy kids, smart choices: the Top Tips, Tricks & Tools every parent should know about children and food, is out now and can be found on www.thoughtsfirst.com on Kindle soon.

Prescription medication together with lifestyle adjustments such as a healthy eating and exercise plan, can help kickstart a weight loss journey, or can help someone get back on track.Speak to your doctor about options for weight loss management or go to www.ilivelite.co.za for more information or for dietician-formulated, kilojoule specific meal plans, which are initiated and guided by your GP for individualised kilojoule intake.

Author: Pedro van Gaalen

When he’s not writing about sport or health and fitness, Pedro is probably out training for his next marathon or ultra-marathon. He’s worked as a fitness professional and as a marketing and comms expert. He now combines his passions in his role as managing editor at Fitness magazine.

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