I have spent the past almost-five years studying obesity, weight loss and mental health. My research is driven by one overarching idea — that when it comes to weight-loss treatment, we’re missing something. Roughly 80% of people who lose weight gain it back. This is especially relevant in Oklahoma, where more than one in three adults have obesity.
When we lose weight, our bodies make changes to try to gain that weight back. Our hormones change, making us feel hungrier; our metabolism slows down, making us have to do more work to burn the same number of calories. We biologically fight against weight loss. Why? Because, historically, losing weight meant that you were sick. It was dangerous. Therefore, we have built-in protection mechanisms. To struggle with losing weight and keeping it off doesn’t mean that we are weak, it means that we are human.
Beyond that, our early-life environment affects our ability to lose weight. Oklahoma State University’s Dr. Misty Hawkins has found evidence that experiencing stressful or traumatic events in childhood — perhaps abuse, neglect or family mental illness — puts individuals at a greater risk for developing obesity and for having a harder time losing weight.
I believe what we’re missing when it comes to weight loss treatment is compassion. The idea that self-discipline is all it takes to be successful at weight loss — and that all people’s abilities to lose weight are the same — is not only uninformed and incorrect, but it’s also harmful. It’s rooted in a cultural bias against larger bodies. These negative attitudes and beliefs about excess weight and the individuals who carry it cause physical and mental harm. We can call this weight stigma, and it’s linked to the same negative health outcomes as obesity — things like heart attack and stroke. Research suggests that stigma is an important component in the development of these conditions.
Weight stigma is harmful because it’s stressful; being stigmatized leads to increases in the stress hormone cortisol. My dissertation, which has been funded by the National Institutes of Health, seeks to learn more about how the stress of weight stigma impacts the body.
Weight stigma can also lead to depression, anxiety and poor self-esteem. It encourages us to eat comfort foods and to avoid places that we might encounter additional stigma (e.g., the gym, the doctor). Being stigmatized makes it more likely for a person to gain additional weight and develop further health problems than for them to lose weight or experience improved health.
Certainly, the traditional just-eat-less-and-move-more approach to weight loss, in absence of compassion, works for some people. But our research suggests that individuals who are more accepting of their cravings for delicious foods are better able to regulate their eating. This acceptance, or compassion, is often neglected. So instead of using tough love to encourage your friend, your family member or even yourself to try to lose weight, consider ways to offer compassion. Consider how the unconscious bias against excess weight is present in your attitude and conversations. Consider how to give encouragement from a place of love and acceptance, not criticism and shame.
The pandemic is encouraging us to find ways to cope with difficult emotions and to protect and love our neighbors. Now is a good time to understand the challenge of our biology and the added burden of past and present stressful experiences, including weight stigma, in order to show love to our bodies, too.
Natalie Keirns is a clinical psychology doctoral student in the REACH Lab at Oklahoma State University. Her work has been supported by the Center for Integrative Research on Childhood Adversity (CIRCA), which is funded by a NIH Phase I COBRE award through the OSU Center for Health Sciences, and by a NIH F31 NRSA Predoctoral Dissertation Award.
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