It’s that time of year again

when we are in full swing applying our New Year’s resolutions! Our Christmas indulgence often leads us to consider changes to our diet and exercise regime as January begins. We are encouraged by marketing and news of celebrity weight loss; this year it seems pictures of Adele are everywhere with her reported 7 stone weight loss (The Mirror, 10th Jan). This information filtering into our everyday lives likely serves to bring weight to the forefront of our minds on a regular basis. It also highlights our society’s culture of valuing thinness (Orbach, 2006). This can often raise negative feelings in us; that we are not doing well enough in meeting this ideal or it may raise worries about health. From my clinical experience I find that our culture and specific events such as the government campaign to tackle obesity can lead to feelings of shame if you are overweight. The answer? Well the mantra seems to be eat less, exercise more. The dieting industry ‘promise beauty, acceptance and a life free of problems’ (Woolsey, 2002). Many of us find however that we have tried a few diets but we are back to square one.

Many people become caught in ‘yo-yo dieting’; a term used to describe the cycle of losing weight and then gaining it again. Research evidence reveals this is a very common phenomenon, as only 20% of individuals are able to maintain weight loss over the course of a year (Wing & Phelan, 2005) In fact, there is also some evidence to suggest that dieting can lead to weight gain over time (Karkkainen, 2018). So why do so many of us not seem to manage to achieve what is sold to us? Well, there are both psychological and physical reasons why diets do not work, that are often inter-connected.

Psychologically, diets promise control in a sometimes overwhelming world, providing something concrete and simple to answer a complex problem.

Diets tend to use emotional labelling such as ‘good’ and ‘bad’ to describe foods often engendering feelings of guilt and shame (Woolsey, 2002). Have you ever noticed that when you decide to remove a food type from your diet you soon begin craving it all of the time? Restricting foods and tipping your body into a starvation state by not consuming enough calories (1500cals for women; 2000cals for men) and losing weight too quickly (1kg a week or more), leads your body to sense a major threat to life and it prompts you to refuel as soon as possible often through eating a banned food or having a binge (Waller, 2007). Psychologically, this can lead us to conclude we have broken the rules. Self-criticism and feelings of shame can follow reinforced by the dieting industry’s approach that this lapse is caused by a failure in your own willpower. This often leads to our relationship with food becoming very emotive, hence we need the diet to help manage those difficult emotions associated with food and the vicious cycle continues.

One’s relationship with food can also run much deeper than the success and failure of repeated dieting.

You may recognise family traits of using food to celebrate, commiserate or dull painful emotions. We know it is more likely for an individual’s weight to be within the obese range if they have experienced early life trauma (Gunstad et al., 2006). Emotional eating is the term used to describe over-eating in response to stress. It is especially common for example to hear people with such backgrounds speak of the physical sensation of emptiness that comes following parental neglect.  The feeling of being full, seems to numb that emotionally driven physical sensation. Food can become so entwined in our psychological make up it can be difficult to find a way out. So what is the way forward?

‘Successful weight loss involves not just losing weight, but avoiding weight regain’ (Waller, 2006)

This means making achievable long-term changes to eating behaviour and it is important to set realistic targets. Evidence now suggests that losing just 5-10% of your body weight brings about significant changes to your health (Vidal, 2002). Do not lose more than 0.5 to 1kg a week; eat 3 meals a day plus regular low fat snacks; eat more fruit and veg; cut down on fat; salt and added sugar; do not ban foods and try and do 30 minutes of moderate exercise on most days (Waller, 2006). It may be that you find this hard to achieve, because of emotional eating or finding it hard to let go of the unrealistic goals you have held for years and remaining stuck in the cycle. If that is the case then a course of Cognitive Behavioural Therapy (CBT) may be helpful in breaking down the problematic cycle you have become caught in. This may involve addressing your diet/shape related beliefs and finding other methods of coping with difficult emotions (Beck, 2010).

If you recognise yourself being caught in some of these dilemmas, please get in contact to arrange an assessment to see how psychological therapy might be able to help you begin to eat for health in 2020.

References
Beck. J.S. (2010) Stress and Emotional Eating: Using Cognitive Behaviour Therapy To Break The Habit. Retrieved from [https://www.psychologytoday.com/us/blog/thinking-thin/201011/stress-and-emotional-eating-using-cognitive-behavior-therapy-break-the]
Gunstad. J., Paul. R.H., Spitznagel. M.B., Cohen. R.A., Williams, L.M., Kohn. M., & Gordon. E. (2006) Exposure to early life trauma is associated with adult obesity. Psychiatry Research, 142 (1), p 31-37.
Karkkainen. U., Mustelin. L., Raevuori. A., Kapiro. J. & Keski-Rahkanen. (2018). Successful weight maintainers among young adults – a ten-year prospective population study. Eating Behaviors, 9, p 91-98.
Orbach. S. (2006) Fat Is A Feminist Issue. London: Penguin.
Vidal. J. (2002) Updated review on the benefits of weight loss. International Journal of Obesity, 26, Ps25-s28.
Waller. G., Cordery. H., Corstophine. E., Hinrichsen. H., Lawson. R., Mountford. V & Russell. K. (2007). Cognitive-Behavioural Therapy for Eating Disorders: A Comprehensive Treatment Guide. Cambridge: Cambridge University Press.
Wing. R.R. & Phelan. S. (2005). Long-term weight loss maintenance. The American Journal of Clinical Nutrition, 82 (1), p. 222S-225S.
Woolsey, M.M. (2002). Eating Disorders – A Clinical Guide to Counselling and Treatment. Chicago, IL: American Dietetic Association, pp. 155-156.