3 ways talking therapies support weight loss goals

This time last year I hosted a three-day eating disorders awareness summit to share diverse narratives on eating disorders. One of the key topics we wanted to shift the narrative on was some of the myths around compulsive and binge eating disorders.

Talking with Dr Antequera of Soma the Associate Professor of Surgery at the European University of Madrid and Honorary Professor of Surgery in Juan Carlos University and Trinity College of Dublin exploring the correct weight without metabolic risk or the risk of dying of cardiovascular disease - the obesity epidemic.

In our society, even in poor countries, people are affected by obesity. Those affected often struggle not only with their health, but the physical consequences of being in a chronic condition, as well as discrimination at work and feeling judged which also impacts on mental health and well-being. 

Even in the healthcare system, people suffering with obesity are not getting the same solutions or speed of treatment as other diseases. But, not everyone who suffers with compulsive or binge eating disorders are obese. 

However, obesity, losing weight or maintaining a healthy weight are common themes for people struggling with overeating. Looking at the trends of obesity figures, everywhere in the world you can see that the amount of obesity in the United States is almost 50% of the population. Obesity is responsible for almost 7% of the total health expenses all over the world and here in the UK we are not far behind.

Does obesity put me at high risk of COVID-19? 

Living with excess weight is believed to put people at greater risk of serious illness or death from COVID-19, with risk growing substantially as body mass index (BMI) increases. Nearly 8% of critically ill patients with COVID-19 in intensive care units have been morbidly obese, compared with 2.9% of the general population. Also, people with chronic conditions such as diabetes are classified as vulnerable, hence more at risk.

According to Pembina Chippewa, a medical anthropologist at the University of Colorado, the severity of COVID-19 in people with obesity is disproportionate in some groups due to poverty, lack of access to healthy food and poor exercise opportunities combined increases risk.

In this pandemic quarantine lifestyle, staying at home and being more sedentary and digital, connected for work and social connection, it is cheap and easy for us to reach for unhealthy calories. Even in a pandemic when many are more time rich, we are still spending less time in the kitchen and more time on Uber Eats.

Obesity myths vs facts 

The future is here and the obesity whirlwind is everywhere. So, it is inevitable that Type 2 diabetes, often linked to diet and lifestyle will continue to grow and we will need to be more intentional about how we perceive obesity or alternative weight loss interventions.

One of the biggest myths is thinking obese patients are guilty, if they just had abit more discipline and self-control then they would lose weight easily. But, if you have ever worked with patients struggling with overeating or patients with Type 2 diabetes supporting a diet and lifestyle programme you will know some of the struggles people are facing to sustain weight loss and healthy, balanced eating.  

In reality food is just at the surface, underneath is a complex myriad of mixed emotions. The negative thinking a patient is experiencing, as well as the negative thoughts projected onto them from others, including healthcare professionals and the wider healthcare system can perpetuate this cycle of guilt and shame.

Another myth that needs to be expelled on obesity is around weight loss surgery and the purpose of weight loss surgery. Not to make people thin, but making people well and healthy.

Is surgery a lazy way to tackle obesity?

If you have been on the dieting rollercoaster for years with no success in sustaining weight loss, as time goes on and your weight increases, so does cardiovascular risk and other mortalities, including cancer and long term health conditions. 

If you are considering any kind of weight loss surgery as a treatment to obesity, you will still need to consider a holistic approach - it is not an alternative to nutrition and exercise or even psychological interventions.

Many studies comparing risks of weight loss surgery alongside diet, lifestyle and mental health interventions shows a relatively decreased risk in mortality for patients who underwent bariatric surgery. 

I think it is also very important to highlight it is not for aesthetics and it certainly isn’t for the lazy. Imposed physical restrictions will force unconscious struggles to the surface and with the removal of food as a coping mechanism, you will have to consider deeper and more buried issues much sooner.

Three ways talking therapies can support those struggling with weight loss

1. Recognise your negative thinking 

If you have been on the dieting rollercoaster for sometime and you are stuck in a rut, telling yourself you are useless because you are not losing any weight and feeling ashamed of your body, talking therapy could really help you to recognise your negative thinking and reduce your anxiety.

2. Identify what your self-talk is like

What are you saying to yourself each day? If your internal dialogue is mostly negative and what you tell yourself is harsh and punishing, it will be difficult to sustain your weight-loss goals because deep down you are telling yourself you can’t do it. Talking therapies can really help you to reflect on your self-talk, recognise your internal dialogue and help you to change your internal dialogue to become kinder and more nurturing.

3. Standing in front of a mirror

For people struggling with obesity standing in front of a mirror is often a painful experience and a reminder of failure when you look back at what you see. Talking therapies can provide an opportunity for you to walk through this with someone else, who is able to walk through the pain and discomfort without judgement alongside you, as well as offer you an alternative perspective to help broaden your perspective and perhaps even alter what you see in the reflection.

For many compulsive or overeaters, surgery is the last resort and not for the faint hearted. Weight loss surgery for some can be a life-saving solution in the fight against obesity. However, this is an option that must be considered holistically, alongside professionals who also promote talking therapies for the sustained management of obesity.

For people seeking weight loss surgery, you should perhaps also consider working with a therapist before embarking on surgery. If you are set on having bariatrics only consider surgeons who work alongside therapists and offer psychological support as part of the overall treatment.