‘Tis the dieting season

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It’s January and the weight loss industry is gearing itself up for the most intensive part of their year. Many have gained a little too much perhaps over the holidays and now they are resolved to losing some of it. An improved diet and added exercise can obviously bring many benefits, but if you are really serious about losing weight long-term I have some added suggestions.

First, you should try to understand why you gained the weight to begin with. Unless you understand this you are less likely to keep the weight off long-term. Factors such as stress, negative thoughts and negative emotions usually play a major role in weight gain, it’s not just about overindulgence or a lack of exercise. You need to go a little deeper.

Secondly, keep a diary of your thoughts and emotions, particularly when it comes to situations where you experience negative thoughts and emotions, but also what makes you happy and relaxed. By becoming more aware of what presses your buttons so to speak, you can avoid getting into the same situations again, so that your thoughts and emotions gradually become more positive.

Thirdly, try to have a mindset where you do things, such as weight loss, out of a positive perspective, i.e. as a reward and not as a kind of self-punishment. If you feel like your weight loss regimen is a punishment, it will probably not work very well.

Finally, learn to listen to your body and what is needs, don’t disconnect from it or view it as something dysfunctional. Remember that  there are always reasons your body has stored extra weight. If you can get to the source of the weight gain, the path to lasting weight loss will be much clearer.

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Chasing a different body weight: what are you trying to compensate for?

Arnold-Schwarzenegger

It seems that whenever we feel that we are lacking something, we usually try very hard to compensate for that lack. The kind of lack that we want to compensate the most is any type of inner lack, for example a lack of self-esteem, self-compassion or feeling inadequate in some way, for example by not conforming to current body shape ideals.

And when we have this much focus on bodies and appearance, it is more or less impossible to feel totally fulfilled in the way we look, because we are constantly bombarded with messages of how the “perfect” body should look, i.e. how you should look. This is all a cynical sham of course. Most if not all of those pictures of slim, toned and tanned bodies we see in advertising have been photoshopped beyond belief.

Companies are very good at making us feel a particular type of lack that their service or product can compensate for, maybe a new car (the old one is not good enough), plastic surgery (your body is not pretty enough) or weight loss (you don’t want to look fat while on the beach this summer), etc. Buying something for ourselves can obviously perk us up a bit but we also know that this effect is very short-lived, a mere rush, unless there is a genuine internal change (which usually takes time and effort).

Since body weight is very much influenced by our internal beliefs, thoughts, feelings and emotions, we can help ourselves improve on those internal factors by understanding more about what we are trying to compensate. For example, if we feel that our current weight is not appropriate, then we have negative thoughts, feelings and emotions about our body that we need to be aware of. Perhaps you were told as a child that you needed to lose weight by a parent, a teacher, a coach, i.e. you were told that there was something wrong with the way you looked. Maybe you then internalized those beliefs, which then started to influence your thoughts, feelings and emotions regarding your appearance and body weight.

Bild 2014-10-27 kl. 08.25 #2

If you are running around from one diet to the next, perhaps it is time to look at those negative beliefs, thoughts, feelings and emotions, to see where they come from, and start practicing greater body acceptance instead to gradually reduce those negative internals factors. You will certainly feel better about yourself, and you will be much less vulnerable in the future to negative outside influences, e.g. advertising that promotes unrealistic body shape ideals.

Bullying and obesity go hand in hand in so many ways

If you have any working experience in an obesity treatment facility you would be very familiar with the many gut-wrenching stories of bullying that the patients have experienced. A routine question to ask the patients is if they have any clue as to why they gained the extra weight to begin with. It’s not unusual to hear that it all started with the bullying, usually from a young age.

bullies_kids

You may think that this is mainly peer-to-peer, but it can definitely be from parents as well. Usually this would be related to something they perceive to be not quite right with the child, perhaps carrying a tiny, tiny amount of extra weight. The child will then be told that there is something wrong with them. Obviously this is not the case, it’s the parent who is wrong for instilling the child with an erroneous negative self-belief (there is something wrong with me).

And how many stories have we not heard about  the completely insensitive bullying athletics coach/PE teacher who thinks that the child is overweight and needs to lose weight ASAP, and who always picks these children last for the teams, et cetera, et cetera.

The message for these bullied children is unbelievably negative: you are not good enough, there is something wrong with you, nobody wants to be with you. It’s not exactly strange that the obese in general have lower self-esteem and confidence than normal weight individuals, both as children and as adults.

Then there is the more classic case of bullying among children, sometimes from pre-school, because of a lack of tolerance and respect for what looks slightly out of the norm, particularly give our completely unrealistic body shape ideals. More and more studies are now confirming all those anecdotes about the toxic effects of bullying:

http://www.ncbi.nlm.nih.gov/pubmed/25157018

Indeed, obese children are much more likely to suffer bullying than normal weight children, which is confirmed by both the children themselves and also the teachers. But this does not mean that the bullying only happens during the childhood years. Studies on obesity bias and discrimination are becoming much more common, for example by Rebecca Puhl and colleagues at Yale. Please take the time to watch some if not all of this excellent talk, for example on how stigmatization has a profoundly negative effect on our physical, social, psychological and emotional health and well-being:

If we are serious about preventing obesity, we cannot emphasize enough the importance of zero tolerance towards bullying, in whatever form it comes in, and regardless of where it comes from. We also need to address all those negative self-beliefs and fears that arise as a result of bullying. This include things like body dissatisfaction because we perceived our body as the reason the bullying started in the first place.

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I also firmly believe that anyone who wants to lose weight long-term needs to overcome their more or less inevitable body dissatisfaction, and connect in a more positive way with their bodies, as opposed to rejecting them and seeing them as the source of shame and discomfort. The more you have of negative thoughts and emotions in relation to your body, the more weight you are likely to trap. It’s not exactly a surprise that more and more studies are now confirming that bullying leads to weight gain, which leads to more bulling, which leads to more weight gain, which leads to more bullying…

Erik Hemmingsson

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Lasting weight loss comes from the inside, not the outside

It’s quite remarkable just how much we continue to search for well-being and happiness from outside sources, such as a new job, new relationship, new car, hairstyle, watch, suit, dress, shoes, and the list goes on. If you take a step back and look at our general way of life, it kind of feels like we are conditioned to run around the treadmill of life constantly in need of outside things and gadgets to make us happy. Of course, we rarely get any lasting fulfillment in getting those new shoes, or whatever we long for, yet we keep doing it over and over again.

Einstein

The same can definitely be said of dieting. The pattern of weight loss and regain will be very familiar to all those who struggle with weight problems. A very large part of why dieting fails is that we don’t get to the bottom of why the weight gain occurred to begin with, and, even though there are different ways of looking at this, my view is that the vast majority of weight gain comes from the inside in the form of negative thoughts and emotions. The origins of those negative thoughts and emotions can be very complex but there is no doubt that they usually make their debut during childhood and stay with us as adults, consciously or not.

Negative thoughts and emotions have a huge influence on our health and well-being, and obviously our weight, both in terms of regulating stress, metabolism and inflammation, but also lifestyle choices and habits. This is why I am convinced that any lasting weight loss is very unlikely to come from outside sources, it needs to come from within. Once you start to understand more about your thoughts and emotions, you can shed the weight in a very natural way, because, in a sense, your body will no longer have its fat storage programs activated (set-point theory) as a result of psychological and emotional distress.

Obviously it could take a while to go through such an internal cleaning process, but I also believe that it does not have to take years or decades, it’s really up to you how hard you work at it. And you should certainly get qualified support if you need it.

But if you skip working on your internal issues and instead go for what you perceive to be the easy way out, i.e. trying a solution from outside sources such as a diet, you are not likely to be successful long-term since those fat storage programs will still be activated, and the weight will likely come back on. Or you will need to be super disciplined in terms of what you eat and how much you exercise for the rest of your life. Some people manage this, but not very many (I know I wouldn’t).

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In terms of losing weight long-term, I believe it’s about time we stopped fighting against our bodies and instead realized that we need to work with our bodies instead. If you are carrying excess weight, it probably means that your body has activated fat storage programs as a result of your internal distress (fat is basically a survival mechanism, and your body is reacting quite naturally to stress). Your best bet in deactivating those programs will be to find out why they are activated to begin with, and then gradually turn them off by releasing those internal distress factors.

Erik Hemmingsson

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New exciting frontiers in obesity research

microscopy

Some of you may be aware of that I used to do research on the role of behavior therapy and low calorie diets in the treatment of obesity, but that I realized some time ago that such treatment options did not provide any long-term solution to the treatment (or prevention) conundrum. Instead I decided to dig a little deeper and look into traumatic childhood experiences, which was very interesting, but to say that obesity is a result of childhood trauma would be a gross exaggeration and oversimplification.

Through a combination of listening more and more to patients as well as copious reading, I have come to focus my efforts on the early life (childhood) social environment. This also includes the time spent in the womb, and such factors as maternal distress and malnutrition, which has a huge effect on the baby.

The path to weight gain and subsequent obesity generally starts before the age of 5, so this is clearly the time we need to investigate more. What is becoming more and more clear is that any type of family dysfunction can very easily transfer to the child in the form of negative belief systems, negative emotions, stress, insecurity, low self-esteem, low self-worth, and so on. The real catalyst of family dysfunction is socioeconomic adversity, but obviously there are other factors as well, such as relationship discord, job insecurity, segregation, a lack of support and cohesion, disease, and food insecurity.

Let me stress that family dysfunction does not imply gross disturbances or failings, it can probably be quite subtle to have a negative effect, depending on factors like resilience and external support, perhaps from a significant other such as a grandmother or grandfather. More or less all families have some kind of dysfunction within them, it’s all shades of grey, perhaps not all the time but at least during critical periods. The effects is likely a balancing act between the amount, duration and type of adverse social exposure, combined with the above-mentioned protective factors.

What is clear is that as we grow older, we carry the effects of those early years with us, consciously or not. If someone is exposed to a lot of early life adversity, it will only be a matter of time before physical manifestations occur in the shape of increased stress, inflammation, as well as metabolic and endocrine perturbations. There is also likely to be behavioral disturbances, such as eating to suppress negative emotions. Eventually, this will lead to a disruption of homeostasis and weight gain.

This why I am very excited to dig deeper into this new field of research that focuses on the child’s social/family environment, and how those early years continue to influence us as adults many years later. The ACE study, which I wrote about recently, conclusively shows that adverse childhood abuseis the #1 cause of early mortality, numerous morbidities, addiction and functional limitations, so there can be no doubt about the very powerful effects that adverse childhood experiences has on us.

It really is time we took those early childhood years more seriously in the obesity field. Personally, I think there is a gold mine of information there, just waiting to be explored. Hopefully this will get us closer to the root causes of obesity, which should be of great benefit for eventually banishing the whole epidemic.

 

Erik Hemmingsson