How Can I Lose Weight?
We hear this question a lot in primary care, and I have to admit, it is a difficult question to answer. Let me first say, everyone is coming with different backgrounds, ages, financial status, work life, home life, food accessibility…and let’s face it, these factors matter in determining the way we eat. A common thought is that weight is determined by calories in - calories out…but that is not the whole picture.
Some of the first questions a provider may ask when someone desires weight loss can sound something like this:
What measures have you tried? For how long? What is an ideal weight to you? What types of food do you eat, and how much/how often? Have you kept a food diary? Do you exercise?…etc…
While these questions are commonly asked, they admittedly miss the mark in addressing the real question behind desiring weight loss, which is, “What is your relationship with food?” and “How does food make your body feel?”
I know I might be bucking the trend here, but I can’t say I endorse any particular “weight loss” plan, diet, exercise regimen, or whatever restrictive behavior that may be initially appealing. I say this not to dismiss someone’s desire for weight loss - but instead, with total compassion. I struggled with my relationship with food, and therefore with my body, for many years, and I hate to see my patients struggle too. I followed ridiculous diets, got excited when they worked, and felt incredibly disappointed, ashamed, and felt “fat” when they didn’t. I saw my relationships and happiness crumble around me, not realizing just how embedded my toxic relationship with food became in my life.
I know not everyone has my story, but our culture surrounding food is a sad one, and I think my story has a lot of commonality to others contending with their body and food behaviors. American culture makes food shaming normal, if not expected, with the undertone that our bodies should reflect an impossible standard, and if it doesn’t, we should do everything we can to fix it. It’s as if eating is fighting, and your body is a battleground. But it doesn’t have to be this way.
When it comes to weight having adverse health consequences, as with many things, it has to be placed in context - a person’s age, gender, lifestyle, family history, and so much more. Their weight alone is not the problem. And while BMI is often a measure used to contextualize risk, a number on the scale is not the only way we determine health.
We underestimate the joy that food brings us. That food is social. Food is nourishing. Food ties together old memories and can make new ones. Food is a privilege - and many out there do not have a reliable source of nourishing food, or variety, or the means to choose.
So you’re reading this article because maybe you’re struggling with weight, or maybe you’re trying to understand how to help a loved one with their struggle, or maybe you’re just curious. Rather than focusing on weight, I invite you to instead consider the role that food plays in your life, and if you connect how your body feels to when you eat. Spend a few days logging not your calories or amount of food, but trying to gauge your physical sensation of hunger with what you eat. And then, after and during eating, periodically checking in with how your body feels, noting feelings of physical fullness, discomfort, or satisfaction, as well as other simultaneous feelings that are often layered around us - feelings of joy, boredom, fatigue, anger, anxiety, etc. It may seem a little bit awkward at first, but the more often you do this, the stronger your relationship with food will be, and in turn, a greater confidence in yourself for what your body truly needs. Approach yourself with kindness and curiosity, as you would with a friend who is struggling, rather than admonishment and shame, as is often done to ourselves if we don’t meet certain standards.
There is a wonderful book out there that helped me recover my relationship with food, it’s called Intuitive Eating. It details the questions I outlined above, and how to approach the journey to building (or re-building) a nourishing, lifelong relationship with food. I have no kickback from recommending this book, I’m not affiliated at all. I just know it helped me along the way, and I strongly believe it can help many others out there.
That all being said, having an open discussion about your goals, struggles, and finding a tailored plan that works for you is what’s most important. I’m here to meet you wherever you are on your road, and to be your best support toward the healthiest you.