Thursday, December 6, 2012

Waiting on Weight Loss

As I often talk about in my lectures, many obese individuals appear to be waiting for their life to start – dreaming of all the things they will eventually do (next week, after their final exam, after Christmas, on January 1st, next Summer, etc.) after they finally get the weight off.

Canadian Obesity Network bootcamper Nicole Glenn, from the University of Alberta, has now published an exploration of just this issue in a paper titled, “Weight-ing: The Experience of Waiting on Weight Loss”, in the journal Qualitative Health Research.

In this phenomenological exploration of what it means to wait for weight loss, Nicole examines the weight wait through experiences gleaned from interviews, blogs and other sources.

As is typical for this type of work, the analysis is deeply personal and subjective and makes no claims to ‘saturation’ or universality of the interpretation or experience. Yet it provides deep insights into an issue that concerns millions of people living with excess weight.

“Phenomenological research aims for a certain effect, one that can lead us to suddenly see or grasp a human phenomenon in a way that enriches our understanding of everyday life experiences. Such seeing may transform our being and thus our practices”

As she writes,

“Waiting on weight loss shows itself through the promise of starting over, through repetition and resolution. The journey begins again, and again, and again. Or at the very least, the possibility of the wait for weight loss rebeginning is ever present.

‘It is January 2nd. I face the scale: Get on, get off. Repeat. I spend the rest of the day telling myself that I will do better, that things will change. Nevertheless I find myself cutting up the leftover ham, mindlessly stuffing the sweet, brown sugar goodness into my mouth. I can literally feel my rings tighten and ankles swell. I start to sob. I told myself last year I would not be in this position next year. In fact, I’ve made pretty much the same promise to myself for the past 20 years.’”

And yet, weight loss, even when it occurs is not the end of the wait – it may now be a wait (fear) for the weight to come back:

“I am somehow unsafe in this my new, thin body. Here I cannot let my guard down. I cannot dwell as I would in a place that is truly my home. So I am left to wonder if the waiting has really ended.”

As for the clinical implications of her findings, Nicole states:

“Recommendations for weight loss are commonplace in contemporary culture, with infomercials and commercials on television, and print and online advertising constantly offering up the newest ways to slim down…..I do not seek to confirm or refute the effectiveness of weight loss as a treatment, but instead strive to shift the focus to how such recommendations might manifest in an individual’s lived experience.”

As I have often said before, simply throwing out “weight loss recommendations” or even just linking numbers on the scale to “health” contains a message of “value” that is hurtful, damaging, and does harm.

Hopefully this paper will be read both by those interested in health promotion as well as everyone involved in obesity management.

AMS
Edmonton, Alberta

photo credit: openDemocracy via photopin cc

ResearchBlogging.orgGlenn NM (2012). Weight-ing: The Experience of Waiting on Weight Loss. Qualitative health research PMID: 23202478

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9 Responses to “Waiting on Weight Loss”

  1. Bobbini says:

    I would encourage people interested in this subject–waiting for your life to begin until after you’ve finally lost that weight–to read Kate Harding’s post on “The Fantasy of Being Thin”:
    http://kateharding.net/2007/11/27/the-fantasy-of-being-thin/

  2. DebraSY says:

    Succinct: “I am somehow unsafe in this my new, thin body. Here I cannot let my guard down. I cannot dwell as I would in a place that is truly my home. So I am left to wonder if the waiting has really ended.”

    What most people don’t realize, and I know all too intimately, if you can last a decade maintaining radical loss, or most of it, this fear is still a constant companion. I slide up at a rate of a pound and a half per year only, and that may be credited to continual diligence and fighting off natural (hormonally driven) impulses to eat. I’m now at minus 26% of highest established weight (or, for the benefit of bariatric surgeons, whose prefer numbers that are horribly misleading, I’m down still by 89% of “excess weight” — and I’m doing it without benefit of surgery). At my lowest, I was at minus 33% of highest established weight, or down by 117% of “excess weight.”

    Most regainers take on a pound and a half or more each month. Empirical research shows that 97% of dieters who lose radical weight will regain all of it within five years (most of these people will do it in the first year) This is an emotional roller coaster: the thrill of grasping society’s brass ring followed by the painful, horribly public humiliation of regaining. Regainers know what people are thinking. “But she looked so great . . . Why is she letting herself go?” People: she’s not letting herself go.

    In the orthodontist’s waiting room yesterday I read an “article” in one of those awful local slick magazines that allow advertisers to write “news” stories on their products. A weight-loss clinic that had been open less than two years, and overseen/owned by an MD, was reporting all kinds of (vague) success because of their three-part program. I rolled my eyes. The loss part, of course, was presented as the noble challenge that they could help patients face (so their new lives could begin), and maintenance was presented in the third phase as being a time when patients could, with oversight by the program’s RD, add back in foods and increase their consumption. Got news for you people: if you don’t want to regain, then the amount of exercise and the amount of food intake that you entertain on the day you reach your “goal” is what you’re gonna do for the rest of your life, day in day out, and even then you will regain. But only a little per year if you can ignore your body’s cues to eat more.

    Obviously, that little paragraph in your post hit a nerve with me, didn’t it? Thanks for letting me rant.

  3. Mavis says:

    This is wonderful. It is so touching and so true. Many overweight individuals delay gratification and therefore surcumvent joy because of the shame and guilt of obesity. This is a GREAT paper. I have helped coach many people to begin enjoying life first and NOW so that they can stay present and focus on the behaviors that cause overeating. I have a patient who has lost 125 pounds, and although he is a new man bodywise, he has refocused his depression on other self depreciating thoughts. Obesity is no longer an issue for him but he is still delaying gratification. Waiting for weight loss is very common in obesity. Speaking from personal experience being an obese child and then becoming a counselor, the trial of weight loss and the dream of weight normalcy can be excruciating. More, More……

  4. SLCCOM says:

    Anyone else who was so fixated on something else as these people are on weight would be diagnosed as mentaly ill. I made a decision back in my 20s after talking to a woman who had lost a lot of weight and was keeping it off. She spent every waking minute planning what she was and was not going to eat. I refuse to live that way.

    I’m not interested in obsession. Unless my depression is getting out of control, maintain my weight without much mental effort, and I refuse to “diet” ever again, since dieting got me 100 pounds overweight. If I had just accepted myself at 20-30 pounds over, I would be much thinner now.

  5. Ms G says:

    The paradigm of shame and guilt and waiting to live may be common, but it is by no means universal. I led a full , rich and shameless life at 330, and losing weight meant a lot of great things, but really had little impact on my life experience, except in the obvious physical ways of greater mobility and energy. I am really happy with my weight loss, but no more so or less happy or depressed than when I was so obese. My fears were/are not of ‘being fat’ or ‘becoming fat again’ but of the effects- fear of falling, fear of being unable to walk far, fear of diabetes, fear of heart attack etc. I want to be respectful of others experience and not diminish it, but have it be acknowledged that it is not universal, and it is dangerous and damaging to consider it so.

  6. Nicole says:

    Thank you for the very thoughtful summary of my work Arya.

  7. RNegade (hopefulandfree) says:

    Nicole Glenn writes, poignantly, “I am somehow unsafe in this my new, thin body. Here I cannot let my guard down. I cannot dwell as I would in a place that is truly my home. So I am left to wonder if the waiting has really ended.”

    I cannot speak for Nicole, of course, but I have found that my body is not the enemy.

    My body was not my enemy when I was “obese”. My body is not my enemy now that I am “thin” or, more precisely, now that I have a body size which is socially constructed as “normal”—a category wholly created and perpetuated by dominant discourses, including medical discourse, indeed, a category which serves to construct social status, as do the categories “overweight” and “obese”—two categories of body size which also happen to socially construct privilege and material rewards, incidentally, for those who claim to offer “effective treatments” for people supposedly “suffering from” these particular body sizes.

    As long as I continued to believe that my body was the enemy (and I responded to my body’s needs as if my body was an “unsafe” and frightening foe that I needed to “guard” against), the real enemies remained victorious and powerful.

    As long as I relied on dominant discourses to dictate my fears and my needs and my worth, I unwittingly and unwillingly participated in the ongoing damage resulting from (social) domination.

    I am suggesting that, perhaps, we provide assistance and support to our shared enemy (assistance and support we could be giving to each other, to our selves, and to our bodies), and we help to construct social and even physiological conditions of alarm and terror and oppression—while we go on believing that we NEED dominant discourses to inform us about our own bodies, and we NEED dominant discourses to interpret for us our own “lived experience[s]“, and we NEED dominant discourses to show us what is “real”…for example, to tell us that our body sizes, and our hungers, and our own behaviors (“…mindlessly stuffing [ham] into [our] mouth[s]“) are the REAL causes of our pain and suffering—are our REAL enemies to be feared and fought against, to be controlled and dominated.

    If an “evil genius” (a la Descartes) launched such a thorough strategy to eliminate human trust and to destroy mutual support and compassion for one another (and for our selves), he couldn’t provide a more “effective treatment.”

    Fortunately, there is no Evil Genius at the helm of humanity. (In other words, no Satan is necessary.)

    Moreover, apparently, human beings do not burst into flames (or fall instantly into eternally burning pits of social hell) once we turn our backs on dominant discourses. Some of us simply abandon our illusions (and false hopes) of being *normal* and of having *personal* control over our lifeworlds—and we seek others who are venturing forth through similar worlds.

    Maybe it’s just an individual *lifestyle* preference… :)

  8. Leslie Nolen | The Radial Group says:

    One of our team members likens dealing with weight issues to being lost at night in a big city.

    - It’s more than a little frightening
    - It wasn’t your fault
    - It didn’t happen all at once
    - It didn’t happen on purpose
    - You don’t remember how you got there
    - You definitely don’t want to be there
    - You feel like you’re running out of options
    - The wrong move could be dangerous, and
    - You could really use a map

    Acknowledging Ms G’s excellent reminder that there is no singular, universal experience, this perspective gives us all some necessary sympathy and insight into the very human side of the issue as many folks in fact experience it.

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