Are You Still Thinking It’s All About Your Weight?


You’re a mixed crowd, dear readers. You are patients, current and past, local and those I Skype with overseas. And you are Anonymous followers whose identity I’ll never know. You are largely female, but include many a loyal male reader. You cover most ages from late teens to into your 70s. On a recent day you visited from all 50 US states (a first!). And you regularly read from all continents. 

I love this! 
I certainly don’t know you well, except for what you share in your comments and emails. You may struggle with an eating disorder of any variety or strive to maintain your sanity in a world of over focus on food rules and misinformation.

You may be underweight or overweight—whatever those terms have come to mean—and you may or may not have come to terms with the work that needs to be done. You may be simply contemplating change or you may be working on maintenance and relapse management.

Yet here’s one thing I know for sure: your weight is not a valid measure of your progress nor of your effort, of your commitment to change or your need for change.

The past couple of weeks I’ve had many an encounter that convinced me I needed to share these thoughts with you.




Here’s a sampling of what I heard this week:

  • She was frustrated by her stabilized weight—it was nothing like those weight loss ads promise! Yet she realized that she is now capable of eating a couple of Oreo cookies. Justa couple—and feeling satisfied. And, she was able to talk about it, as opposed to keeping this info a secret. No more Oreos in the closet.
  • There was the realization that food tastes good! From someone who has spent the past umpteen years eating while barely using her senses (similar to how she was living life) this was a giant accomplishment. She now appreciates what she likes, and can follow her preferences. And she can allow herself this pleasure long denied.
  • “Do you mind if I eat in our session?” she asked me, as she nonchalantly pulled out her McDonald’s French fries. “I haven’t had time for lunch yet”. Long ago when we started our work together, reliance on a meal plan was absolute and deviating from the plan was a non-option. Food was restricted and binging was common. Think what you might about fast food, seeing this meal enjoyed, and eaten normally, made me happier than I’ve ever imagined a McMeal might!
  • He is learning to reframe his actions. Instead of, “I only walked 3 times this week, for only 10 minutes”, I can, with a mere raise of an eyebrow have him shift his focus. “I walked threetimes this week! I’ve started to make walking a priority to help my blood sugar! And it’s feeling good.”
  • Black and white thinkers may still struggle with what I refer to as the what the heck effect, that sense of why bother I’ve already ruined it. Yet even their acknowledgement that the thinking is the culprit, not the food item, is a major and necessary shift.
  • And finally there was this list I received from Dana just yesterday:


First I'd like to begin with the positive changes I have made since under your care:

    -I'm not starving myself
    -I'm throwing up TONS less
    -I do NOT exercise, ever
    -I incorporate risk foods into my diet
    -ed thoughts no longer consume 100% of my brain
    -buffets are "manageable"
    -I allow myself to eat after dinner
    -I no longer consume bottles and bottles of diet coke/day, just 1 or 2 glasses
    -I only drink 2 cups of coffee/day - not 2 pots
    -I DRINK calories!!!!!!!!
    -I allow myself to snack in between meals
    -I can go to dinner with my friends now with very little anxiety
    -I eat in front of people with more ease
    -I can control binges with much greater power
    -I recognize and honor my hunger now
    -I have learned to speak up a little more
    -I am present
    
 I know there's a LOT more to that list, but those were the ones at the top of my head.

Proud Tiger Mom and her cub, taking her
French pastries home after a satisfying brunch.

I feel like a proud Tiger Mom. Really.

In each of these cases, focusing on weight as the end point would have been absurd. In Dana’s case, weight has been around the same for probably a year. Why probably? Because honestly I rarely obtain it. But the times I do, it never surprises me. I’m not blindsided by positive talk without substance. And I ensure my patients are following up with their physicians for medical checks when necessary.

Weight can be stable or in a normal range while binging and purging. It can be stable while restricting followed by rebound overeating. And weight can be outside the “healthy” BMI range with either healthy or unhealthy diet and behaviors. What a disaster it would be then to focus on weight without attention to the damaging behaviors!

Just the setting for enjoying a pastry out!
Weight assessment certainly has its place. A progressive shift in an unhealthy direction (for an individual’s need) is clearly a red flag. But without assessing the underlying thoughts as well as the behaviors, obtaining and focusing on weight is nothing short of damaging.

I'd love to hear how your thoughts and actions have shifted, so please share!

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