Since we’ve been talking a lot about weight on The DSM Blog lately, I will highlight a few recent ideas about weight. You probably know most of them, but hopefully at least one will be helpful. This week is mostly about causes. Next week we’ll start on management. I would really like to get your feedback on these ideas.
1. Severe overweight is a chronic condition, like, say, arthritis. It has many causes — genetic, environmental, behavioral, and others. As with my own chronic condition (multiple sclerosis), there will probably never be a “cure.” But as with diabetes, you can manage it and get better.
Notice that I don’t use the term “obese.” I hate that term. It comes from the Latin for over (”ob”) - eating (”edere”), as if overeating was the whole cause of the problem. As several commenters wrote on Jan’s blog entry last week, body size doesn’t have much to do with how much you eat.
2. As I wrote last month, it’s probably not the fat itself that most harms your health. Instead, the stresses and behaviors that make you fat also cause diabetes, heart disease, and other illnesses usually associated with weight.
3. Weight loss is easy for most people. Keeping the weight off is hard. Read a really good article on weight loss maintenance here. As dietitian Jacquie Craig says in this article, our bodies hate to lose weight and have all kinds of tricks for getting us to gain the weight back.
When losing weight, bodies slow down their metabolism to burn fewer calories. They change production of hormones such as leptin so that you never feel full. So as weight comes off, you have to work even harder to keep it off. This effect may or may not wear off over time.
4. Overweight is an environmental illness. If there wasn’t so much unhealthy food so easily available, weight control would be a snap. If you had to walk everywhere instead of drive, you could eat all you wanted. If you lost 50 pounds and moved to the Ethiopian highlands, you would not regain the weight. But here in the land of sugar, stress, television, and cars, it’s a lot harder. I wrote Chapter 3 in my book Sugar-coated Crisis about this.
So the environment is set up to make people fat. Corporations spend billions on advertising to get us to live more fattening lifestyles. They set up all kinds of barriers to living a healthy life. Then they blame you for putting on weight and say you lack willpower. What a scam!
5. Stress is a major cause of overweight. Learning to reduce and cope with stress is key to getting control of one’s weight. An excellent article about coping with stress can be found here. My book The Art of Getting Well is also good on this.
6. Most overeating is emotional. Psychologist Joe Nelson says, “If we’re happy, sad, angry, celebrating, grieving, lonely, or bored, we eat [in response]. Emotions become connected with food. Some foods also can have the physical effect of actually helping us feel better, temporarily.”
If we can stop eating for comfort or company or distraction or love, it becomes a lot easier to control weight. According to the University of Texas Counseling and Mental Health Center, you can tell when eating is emotional because emotional hunger comes on suddenly and needs to be satisfied immediately, usually by one specific food. Physical hunger comes on more slowly and can be satisfied by a variety of foods.
Many times “emotional eating” and “stress eating” are the same thing. If we can heal some of the emotional hurt, we’ll be better able to resist the stress. If we can reduce the stress, there will be less pressure on our emotions.
Next week, with your help, we’ll get into self-management strategies. If you have any good ones, comment here or write me directly.