Therapists Supporting Weight Loss

This week I was asked how to help educate a therapist who thinks that losing weight is how to help clients improve their self-esteem. Oh boy, where do I start? 

Fuck no.  How is that for starters? 

I understand why therapists think that weight loss helps self-esteem because many people think that is true. Most of our world thinks that is true and it shows how pervasive diet culture is and how no one is immune.

But if therapists want to truly help people feel better about themselves, supporting the notion of intentional weight loss as a necessary step is not helping and I urge them to reconsider. 

Let's look at weight science. Weight science tells us that 95-98% of diets fail and people gain back the weight that they lost, often plus more, within 3-5 years.   

So even if it were true that losing weight could improve self-esteem, what happens when you gain it back? Plus more? What happens to your self-esteem then? 

If we don't think we are worthy in a bigger body, we actually won't think we are worthy in a smaller one either. 

The second problem here is that self-esteem is based on external validation. It's not a solid foundation on which to build your life. Self-compassion is way more stable and healing.  

Self-esteem says - when everyone else thinks I'm great, then I'm great. Self-compassion says - oh honey you are great just the way you are.

You don't need anyone else to have self-compassion, it's a gift you can give yourself. And Kristin Neff's research on self-compassion shows that "self-compassion is associated with more intrinsic motivation, learning and growth goals, curiosity and exploration, and less fear of failure so you don't have to worry that having compassion for yourself is going to make you soft. 

In addition, the part of this problem that makes me want to start swearing (oh right, I already did) is the implicit belief that thinner is better. Say what? 

This is only something that insurance companies and the fashion industry thought was true at one time and it has pervaded our culture ever since. 

This is weight bias, pure and simple. Unfortunately, none of us can really see our own bias until something makes it obvious. So I would ask any healer who thinks intentional weight loss is necessary for happiness to investigate what they think about fat. 

Thinner is not healthier. You can read Health at Every Size by LInda Bacon to learn more about that. 

Thinner does not make you a better person. 

Thinner does not guarantee financial success, great relationships and that nothing bad will ever happen to you. 

Thinner does not mean you deserve better job opportunities or pay. 

Thinner does not mean you will have more fun at social events or have better sex. 

Also, research shows that weight stigma is more damaging to a person's health than the weight itself? So tell me, healthcare provider, how is seeing a clients weight as a problem helping with the stigma? I can tell you that it's not. It's exacerbating the discontent a client might have with their body. 

As Ragen Chastain says, "When we can help people opt-out of a culture of body hate and fatphobia, and appreciate the diversity of body sizes that exist, we can give them a chance at a complete recovery." Amen. 

As a therapist, it is important to check your weight bias before you talk to clients about their bodies. 

The goal is to help people feel better about their bodies, not worse. If what you say is not empowering them, then it's not helping. 

So I'm sorry (not sorry), but losing weight is NOT the way to improve self-esteem. Body Trust® and self-compassion are the paths to the happiness and peace your clients seek. 

So, for now, could you do me a favor? If you think that thinner is better and is required to make your client happier, could you just keep that to yourself before you do more harm? 

Feel free to contact me if you'd like to learn more, I'm happy to help educate you! 

Thank you.