Most people oversimplify why fat people “yo-yo,” or lose then regain large amounts of weight. Cultural mythology says it’s because fat people “get lazy” or “don’t understand it’s a lifestyle change,” and return to their old ways. In fact, most fat people (over age 20) are energetic, well-informed, earnest people who think this time they’ve found their perfect plan, forever and for good. Something has “clicked.” Shortly after losing the weight, they go through an optimistic honeymoon phase where they endeavor to inspire their friends and family to lose weight. Yet for most people, no matter how smart, disciplined, optimistic or committed they are, the weight comes back. It’s humiliating. Yet their shame is a travesty.
Only 3% of people who intentionally lose radical weight will maintain their losses for five years, according to evidence-based, empirical research. Why?
Accept the following paradigm shift from common wisdom: fat people are no more ignorant, lazy, weak-willed or emotionally broken than naturally trim people, but weight-loss maintenance is abjectly unfair. In subsequent postings to this blog you will learn how to make some peace with each of the following inequities. But today is not your pep talk; it’s plain-talk.
Unfairness 1. Maintenance isn’t a “lifestyle”; it’s a third- to half-time, unpaid job. It need not be joyless, but sometimes it’s a bore.
Unfairness 2. Your boss is a tyrant. Your food management must be scrupulous, your exercise intense, and you get no vacations. If a maintainer “takes off” for even a week, he or she may gain back several pounds that won’t “come right off if you return to your routine” as the know-it-alls love to say. The National Weight Control Registry confirms that only 13% of successful maintainers who partially regain will lose that weight again.
Unfairness 3. Zero-change is a time-consuming and unsatisfying “goal.” Sure, you can add other goals – “learn golf,” etc. – but those goals are secondary and may not contribute to your zero-change primary goal, and time is limited for most of us.
Unfairness 4. Binge impulses are real, based in biology/endocrinology, and you must circumvent them or you’ll ultimately succumb and regain the weight. Pop psychology carelessly throws around the jargon of “emotional eating,” and encourages people to take control of their emotional issues on the precept that they may then gain control of their weight issues, including their impulses to binge. In practicality, most people are better advised to perform a “problemectomy” and separate emotions from weight. Address weight issues as a scientific challenge. Get separate counseling, if you need it, for emotional issues.
Unfairness 5. Simple “portion control” is a fairy tale. Your excess fat was (or is) probably a symptom of your body’s inability to process the poisons of a modern diet. Maintainers eat a “cleaner” diet than most naturally trim people who do not face this challenge.
Unfairness 6. Damage to the joints from the weight you once carried makes it difficult, over time, to create and sustain an exercise regimen that is intense enough to maintain losses.
Unfairness 7. You hide a secret under your clothes: your body may be deformed. Friends say you look great, but naked in front of the mirror you find your pendulous parts and saggy skin discouraging. Some maintainers may need counseling; others undergo expensive plastic surgery.
Unfairness 8. All the support you received while losing weight dries up, and often turns to sabotage. People push food at you and lose patience with your time-consuming exercise.
Unfairness 9. The experts don’t have maintenance figured out, and add their authority to the mythology. Even MDs think that maintenance is simply about willpower and portion control. How dispiriting to those who regain weight and need their doctor’s support, not judgment!
Unfairness 10. Contrary to cultural mythology (“If I can do it anyone can!”), NOT everyone can do this. In addition to having sufficient time and energy for an added third- to half-time job, you will need a stable support system, adequate resources for proper food and exercise, and other blessings. Even with an ideal situation, your genetics and endocrine system will put up a much fiercer fight that anyone currently acknowledges.
Weight-loss maintenance, if analyzed fairly, might qualify as a disordered mindset, though I’m not a doctor and am unqualified to diagnose. I prefer to think of it as a job or avocation. You may prefer to think of it as a time-consuming hobby or even as a fine art, like playing the cello. It’s fair to speculate that YoYo Ma has done more than adopt a “cello lifestyle” to play at the concert level. I’m no YoYo Ma of maintenance (I hold only Jared Fogle in that esteem), but I still must do more than cobble together “tips and tricks” from women’s magazines to do this.
Weight regain is an unwitting slide into Hell that involves all the Elisabeth Kübler-Ross stages of death. People who regain weight often think they have failed, and then they avoid doctor’s offices, gyms or other places that might contribute to their health and well-being. What a tragedy! In truth, they accomplished something quite difficult by losing the weight in the first place, but then they were failed by a cultural mythology regarding maintenance that continues to fail us all.