Weight loss could greatly improve the health of many people, but focusing on losing weight often backfires. Dietitian Lucy Carey explains.

“I know you keep saying that the weight isn’t what this is about but…”

She was agitated, her blonde hair flicking into her eyes as she spoke. She had clearly steeled herself to ask the most important question to her and my heart sank because I already knew what it was before she could finish the sentence.

“When am I going to lose weight?”

Look, I’m not some high-falutin hoity-toity new age hippy, who thinks that the negative effects of obesity are all down to fatphobia. Perhaps that’s a contributing factor, but it’s certainly not the only one.

Fat is not just this white stuff that covers you up and keeps you warm. It is an endocrine organ, secreting a whole bunch of hormones in a complex network that affects everything from glucose and lipid metabolism to reproduction.

So when fat cells are markedly increased, stuff is gonna happen to your body. I think that’s pretty clear. So I have absolutely no doubt that weight loss is beneficial for many people. Possibly not so much for the ones who are just a little over the ideal BMI (because that’s just an arbitrary number that doesn’t mean much on an individual level), but when your client is pretty heavy, it’s a pretty safe bet that weight loss is going to be good for their health.

So I get it. Clients want to lose weight. And we want to help them to lose weight.

But the thing is, focusing on weight loss is honestly likely to just make our clients fatter.

Let me explain.

First up, most clients don’t actually want to lose weight for their health. They want to lose weight for their looks. That’s not wrong or right, and I’m not judging it, but I think it’s important to keep in mind what the real driver is for so many of our clients, because they will likely need support with their body image and respecting their body (even if they don’t love it).

Secondly, the drive to lose weight tends to lend itself to an all-or-nothing mindset that is completely at odds with the goal of better health. The thinking goes something like “If the scales don’t shift, it’s a failure.” Nevermind if they’re sleeping better, if they have more energy, if they’re fitter. If the goal is weight loss, it’s like clients get their blinders on to everything else, making it way more likely that they’ll give up completely if they don’t lose weight.

Thirdly, restriction is the first thing our clients will do, with disastrous results. How many times have you been told, “I eat well, I just need help with my portion sizes?” In my experience, that’s often code for, “I’m stuck in a starve-binge cycle where I try to restrict myself but then I can’t last and it backfires into binge eating and weight regain.” We call it the J-curve of dieting and it’s backed up by considerable research.

Interestingly, it’s not just adults. One study found that normal-sized children whose parents (wrongly) believed they were overweight, were more likely to actually become overweight over time. I suspect that restriction plays a key role here. If you restrict food, you become kinda obsessed with it. Ignoring your natural hunger and fullness signals means that your body loses trust in you to feed it when it asks, so it will send hormone signals out to eat all the food you can when you can. I think the parents of these children probably started restricting their child’s food intake (consciously or subconsciously I don’t know) to try to get them to slim down. And it backfired.

So what are you meant to do when you have a client who wants to lose weight and who will benefit from weight loss, but you don’t want them to focus on losing weight?!

1. Shift their mindset from the get-go by asking one key question: why do you want to lose weight? Find the positives in there and make those the goals instead. You can watch my free 10 min training video on how to do that here.
2. Heal their relationship with food. This is going to mean having unconditional permission to EAT. Which may very well mean weight gain at the start. But if they can successfully relinquish control over their restricting ways, it will re-establish trust with the body and their hunger and fullness cues can get back to normal. More on that in this post.
3. Work on body image. Many clients have rose-tinted glasses when they think of their smaller bodies. They assume they were happier when they were smaller back then, ergo they will be happier when they are smaller in future. That is rarely the case. If they can’t accept and respect their body as they are now, they probably won’t accept and respect it at a smaller size either. Remember that they don’t have to love their body, they just need to respect it.
4. Remember the soft drivers of health: sleep, stress management, positive social connections. These things affect health and weight far more than most people think.
5. After all that is addressed, their body will start to naturally change. And they will be in a much better place mentally to make small alterations to some habits for the sake of feeling their best (because the emphasis will now be on how they feel, not what they look like), e.g. “I know that I feel my best when I have protein in my breakfast meal” as opposed to the old way of thinking, “I need to load up on protein and cut carbs so that I can lose weight.”

It’s a lot for our clients to wrap their head around. Hell, it’s a lot for health professionals to wrap their head around when they are first introduced to this idea.

But it is SO WORTH IT. Because seeing your clients get their pep back, smile again, eat joyfully, and become the healthiest and happiest they’ve ever been makes it worth it. I’ve lost count of the number of times my clients have said to me, “I feel like me again.”