Dear Doctors,

I know that you care about your patients. And I know that you have very limited time with them. I also know you have been told to tell them to lose weight for their health and I know that it's true - weight can sometimes be a factor in health issues. No one is denying that. 

As an alternative to prescribing intentional weight loss, I would like you to know what my clients have experienced with regard to their health after following a non-diet approach to wellness that is not weight-focused.

When I work with someone, I get to hear all of their stories. If you heard these stories, you would not be so glib or inclined to tell someone to just go lose some weight to be healthy.
 
Have you ever heard of the ACES study discussing Adverse Childhood Experiences?

Every doctor should be familiar with this study and every doctor should know that it came into existence after a weight loss doctor wanted to know why people who were successfully losing weight on his program were dropping out.

In trying to make sense of things, the doctor asked one of the people how much they weighed when they were first sexually active.  He meant to ask how old were they.

The answer was 40 pounds.   

It turns out that of the 286 people this doctor interviewed from his weight loss program, MOST had been sexually abused as children.

As children.

This discovery led to the development of the ACES study which shows the correlation between a person's health and their early childhood experiences. When people have addictions, pains, food issues, anxiety, heart conditions, high blood pressure, and a whole host of other ailments, it can be related to the trauma they experienced as children.

 It turns out that eating in the face of trauma is actually a brilliant coping mechanism.

From the article linked above: “One way it (eating) was a solution is that it made them feel better. Eating soothed their anxiety, fear, anger, or depression – it worked like alcohol or tobacco, or methamphetamines. Not eating increased their anxiety, depression, and fear to levels that were intolerable.

The other way it helped was that, for many people, just being obese solved a problem. In the case of the woman who’d been assaulted, she felt as if she were invisible to men. In the case of a man who’d been beaten up when he was a skinny kid, being fat kept him safe, because when he gained a lot of weight, nobody bothered him.  Losing weight increased their anxiety, depression, and fear to levels that were intolerable.”

So to tell someone to go lose weight without knowing anything about them misses the boat entirely and doesn't even get close to the root of the real problem. In fact, it makes it worse by shaming people and continuing to make people feel like failures and unworthy.

Whether a person has an underlying trauma history that they recall or not, being in a larger body in our culture can in itself feel traumatic. Creating a harmonic relationship with food and body, therefore, needs to include emotional, spiritual, and mental components - not the usual rhetoric of "eat less and move more."

“Eat less and move more” can't begin to address the nuance of the situation for the majority of people.  

A non-diet approach to well-being looks at the whole person with all of their stories, experiences, and life challenges.

It looks at their coping mechanisms and patterns. It looks at their desires and preferences. It looks at their dreams and goals.  It sees people as individuals and knows that no one answer fits all. Most importantly, this approach is based on the fact that people are worthy always - no matter what they weigh. 

This approach also focuses on what the individual wants to explore with regard to their own well-being, not trying to "fix" something that someone told them was wrong. 

When people are held in this container, here are some of the results:

Clients report sleeping better because they are no longer tossing and turning all night long thinking about what they ate the night before, what they will eat the next day, or how they have failed again.

Clients are no longer fixated on calorie counting and food tracking and are able to take pleasure in a meal and digest it with ease.

Clients report digestion improving due to this new level of relaxation in eating. (You are familiar with the role of the Vagus nerve in digestion, right doctor? And you do know how the nervous system is developed in early childhood - modeled after our caretakers - right? So you do know how dysregulated the nervous system might be for someone in a trauma situation, right?)

I really do hope you know all this before you go tell people to lose weight. Because unfortunately, there is more trauma than you can imagine in this world and that is the true crisis, not "obesity". 

Lack of access to nutrient-dense food, lack of support for low-income families, lack of jobs and educational opportunities for people, lack of medical care and community services - are the things that need changing.

With the non-diet approach to wellness clients reported feeling more at peace in their lives.

Clients reported wanting to get up and move more because it felt good.

Clients are no longer ashamed to admit to being hungry and tending to their biological hunger drive.

Clients reported noticing what foods felt good in their bodies and gravitating towards more nutrient-dense options without force, restriction, or food plans.

Clients reported improved work/life balance as they learn radical self-care.

Clients reported improved relationships with family members since they feel better in their bodies.  That positive energy ripples out into the rest of the family dynamic.

Clients reported taking up hobbies that they had ignored for decades or trying new activities that they had always wanted to try - leading to even more peace, ease, contentment, and joy.

Clients reported perfect bloodwork regardless of what they weighed.

Clients reported less stress and anxiety and an ability to be with discomfort more easily.

Clients even reported moving toward their natural weight - the weight they may have been without the stress of chronic diets, shame, weight stigma, and trauma.  This weight is not a number in their head or something someone else thinks they should weigh. It's the place they feel good in their own skin.

This happens without diets and without punishing exercise. It happens with love. 

Clients reported a desire to engage with the world and support those who are less fortunate because they are feeling more grateful and appreciative of the life they are leading.  The act of giving then supports both their well-being and the well-being of others in a classic win-win situation.  

Clients reported going from feeling broken and thinking it was impossible to heal to learning how to engage with the world from a newly empowered place.

Clients were able to let go of the victim mentality that diet failure supported and took back their full power and autonomy in their relationships with their bodies, leading to improved mental and emotional health.

None of this was accomplished with pills or food plans. It came from the power of being fully seen in the world and being loved exactly as they were.

So doctors - please keep doing the thing that you do so well, but please leave weight loss out of it. If it is not your zone of genius then like everything else - please refer to those who know what to do. You wouldn’t give advice on something that wasn’t your specialty, would you?  

Luckily, there is an amazing collection of supportive and loving weight-neutral intuitive eating dietitians, coaches, counselors, and therapists in the world who know exactly what to do and would love to help you out.

 Thank you.