A Slight Hope of Success
The Courier Mail, April 2006.
Most people can lose weight, but keeping it off is really tough, writes Fran Metcalf.
ADRO may have won the battle but has he won the weight war?
After months of sweating, crying and public humiliation on national
television, he hit the $200,000 jackpot and was crowned The Biggest
Loser on the reality TV show's grand finale, which aired on Thursday
night.
It has been a long journey since he first stood on the scales in March,
stripped to the bare essentials. Weekly weigh-ins revealed every one of
his dimples, rolls and bulges to the 1.4 million Australian viewers. He
and the 11 other original contestants were subjected to food
temptations and fitness challenges designed to drive them to their
physical and emotional limits.
And it worked. There were hours of sweating in a gym, where two
American personal trainers pushed the players to the brink. It helped
Adro achieve his slimmer frame, but medical research doesn't bode well
for his long-term success.
Many studies show that more than 80 per cent of people who lose weight
not only regain it all within five years but, more worrying, add an
extra 15 per cent. Then there's the medical literature which reveals
the most reliable method of weight loss is neither exercise nor diet.
"It's lap-band surgery,"' says University of Queensland psychology professor Justin Kenardy.
"That is what most reliably leads people to lose weight. I'm not
recommending everyone do that, but the point is that it's bloody hard
to lose weight and keep it off, and the thing that most reliably works
is something that comes externally -- it comes from outside the person
and takes the weight away."
But surgery is extreme. Apart from being relatively expensive - an
average lap-band procedure costs about $5500 - it's an option not
seriously considered by either the obese and overweight or their
doctors, unless all else has failed.
So, in Australia, that leaves
most of the 62 per cent of men and 45 per cent of women reported being
overweight or obese in the February National Health Survey with the
traditional weight-loss methods of diet and exercise.
But these don't work, either. A quick glance at a local newsstand
reveals dozens of magazines and books pushing newer, better, faster fad
diets that promise to work.
More starkly, statistics show that one in every three Australian adults
will be either overweight or obese by 2025. According to some in the
health profession, all our efforts to slim have and will continue to
fail until a vital element in the battle of the bulge is acknowledged -
the psychology of weight loss.
Specialists like Gold Coast psychologist Dr Bob Montgomery and Brisbane psychiatrist Dr George Blair-West say that the old-fashioned notion that weight loss simply requires willpower and self-discipline ignores deeper issues.
"Many people could lose weight if we helped them deal with their emotional issues," Blair-West says.
A psychodynamic therapist, Blair-West is often the last port of call
for patients referred by endocrinologists, lap-banding surgeons and
other specialists. By the time they reach his Indooroopilly consulting
rooms in Brisbane they've been on a weight loss journey that has
spanned years and often involved drugs, surgery and a host of fad diets.
All, Blair-West says, know what they should be eating. What they don't know is why they don't do it.
"I WORK TO GET them more in touch with some of the emotional pain
behind what they're eating," he explains. "For some, there's success
stress. If they start to achieve weight loss, the threat of success
alone causes them to become anxious and sometimes it causes their
partners to become anxious, too, so they sabotage their efforts.
"I had one client who used his weight as a reason he couldn't go out
socially, so overcoming his anxiety through group therapy enabled him
to lose the weight.
"Just as people at work will say they don't want to take that promotion
because it has extra responsibilities, unconsciously some people feel
that if they become slimmer there will be more 'responsibility'.
"Some people use their weight as a protective barrier. In fact, 69 per
cent of people on lap-banding waiting lists have experienced some kind
of abuse as children -- sexual, physical or emotional -- and their
weight is a way of protecting themselves from the world."
Blair-West has been invited to speak on the psychology of weight loss
at the 10th International Obesity Congress in Sydney in September, and
has also been invited to attend the Queensland Obesity Summit being
held at Parliament House on Wednesday and Thursday. He is hoping he'll
be invited to address the summit. Both he and Montgomery fear it could
be another "window-dressing exercise" that ignores the psychology of
weight loss.
But Premier Peter Beattie says an on-line consultation forum was set up
weeks ago to enable clinicians, stakeholders and members of the public
to have their say.
"There's no silver bullet, no quick-fix to obesity, and I've said that from the outset," Beattie says.
"This summit is not a medical conference, and that's why its focus is
broader. We aim to develop solutions to how government, industry and
the community can work together to help the next generation avoid the
pitfalls of unhealthy eating and lack of exercise."
Montgomery, who runs workshops and seminars to train health
professionals on applying psychology to health issues, says the
prejudice against overweight people is widespread. "Obese people are
seen as ugly, awkward, weak-willed and that was a study using doctors.
"In another group of health professionals, 84 per cent said obese
people were self-indulgent, 70 per cent assumed they had emotional
problems, 88 per cent said they were eating to compromise for something
and 74 per cent thought they had family problems.
"There's no evidence to support any of that prejudice. You must never
encourage someone who is overweight to lose a certain amount of weight
or to achieve a particular body weight because they may do their
personal best to manage their body weight, but for reasons outside
their control, they don't achieve that goal,'' he says.
Instead of setting a goal to lose 2kg a week, an action plan would be
to exercise and eat a nutritionally sound and enjoyable food plan for
the rest of your life.
"A useful goal depends on your personal efforts . . . when people see
themselves doing these things, they have good self-efficacy," he says.
For Montgomery, self-efficacy is the psychological key. ``Your
self-efficacy is your belief in your ability to carry out a specific
task to achieve a successful outcome,'' he says.
"That determines what you will try, how hard, and for how long. If you
want people to stick at anything you need to increase their
self-efficacy for doing so.''
But, for overweight people, this is where the trouble starts.
"Cheats, lazy, dishonest, mean and it's your own fault -- that's how
overweight people are viewed in our society," he says. "And we can't
stand fat women -- they are more likely to suffer prejudice, probably
because we have peddled a message about how women should look."
The real danger, according to Kenardy, is that it can become a
self-fulfilling prophecy for many people battling their weight.
"If you're overweight, you're not as happy as you could be and if
people are telling you that you have brought in on yourself because you
have no willpower, and so you attempt to lose some weight but don't
succeed, you start to think that maybe they're right," he says.
"It's common that they get stuck in a cycle of trying and failing."
This is exactly what Blair-West is trying to break in his book, Weight Loss for Food Lovers: Understanding the Psychology and Sabotage of Weight Loss, to be released next month.
Montgomery says the weight loss industry should shoulder much of the
blame. "It sends a message to people that they have a big choice over
what they weigh and that they can lose weight from certain parts of
their body, which is just not true.
"They pretend to be interested in health but what they market is attractiveness," he says.
And shows like The Biggest Loser, say Montgomery, Kenardy and Blair-West, simply peddle the same useless and harmful messages.
Case Study
AMANDA, 34
Solicitor, 120kg, 170cm
Amanda had tried dozens of weight loss programs. Through therapy with
Blair-West, it became clear she wanted to lose weight by exercise alone
because she enjoyed her food too much to give it up.
Though Amanda regularly visited the gym, she continued gaining weight.
It became clear that Amanda's weight was linked to her father and his
misogynist views of women. Since she was young, Amanda said her father
had evaluated women entirely on their looks. She rebelled by gaining
weight rather than aspiring to his view to be slim.
With Blair-West, Amanda developed a low-sacrifice, long-term eating
plan in which she kept the foods she liked but began to change her
eating habits - eating more slowly to savour food and factoring treats
into her daily diet.
While continuing to explore her relationship with her father, Amanda
lost 12kg over eight months and has kept the weight off.
More Information
www.users.bigpond.net.au/abra (Montgomery)
www.thepremier.qld.gov.au/obesitysummit
Back to top.
|
