Weight loss psychology

If you want to succeed at weight loss, you need to "cut the mental fat, and that will lead to cutting the waistline fat," says Pamela Peeke, MD, author of Fit to Live.  "Look at the patterns and habits in your life that you are dragging around with you that get in the way of success.

Cognitive behavioral therapy (CBT), which focuses on changing how you think about yourself, how you act, and circumstances that surround how you act, is an effective treatment for a wide range of problems, including weight loss.  Key to it is its focus on making changes and sticking to them.

The best way to improve your belief in your ability to succeed is actually to have some success.  Setting concrete and achievable goals, such as eating fruit at breakfast or replacing an after-dinner TV show with a walk, can build your confidence to set more ambitious goals.

If you want to be thin, picture yourself thin. Visualize your future self, six months to a year down the road, and think of how good you'll look and feel without the extra pounds. Dig up old photographs of your thinner self and put them in a place as a reminder of what you are working toward.  Ask yourself what you did back then that you could incorporate into your lifestyle today. And, advises Peeke, think about activities you would like to do but can’t because of your weight. Stop criticizing and shaming yourself for not sticking to your diet plan. Have it out with your critic! Make your critic’s words explicit—say them clearly and out loud and then fight back as intelligently, fiercely, and clearly as you can. This exercise will support your self-love by building a more empowered self. Going further, make a list of other plans, activities, and people you would like to say “no” to and begin practicing immediately.

Weight-loss counseling most prevalent between male physicians and obese men

A study published in the June 2011 issue of the American Journal of Preventive Medicine examined the association between patient-physician gender concordance and weight-related counseling in obese individuals. Investigators from the University of Pennsylvania and Johns Hopkins University found that obese male patients seeing male physicians had higher odds of receiving weight-related counseling than obese women seeing a female physician.

Commenting on the study, Octavia Pickett-Blakely, MD, MHS, Hospital of the University of Pennsylvania, observed that "Perhaps societal norms linking physical fitness to masculinity leads male physicians to view obese men as more receptive to weight-related counseling and contributes to open dialogue about weight in male gender-concordant relationships. The findings of this study should heighten clinicians' awareness of how the personal attributes of physicians and patients may influence obesity care. Future studies should objectively measure weight-related communication (e.g., direct observation, audio tapes) in gender-concordant and gender-discordant patient-physician encounters, and explore the potential role of physicians' explicit and implicit attitudes regarding obesity and gender, in weight-related counseling for obese patients."

The study revealed that male patients had about a 60% higher chance of receiving diet/nutrition advice and about a 76% higher chance of getting exercise counseling from male doctors compared to female patients receiving care from female doctors. In female patient/female physician pairs and female/male pairs of both types, there were no significant differences in any form of weight-related counseling.

The finding that all patients had similar odds of receiving weight-related counseling when a female patient or female physician was part of the pair may result in part from the perception that women are more likely to be dissatisfied with their weight. Female physicians may choose to avoid weight-related discussions with their obese patients and male physicians may avoid weight-related discussions with their obese female patients.

Using data from the 2005-2007 National Ambulatory Medical Care Survey, researchers analyzed clinical data from 5,667 obese patients to determine association between patient-physician concordance and three types of counseling: diet/nutrition (30%), exercise (23%), and weight reduction (20%) counseling.

Although one-third of US adults are obese, less than 30% of these individuals receive weight-related counseling despite the fact that such counseling is associated with modest weight loss, which is in turn linked to lower blood pressure, cholesterol, and blood glucose.


Journal Reference:

  1. Octavia Pickett-Blakely, Sara N. Bleich, Lisa A. Cooper. Patient–Physician Gender Concordance and Weight-Related Counseling of Obese Patients. American Journal of Preventive Medicine, 2011; 40 (6) DOI: 10.1016/j.amepre.2011.02.020