Weight-loss success stories tend to highlight the significant impact losing excess pounds can have on a person’s physical health and outlook on life — and for good reason.
“Some people lose dramatic amounts of weight and it really is life-changing … in a positive way,” says Alexis Conason, a psychologist in private practice in New York City who specializes in the treatment of body image issues and eating disorders. But flying in the face of a cultural fixation on weight — and getting down to a smaller size — Conason says that frequently high expectations aren’t realized when the scale registers a lower number. “For many people there’s a certain disappointment that goes along with it.”
Weight-Loss Letdown
In addition to unhealthy weight loss — such as resulting from a medical condition or inadvisable diet tactics, like extreme deprivation — shedding extra pounds can leave one dealing head-on with emotional or psychological difficulties. “Living in a larger body can be a factor for depression or anxiety. But very often people lose the weight and their body image doesn’t necessarily improve — they don’t feel much better about themselves,” Conason says. “The depression and the anxiety continue.”
Besides expectations not being met, sometimes new issues can surface that leave a person feeling exposed after significant weight loss. Patrick M. O’Neil, a clinical psychologist and past president of The Obesity Society, which fosters research and seeks to improve the treatment of obesity, says occasionally he’ll see patients with a history of childhood sexual abuse who, as they lose weight, “start to feel like they’re losing some protection. They feel more vulnerable, they may be getting more attention, and that makes them uncomfortable.”
A history of sexual abuse is often associated with overeating and other disordered eating, and a higher proportion of people who are severely or morbidly obese have endured sexual abuse as children, compared with people who aren’t obese. Still, O’Neil is careful to point out that the experience of feeling vulnerable at a lower weight is neither typical for all who have been sexually traumatized, nor an argument for not losing weight. But for those who feel that way, he says, it’s important discuss those feelings with a mental health professional.
While O’Neil says predominantly female patients who are victims of childhood abuse bring up feeling vulnerable following weight loss, Conason says issues related to receiving unwanted sexual attention after losing weight can affect men and women, including those who haven’t been abused.
[See: Debunking 5 Common Weight-Loss Myths.]
Weight loss by only one partner can also prove potentially volatile in a romantic relationship, according to previous research from North Carolina State University and the University of Texas at Austin. Surveying 42 couples from across the country, where one partner lost 30 pounds or more in less than two years, researchers found some reported improved physical and emotional intimacy. In other cases, however, partners who hadn’t lost weight reported feeling threatened or insecure by their partner’s weight loss; some were critical, less interested in sex or even tried to sabotage their partner’s weight loss. Though there’s no way to head-off all potential conflicts, experts say that a person who has lost weight or is seeking to do so might increase the chances of a partner being supportive by trying to make healthy changes as a couple, while not giving unsolicited advice and talking through insecurities as they arise.
An Uphill Battle of the Bulge
Particularly for those who are severely or morbidly obese, whether trying to lose weight with a partner or alone, the challenges are many. The growing worldwide obesity epidemic is rooted in a complex combination of psychosocial, environmental, genetic, dietary and cultural elements, say Australian researchers who recently looked at factors contributing to self-harm, mental illness and suicide in some patients following bariatric surgery.
[See: 6 Ways Obesity Can Weigh on the Brain.]
In the study published online in the Annals of Surgery in July, researchers found that a higher proportion of bariatric patients were hospitalized for deliberate self-harm, as compared to the general population. The study found, however, that the surgery itself wasn’t associated with an increased risk of hospitalization from self-harm or suicide, in contrast to previous research that reported this association. The findings instead highlighted how rates of depression and certain other mental health disorders — which are higher among the severely obese, including bariatric surgery candidates — may play a role in higher rates of mental health issues after weight-loss surgery. The study also noted that gastrointestintal complications from certain types of weight-loss surgery, such as infection and perforation of the intestine, could be a factor.
The principal benefits of weight loss are still found in the physical domain, including the potential for reversing conditions including diabetes, high blood pressure and sleep apnea, says Dr. Paul Thodiyil, director of the bariatric surgery program at Mount Sinai Beth Israel, a hospital in New York City. However, for those who achieve dramatic weight loss following bariatric surgery, he adds, “We also see a substantial improvement in quality of life, including measures of psychological health.”
Similar to the findings from UNC’s research on partners’ weight loss, Thodiyil notes that some bariatric patients find unexpected interpersonal issues can arise as the result of dramatic weight loss, and even its seemingly positive effects, such as increased confidence and receiving more attention from peers and coworkers. “Sometimes this may result in difficulties in their [pre-existing] personal relationships,” he says, like jealousy.
As part of regular ongoing follow-up care with a patient’s surgical team, Thodiyil says it’s important to discuss such concerns, and that providers try to be proactive in alerting patients to potential issues that may arise. “The purpose of that really is to help us have an ongoing dialogue,” he says. He advises discussing concerns in support groups with others who have had bariatric surgery. And those who lose weight through non-surgical means may also benefit from the advice and encouragement of individuals who have successfully lost weight and kept it off.
Working on Your Core Self
Rather than expect that weight loss will be the cure-all, Conason says, it’s important to undergo mental health treatment to address specific concerns; that includes body image issues, which can be treated at any weight. “Try to understand what’s about the weight and what’s an emotional issue that you’ve attributed to the weight,” she adds, noting that’s sometimes difficult to do. She also emphasizes shifting from a focus squarely on weight loss to one that’s about overall health, including making lasting lifestyle changes, such as eating better, being active and practicing self-compassion. “Because we know that shame only perpetuates the overeating cycle and when we really can embrace a kind, caring, compassionate stance towards ourselves, we’re able to take care of ourselves in much better ways,” she says. “That self-care may or may not result in weight loss, but it does tend to improve health both physically and emotionally.”
[See: 11 Simple, Proven Ways to Optimize Your Mental Health.]
Above all, experts reiterate that when shedding pounds, it’s important to keep proper perspective. “When people try to lose weight thinking their weight loss will do things that it’s not going to do, they’re inevitably disappointed, and so they give up and regain their weight,” O’Neil says.
More from U.S. News
How to Find the Best Mental Health Professional for You
What Not to Say When Someone Loses Major Weight
Has Losing Weight Left You Feeling Exposed? originally appeared on usnews.com
