Weight Loss & Management

Many people encounter difficulties with weight management at some point during their lives. People gain weight for a variety of reasons, such as aging or following an injury. If we accumulate weight beyond that which is considered normal for our height, we are at increased risk of health problems and mental health challenges such as depression.

Managing weight can be a real challenge, one that’s not always easy to overcome by willpower alone. If you are finding it difficult to make changes, consider enlisting the help of a therapist. Eating less and exercising more are important elements of weight management, but quite often people struggle with managing thoughts, emotions and changing unhealthy habits. Therapy can help you to overcome the psychological and behavioral barriers to weight management.

Prevalence of weight issues

Many people around the world struggle with the weight issues of obesity or being overweight. The World Health Organization reports that obesity has nearly tripled worldwide since 1975. Their data from 2016 showed that (1):

• 39% of adults were overweight
• 13% of adults were obese
• 18% of children and adolescents were obese

Psychological challenges associated with weight management

Weight issues can be distressing and can impact on a person’s health and ability to function. Some people experience symptoms of mental health conditions as a result, including:

• Self-esteem issues: The stigma associated with obesity can lead to health inequalities. This influences how people feel about themselves, and can lead to lower self-esteem (2).
• Sadness or depression: Weight management issues can be distressing and prevent us from doing the things we want. This can lead to feeling sad, hopeless, or depressed, which can make it more difficult to manage our weight. There is a significant relationship between obesity and depression (3).
• Shame or guilt: This can be triggered in a number of different ways, such as being bullied or treated unequally by others, facing health issues, or unhealthy eating behaviors.
• Anger or frustration: Weight issues can stop us from doing the things we need to and impact on our quality of life. Many people find it difficult to change behaviors linked to weight management. These struggles can lead to feelings of anger or frustration.
• Anxiety or worry: You may worry about weight or health issues, or find that your anxiety interferes with your daily activities.
• Disordered eating: There is a tendency for the weight loss message to be oversimplified when actually, weight management is a complex issue. Some people may try to manage their weight in unhelpful ways, using diets or binge eating, for example.
• Poor body image: The cultural preference for slim body types means that those struggling with weight issues are often dissatisfied with their bodies. This can lead to feelings of sadness, shame, and poor body image. In turn, this can make weight management even more difficult.
• Substance use problems: You may use alcohol, other drugs, or prescription medications to cope. This can be unhelpful or lead to problems with addictions.

Other challenges associated with weight issues

Weight issues are associated with a range of social, psychological and physical health risks (2). Physical health risks include:

• Diabetes
• Cardiovascular disease
• Cancer
• Hypertension

Social issues commonly encountered include:

• Bullying or victimization
• Discrimination
• Withdrawal from family and friends

What to do if you’re having difficulties with weight management

Weight management is a more complex issue than simply exercising more and eating less. Consider a combination of the following strategies:

• Check-ups: It’s important to have regular check-ups with your primary care doctor, given the health risks associated with being overweight. An assessment can also help by ruling out any underlying medical conditions.
• Therapy. Therapy can help you to make the behavioral and lifestyle changes necessary for weight management, which many people find so difficult to implement by themselves. Therapy can help equip you with coping strategies for dealing with cravings, identify triggers, and form new habits and ways of thinking. See more tips below on types of therapy and selecting a therapist.
• Self-care: Try to maintain a regular sleep pattern, and exercise regularly. Find activities that you enjoy, and make time for them in your schedule. Such lifestyle factors can help to regulate our moods (5,6,7), which is important because our mood can affect our eating behaviors.
• Social support: Family and friends are an important source of support, and talking can help you to feel understood. Additionally, research shows that social support can help people stick to the behavior changes in weight management programs (8).
• Hotlines: If you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255.

In addition, the American Psychological Association suggests the following strategies to help (4):

• Keep a diary: People tend to have more success with weight management when they record eating patterns. Keep a diary noting what you ate, where you were, and what you were feeling. It’s also helpful to track your activity levels. This can help you to identify patterns and factors contributing to unhelpful behaviors.
• Look for patterns: Using the diary, you identify connections between eating and factors unrelated to hunger. For example, you might notice that you eat when you are bored. You can use this information to break the association. For example, you might brainstorm a list of other things you can do when you feel bored, and keep it handy for the next time you experience an urge.
• Eat regularly: This can help avoid unhelpful binge eating or feeling excessively hungry, which can lead to overeating.
• Practice mindfulness: Becoming more aware of the sensations of hunger can help people learn to eat in response to hunger, and stop eating when full. It also makes eating more enjoyable.

Weight management: Therapy types to consider  

Psychological treatment can help people work through the thoughts, emotions and behaviors related to weight management issues. Common evidence-based therapeutic approaches include:

• Cognitive Behavioral Therapy (CBT): CBT has been shown to be helpful for weight management. It helps us to become aware of and change unhelpful thinking patterns and behaviors that can exacerbate our difficulties, such as all-or-nothing thinking.
• Mindfulness Practices: Mindfulness helps people to become more aware of the sensations of hunger, learn to eat in response to hunger, and stop when full. It also makes eating more enjoyable.
• Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies to help people take an acceptance approach to weight management.

What to look for in a therapist for weight management

There are several factors to keep in mind when selecting a mental health professional, including:

Education and credentials

Look for a licensed mental health professional who has specialized training in weight management and/or prior experience working in the area. Many therapists have a particular interest in treating weight and eating difficulties. They will often include this in their biographies so that it’s easy for you to locate when searching.

Personal fit

It’s important to find a therapist with whom you feel comfortable working. The trusting working relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy.

Learn more about the types of therapy suggested above and consider which one feels like the best-aligned approach for you. You can then look for a therapist who specializes in that type of therapy.

Talk in advance

The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call (you can do this with our vetted Zencare therapists). Most therapists will be happy to oblige. This gives you the opportunity to ask about:

• The therapist’s qualifications
• The therapist’s experience helping others with weight management challenges
• Any ongoing training they are undertaking in eating and weight issues or related therapies
• Which therapy they suggest and what that will be like
• Their participation in insurance plans and cost of therapy

Try to speak to a few different therapists before making your mind up.

Sources and references

1. World Health Organization, “Obesity and overweight”
2. World Health Organization, “World Obesity Day: Understanding the social consequences of obesity"
3. Psychiatric disorders and obesity: A review of association studies
4. American Psychological Association, “How psychologists help with weight management”
5. Lifestyle and Mental Health
6. Physical Exercise for Treatment of Mood Disorders: A Critical Review
7. Sleep: A Marker of Physical and Mental Health in the Elderly
8. American Psychological Association, “How social support can help you lose weight”