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More Often Than Not, It Is Not An Excuse, It Is A Valid Reason

Having-an-important-conversation-September-2022

I have listened to hundreds of people over the years, who, have been told that they are just making excuses, when they have  not been able to follow the advice they have been given. I challenge this assumption, as it is just more blame being placed on someone who is already vulnerable.

I think it is really important for us who work in the area of weight management to listen carefully to what our client is telling us.We need to listen to not only their description of their external world and life circumstances, but to pay careful attention to their inner world.

Prescriptive advice while on the surface might make sense to those dispensing it; we need to understand why this advice often falls flat.

It is almost never because our client is being defiant or lazy or obstructive.

If someone is seeking help with their weight and go away with a list of strategies, challenges and changes they need to make, not only might it be overwhelming but it might be so generic that it doesn't resonate or make sense for the life they lead.

People will often preface a session with me saying, "I know I'm making excuses". I'll ask them to talk to me about what those excuses are. So, for example they explain that they know home made meals are better than take away meals but they just cant bring themselves to cook. We have an option here to look into their world. What is it that makes cooking hard? Not to just dismiss them as being lazy.

Here is one familiar scenario:A single parent who is working a 40 to 50 hour week.They are up before dawn (oh here is another excuse they are told) why haven't they gone for a walk or to the gym before work ?Well, because  they were up before dawn, often after a night of relentless broken sleep due to a wakeful or unwell child.They then take a load of washing out of the machine and hang  it out so it might be dry for the next day. After that they are filling out permission notes for their child's school, packing lunches, tying shoe laces, consoling a crying child who doesn't want to leave the house, then the pet dog has a big vomit just as they are trying to get out the door to get to work by 9am. But first they need to drop the children at the day care centre where there is usually a traffic jam on the way. They cannot be late because their work is not flexible and they cannot risk losing their job, because the bills don't stop coming in. They are lucky to get a proper lunch break let alone prepare the five-veggie salad and protein lunch they have been advised to do. They struggle to get to day care to pick their children up before the day care centre closes. Every one is tired, frazzled, needing attention, it is starting to rain, the local supermarket is crowded and the parent can scarcely stop their tears of exhaustion let alone start to prepare a healthy balanced meal that everyone will eat. So another night of take away makes more sense in that moment. There will be no pans and pots to wash up and dinner will be ready instantly. Instead of shaming them for not being  a super person, we could work with them to ask what would help make their life easier. None of this might include food or exercise options at this stage. But we can ease a bit of their burden by telling them they're definitely not making excuses for not doing their assigned weight loss tasks of gym, walks and healthy eating. Those things can fall into place a bit more easily or readily when other support structures are in place.

Another scenario that is a true story is when I worked as a consultant a long time ago in a gym. Week after week a client would say she simply could not cook veggies each night as she was advised to do.

I have never found it hard to do for myself so it could have been easy for me to assume a position of disbelief and say how hard can it be? But it was actually really distressing for her because all our suggestions and ideas just kept falling flat for her. We talked more and I listened carefully and one day after many weeks she told me how when she was growing up, she was raised in a remote village in Indonesia and her mother outsourced all their meals. She had never learnt to cook or shop or seen anyone cook.It was such a light bulb moment and I suggested that perhaps she could order her favourite dishes from her favourite local restaurant with side dish of cooked vegetables to start each meal with.

She came back the following week beaming and everything was suddenly a non-issue. She was eating her veggies regularly and stopped beating herself up or feeling like she was failing.

We don't know about someone's internal world where they might be struggling with serious mental health and without their medication they cannot function The medication is keeping them safe and out of hospital but it is causing weight gain.They may not be ready to disclose this information for fear of judgment or it is too private for them. We don't know the struggle of someone who was so neglected and abused as a child that food was their only solace and taking that away from him or her creates extreme distress. We need to be able to hear their distress, sit with it and not add to the layers of shame by telling them they are just "making excuses" for not making the changes we suggested.

We also know that diet and exercise while  undoubtedly important in managing weight are only part of what people need to support them and help. The causes of excess weight are  so incredibly complex, and reducing it to a simple formula,  I think is being negligent towards our clients. There are thankfully medications and surgery that can make a big difference for people, but I cannot believe how many people are criticised for reaching out for this help by their family and friends and are  being told it is yet  another excuse for not just eating less and moving more.

The cliché of walk a mile in someone else's shoes is actually really important when listening to people needing help for managing their weight.

Ginette Lenham © September 2022

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