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If we can accept that two or more things might be, and, or are true at the same time we open up the capacity for another layer of support for our patients. One truth, belief or experience doesn't necessarily exclude the other.

I am not talking about facts or data here, rather about people's thoughts, feelings, emotions and experiences.

We are making enormous strides in understanding and helping people who are living with obesity, which is wonderful and full of hope.

Something I am hearing a lot of lately is the unexpected worry accompanying this hope for a lot of people. I think it is important to acknowledge these concerns for our patients when they bravely share them with us.

Once they have shared these concerns it is extremely important to validate them and not try to dismiss them by telling them things like "You should be grateful you have lost the weight" Or "gosh you are never happy, first you ask for help with weight loss and now you are complaining about this"

Some of these worries are about maintaining their weight loss. This is a frequent and major worry. I see people who have had bariatric surgery, sleeves, balloons, are on medications, VLCD, doing IF or just watching what they eat. The same worry comes up for all of them. They worry about being perceived as a failure and of failing themselves if the weight returns. For many, historically that has been their experience due to the nature of weight regain after significant weight loss when treatment ceases. So while they may be really happy with their weight loss this background anxiety is very real for them and ever present.

Another worry that comes up is about loose skin or new wrinkles. They are happy with their weight loss but the loose skin or wrinkles on their face worries them a lot and is causing insecurities.

For some people it has triggered quite significant relationship stresses. It may be that the other half resents their partners weight loss, as they feel threatened by the partner's new feelings of confidence in clothes and even threatened by their partner's new happiness. Or, the food that the couples used to share and enjoy together is no longer possible especially if someone has had major surgery. This creates a sadness of not being able to go out to the same restaurants they used to go together and have that shared experience or they miss sharing evening meals the way they used to.

Some people feel sad because they used to love baking and cooking for others and now feels less inclined to bake as they can no longer participate in sharing the experiences of sharing the food together.

Then there are the people who tell me that certain friends feel jealous of their weight loss and they don't know how to manage this new friendship dynamic.

Some people feel they have to hide what weight loss method they are using or have used, to avoid judgment and criticism, which makes them, feel like they cannot be authentic and honest about their life.

These are just a few examples of some of the concerns I have heard. 

So, while the health benefits have been fantastic for them, these worries are valid and real for them in their day-to-day lives.

In a rather ironic way knowing more than one thing can be true at the same time also can relieve a lot of internal pressure.

Ginette Lenham © February 2023

Image  with thanks to Tengyart

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