When Recommendations Fail To Be Implemented : (When Theory & Practice Sometimes Don't Align)
I really feel for people wanting to lose weight for many reasons. It is a vulnerable place to be asking for help with weight management. Also, for the most part many of these people have heard and tried a lot of the recommendations currently available.
Apart from the understanding we now have, ie that losing weight is far more complicated than implementing dietary restrictions and exercising, it can be also incredibly hard to implement some behavioural changes related to food. I have written in previous blogs about a lot of emotional and medical reasons that make weight loss challenging.
I think it is important not to project what seems easy or doable in theory, and expect that the client can take that information on board and make it work in their real life.
Our relationship with food and eating can be incredibly fraught let alone our relationship with our bodies and weight.
Here are some reasons why so many of these recommendations can fall flat and might on the surface appear like a refusal to engage. For the client they can feel like they are failing the program or advice they have been given. And, they often feel they are being judged for not following through. Yet, there are many valid and understandable reasons. (These are reasons not excuses)
When I hear advice on social media or main stream media from people who have managed to make changes saying "its easy to prepare home cooked meals", "why don't they just stop when they are full" " Its easy to buy healthy food" "How hard is it to cut sugar, carbs?"I feel like they are missing some important considerations. Making these statements tends to minimise the very real struggle people might have and consequently can make it harder to ask for help. Here are some reasons that can affect making changes to food and eating habits.
There are many more things to add to this list and please feel welcome to be in touch if you would like to share other reasons I have not included.
- Perhaps they grew up in poverty and often went hungry, so feeling deprived of food brings memories and anxieties from that time.
- Perhaps they finally have enough money to buy food and having this sense of control around choice of food feels more important than imposing restrictions.
- Perhaps meal times as a child were tense, angry family times, and they associate meal times as being unpleasant, hence home cooking feels reminiscent of those times.
- Perhaps food was used as a punishment ie they were forced to eat all of a food that they hated or they could not leave the table till it was all eaten and they never want to have negative associations with food again.
- Perhaps they never learned how to cook as their care givers/ role models didn't know how to cook, had no time to cook, or had little money to buy anything other than the basics, or were too sick to cook or shop, and the children had to fend for themselves.
- Perhaps they went to boarding school or grew up in a large family and it was first in first serve or they would go hungry, so eating as much as possible in a short space of time became a survival mechanism.
- Perhaps the school playground was a lonely place where they felt excluded and bullied and food was their only source of comfort.
- Perhaps their family denied them food when they were growing up thinking it would help them stay healthy but the deprivation caused strong yearnings for the withheld foods
- Perhaps there is a history of childhood trauma and sexual abuse and having excess weight helps them feel safe.
- Perhaps food is the one constant in their life that has been a source of self-soothing and companionship from a young age.
- Perhaps they had a very serious child hood illness where they could not eat for long periods of time and they don't want those feelings ever again.
- Perhaps they are on medications that make them very hungry so they can't start to restrict their food without feeling unwell.
- Perhaps they are on medications that alter their taste receptors or certain textures of food become unpalatable.
- Perhaps they have sensory processing issues so lots of food and textures are unpalatable
- Perhaps they are unemployed or on a very low income and they have a family to feed, and this takes priority over the food plan suggested to them.
- Perhaps it is physically difficult to get to a shop to buy fresh vegetables and fruit.
- If that is the case, the argument then for them do online shopping is making an assumption that they have access to the internet.
- There are a lot of current stressors going on in their life making being able to engage in health change behaviours difficult.
- Realising past efforts of weight loss has always resulted in rebound weight regain so they don't want to go through the disappointment again.
- They now know diets don't work and never did work so are reluctant to try again.
So, next time someone appears to not be able to engage with some recommendations made for behavioural change it is important to spend time with them to understand who they are, find out about their inner world and see if together there is a way to help make some changes that do not seem threatening or incompatible with their own sense of self.
Tough love isn't everybody's cup of tea for all the reasons above, and more.
Ginette Lenham © 2021