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I think those of us who have lost a lot of weight and kept it off for a long time know that guarantees like “Lose 40 lbs in 4 months” are useless promises and full of fluff.  But I want to explore how this kind of thinking really impacts the “weight-loss relationship” between a client and someone who is counselling a person on losing weight, even if the relationship is between a client and a registered dietitian or even a physician.

I am sensitive to these kinds of guarnatees because in psychotherapy it is “bad form” to make promises like “I can cure your depression in 4 months” or “anxiety will be a thing of the past”.  Ontario’s college of psychotherapists prohibits claims such as this and client testimonials, and I want to explain why they do that, and how weight-loss claims have a similar negative impact.

In psychotherapy, it is up to the client to lead how the session progresses, and clearly, every client is different.  If you have an image of a therapist who sits back, says nothing and just nods and nods, you likely have a bad view of that therapist.  While it is true that some therapists may not be practicing well when using that “technique”, we often we are waiting for the client to have their own breakthrough rather than having the therapist interrupt the process, or possibly plant an idea in the client’s head while they are doing their own thinking and work.  In other words, we do not want to move the client any faster than the speed at which they are able to progress.  This is fundamental to sound and ethical psychotherapy, and though complete silence may be bad form, it is often better to err on the side of silence than it is to talk and disrupt the patient.

However, imagine this scenario though – where a therapist says “I can cure your depression in 10 sessions.”  By the 10^th session if the depression isn’t cured the therapist needs to work at “warp speed” to get there.  Alternately, if the client doesn’t feel cured after 10 sessions then the question becomes “whose fault is it that the promise wasn’t kept?”  When dealing with a vulnerable population like therapy patients, many of them will assume it is their fault, especially if the patient feels that the therapist is all-knowing and highly educated, and feel worse after such a course of therapy.  Hence the reason why therapists do not make any sort of guarantee or “time promise” about when someone can expect to feel better.

Now, lets apply the exact same thing to weight loss.  If there is a promise to lose a certain amount of weight over a certain amount of time, the provider is going to unduly apply pressure to the client, whether the client is ready for it or not.  I think many weight-loss clients will hear something like “Bob, it’s time to switch to vegetables.  I know you’ve not eaten a lot of them in the past, but we’re trying to lose weight here, and you’ve been working at eating them in little bits, so let’s make a big change.”  Bob is entirely set-up for failure if he must only eat carrots instead of carrot cake.  And if Bob does not lose his weight in the required amount of time, Bob will look at the hundreds of testimonials of other clients that have managed to succeed on this plan and feel that he is at fault.  It’s a very poor outcome for Bob either way.  In fact Bob’s provider has a financial vested interest in insuring that Bob achieves the promised results.  If Bob doesn’t achieve those results, and if there is any truth in advertising, the provider must lower his averages and be forced into reducing the promises he can advertise about.  Hence the relationship between Bob and his provider is influenced by his provider’s financial gain!

If you don’t think this is a real issue, look at the following link about the Bernstein Clinics that operate in Canada.  These clinics are run by physician Dr. Stanley Bernstein.  The College of Physicians and Surgeons of Ontario launched a complaint against him saying that his advertising violated their guidelines.  His lawyer argued that the regulations are unfair to Dr. Bernstein because other, non-physician providers can make any claims they want about the efficacy of their weight loss programs.  The College’s position is that there must be some ethical standards for one of the most respected professions in the province regardless of what other providers may claim!

In my therapy practice, I see many patients who complain about their weight loss providers, and I often tell them there is an inherent conflict of interest between providers who promise results and patients themselves.  I tell my patients that other providers must force them into diet and exercise plans they may not be ready for in order to reach the publicized goal.  In contrast, I inform them my focus is on having them work through blocks to weight loss when they are ready and not on some arbitrary schedule that is no more than an advertisement.  My patents appreciate the perspective and the time they are given to work at their own pace, because that leads to long-term weight loss – and really it’s the “long-term” that is the only time period that should count in weight loss.

I am often asked how I started my “diet” when losing my 100 lbs, and people are often shocked when I say “My first meal for breakfast was Nutella on a white flour bagel.”  Every person I tell this to looks stunned, and a few people even tried to work it through in their minds to see if there was somehow a nutritional component or benefit to such a breakfast.  I readily tell those people that there is absolutely no nutritional or weight loss property to such a breakfast, and they remain mystified as to how such a plan lead to successful weight loss.

With that query, I tell them the following story….

Every day I would eat my Nutella on a white bagel for breakfast at 7:00am, and every day my wife at the time would come downstairs and give me a weird look.  She and I were both obese, and as an unwritten rule, we never discussed each other’s eating habits with each other directly.  However, she did know I was on a diet and she did know I was going to the gym every day and it was clear she could just not see this fitting in as part of a weight loss plan, but did not want to comment.  So after about two weeks of these looks I said “So I bet you want to know why Nutella on a white bagel is part of my weight loss plan.”  She nodded her head.  I simply said to her “Prior to this, when was the last time you saw me make it down to eat breakfast at 7:00am in the morning, let alone doing so consistently over two weeks?”  At that point, a wry and knowing grin came over my ex-wife’s face and the conversation pretty much ended there, because with that she could guess my strategy.

What she realized is that for years I didn’t eat breakfast or lunch.  My eating habits were so far gone that I would often not eat until 4:00pm in the afternoon for my first meal of the day, and much of the time that meal would often be fast food.  The very act of eating regularly, setting a schedule and being able to get-up every morning to eat a breakfast was my first start - that was my goal.  The Nutella on a bagel was just a vehicle to get me to eat regularly, which was my real strategy.

My consumption of food was so bad and awful I needed something I could commit to and call an easy victory.  When you are 100 lbs over weight and do not eat well or exercise, getting up in the morning at 7:00am to eat breakfast regularly is a challenge – so I needed something to induce me, something to reward me and Nutella on a bagel was able to do just that.

Now, would I recommend this strategy for anyone else starting on a diet or on a permanent weight loss journey?  Absolutely not!!!!!!!!!!  However, I would recommend that every person who wants to go on a permanent weight loss journey know themselves inside and out very well, and from that figure out the best strategy for them?  Absolutely!!!!

See, my Nutella on a bagel strategy was informed by many pieces of self-knowledge that I knew prior to my weight loss journey.  He is what they were:

• I knew I could not give up my junk food immediately, it would have been a disaster. However, I knew that I could taper it, so Nutella on a bagel was my junk, and a promise to myself not to snack in the evening.  If I wanted a sweet snack in the evening (which I would compulsively do), I remembered my Nutella on a bagel was my limit, so I ate fruit or trail mix… and if I wanted the occasional binge, a simple spoonful of Nutella was allowed once or twice a week.  So the Nutella on a bagel not only got me into regular breakfast habits, it was a way of breaking my reliance on sweets in the evening – pretty smart thinking, if you ask me.
• Why did I know I could not give up junk-food immediately or entirely? Because I knew I was an emotional eater and I still had bigger issues to sort through to understand my life and my emotions.  I knew that cutting off my junk food - or my emotional crutch entirely - would not be possible.  I had to know that I could scale back gradually.
• I knew that I could not work with any sort of nutritionist or trainer because I knew they would not support this aspect of my journey. So I needed to complete it before I sought professional help that would clearly not understand and/or shun my behaviour.
• I also knew that I could substitute my Nutella on a white bagel for other foods at breakfast and not feel deprived. Even moving to a sweetened cereal would have been a step in the right direction and still have kept me satisfied.
• Finally, even after the first few days, I was beginning to feel the ill physical impact of eating such a high dose of sugar in the morning (not to mention Nutella gets everywhere and is really sticky). I knew that if I could tap into that feeling of fogginess, that really yucky feeling of over-indulging on sugar, that feeling of rush and fall with such a high dose of sugar, I knew I could turn myself off that kind of treat.

Overall, within a month, I had substituted cheese, eggs, whole-grain non-sugar cereal, sausages, fruit and even the occasional piece of pork for breakfast and was on my way.  Eating a regular breakfast also stabilized my eating throughout the day – I was eating three square meals a day, something I had not done for years, if not decades.

As I sit here and write this, a very interesting thought is occurring to me.  No one I tell this story to has ever told me I was wrong in doing what I did.  The reason is obvious – the proof is in the pudding, or the size 34 jeans that I have been wearing for almost five years.  But what if, during my diet, people saw my Nutella on a white bagel for breakfast?  Would they laugh at me, tell me I didn’t know what I was doing, assume that I bought into the false premise that Nutella is “healthy” (afterall, they do market it this way)?  Would they assume I was weak, that I was setting myself up for failure?  Most importantly, would they have believed that I knew myself well enough to know what I was doing?  Who are they, or who are nutrition experts, to tell me how to eat and properly diet?

The fundamental goal of my story is this – a permanent weight loss journey is a very personal experience.  When you are committed to losing weight long term, and when you know yourself, you will do what it takes to pace yourself accordingly.  I simply could not imagine eating broccoli and cauliflower as my first diet food. I wasn’t ready for it and in fact it took me three years to actually start eating vegetables regularly.  Is an out of shape person going to run a marathon as their first exercise or dead-lift 300 lbs?  When I started at the gym with exercising, I could not even make it through my warm-up stretches for the first three weeks – why should I assume that my eating should be well ahead of where my body was?

When someone says “I’m going to commit to some sort of diet ‘plan’”, their commitment is entirely in the wrong place.  However, when your commitment is to yourself – and when you’ve done the work to know yourself well - that’s when Nutella on a white bagel becomes a completely viable strategy for the first food on your diet.  I should know, I did it!

As a psychotherapist who has battled his own weight issues, I am often asked if it is necessary to address these issues to achieve long-term weight loss.  The answer, as with most things about long-term weight loss is not easy.  On an optimistic level, I don’t believe it is necessary.  There are some people who wake-up one day and say “enough is enough” or that they are sick and tired of being sick and tired and start on a successful weight loss journey regardless of any hurdles – psychological or otherwise – that they are facing.

In the kind of therapy I practice – and in the way many modalities of therapy are being practiced – the therapist does not deal with a particular diagnosis or condition, though we do understand them quite well.  So in some cases, just the act of therapy itself can cause weight loss, or address other psychological issues without directly talking about say “depression” or analysing one’s food diary.  I am reminded of many patients who I consulted for the purposes of weight loss where the primary area of discussion has been about their work or occupations.  Now this is not to say that one’s work schedule or routine is the issue that is at the root of one’s obesity.  Rather, I always recall the words of my clinical supervisor – “Good therapy is done when the patient doesn’t even know that therapy is being done.”  What this means is that underneath the conversation, the therapist is addressing issues of avoidance, self-esteem, fear of taking action, fear of failure or fear of change.  In fact, often talking about weight – when one is not ready to directly address it - can be embarrassing for people.  Moreover, as a therapist, my ability to provide psychologically valid weight loss strategies that will work to address someone’s disordered eating can often be difficult.  I am not a nutritionist and as someone who has lost weight long-term, I know that finding a solution to something like binge eating comes from within and not from outside.

So whether a therapist is talking about something as benign as the weather, or about the client’s battle with depression, there is always an eye towards these deeper issues, even if it is done subtly.  In fact some other clinical axioms are “You can never win an argument with a depressed person” or “It is difficult to tell a trauma victim that they are a good person.”  The reason for this is that attempting to dispel a person’s negative of view of themselves directly is fraught with clinical difficulty.  People just do not believe anyone or any evidence that they are worthy, and find ways of refuting those who tell them otherwise, and when the patient does not believe the therapist’s praise, a healing relationship is challenging.  In fact, it is this inability to see one’s self as worthy that is often very familiar to those who battle with their weight.  Unless the therapist properly balances the optimistic view that change is possible with a patient’s deeply held views that change is impossible, it is difficult to form a healing relationship.

Some caveats are important here.  I know some therapists who feel that all weight issues are trauma-based, and take a trauma approach to weight loss with their clients.  Since I was not trained directly in trauma and since my own lived experience doesn’t support this, I tend not to use this as a default in my treatment, but at the same time will not exclude it.  In fact, many people – even those with complex psychological conditions – are able to achieve the results they want working either with a therapist or a weight loss coach, especially since better diet, exercise and overall health ameliorate many psychological conditions as well as physical ones.  However, when barriers to following weight loss advice seem unattainable deeper work may be necessary.  It is why I will spend six months with some patients just talking about their work or other life issues, and not even address their food issues directly – especially if the client does not seem ready.

In all cases though, the deeper work around weight loss involves inducing feelings of respect, self-love and care in ways that circumvent an individual’s attempts to see themselves as flawed.  The therapist becomes someone who has an optimistic view without being a cheerleader, someone who is consistent without being overbearing and someone who expects progress but does not withhold love when it is not achieved – and all of these are crucial traits that someone must practice internally in order for long-term weight loss.  When someone who is facing a psychological condition like anxiety, depression or past trauma cannot learn these principles directly, a good therapist is able to impart them in ways someone will still listen.  When that happens, long-term weight loss is indeed possible for those who may feel otherwise.

When I first entered into the weight loss market, I fell into the same trap that most every provider does.  I started telling everyone I saw that “you can do it”, or “lose all the weight you want”.  Then about six months in, I started networking with physicians and directly with obese individuals – and let me tell you, the saccharine and maudlin notions of “you can lose all the weight you want” fell right out the window for two main reasons.

First, physicians deal with really tough cases.  A sample patient may be an individual who is 60 years old, have had one heart attack, have had high blood pressure, have diabetes and have weakened joints from carrying around significantly excess amounts of weight.  And for those of you who didn’t spot it, if someone is diabetic, they may be taking medications that actually have the side effect of weight gain, so those individuals have to choose between weight loss and managing a very nasty chronic condition.  Those individuals are not as likely to lose weight as a 40 year old with no medical conditions.

The second reason my approach of “you can lose all the weight you want” is that some obese individuals are very happy with their body types – plain and simple.  They are not looking for massive amounts of weight loss, but rather simply looking for ways to manage certain aspects of obesity.  Messages of “you can lose all the weight you want” assume that an obese person wants to lose weight.

As I sit here and type this, I am almost shocked that my background as a therapist did not stop me from initially pursuing these messages.  I regularly counsel depressed individuals whose weight fluctuates not only because of the condition in general but because of their medications.  Also, I fundamentally forgot a main outcome of therapy – a patient who can accept themselves is a patient who no longer needs therapy!  I completely missed these very important parts of my job in favour of being caught-up in hype.

As I sit here and write this article I think about why I let myself get caught up in the “hype” of weight loss messages given my background.  I think at first, it was because I wanted to make money and because I wanted to reflect the messages that the market wanted.  However, reality set in.  Long-term weight loss is not easy.  Messages of “everyone can lose weight” are harmful to people who have health or psychological conditions that make weight loss a challenge.  What if people are happy the way they are?

Now when I deliver weight loss messages, rather than delivering a rah-rah message, I deliver one that is much more respectful and tempered.  I tell people that the goal of weight loss is not losing weight but accepting yourself because that acceptance will guide you through the journey better than any message I provide.  When I work with people on the start of their weight loss journey, I guide them through awareness of their thoughts and their body.  I discuss blocks that stop people from listening to themselves, or blocks that derail them.  I help them sort out the deep conflicts they have with weight, trauma, comments made to them throughout their lives, using food to cope and other factors that influence their weight.

When awareness and acceptance is in place, humility will follow, and with humility comes perspective.  With all those in place – humility, perspective, awareness and acceptance, the weight loss journey becomes your own.  Ask someone who’s done it and you’ll find these are the drivers of success.  It is unfortunate that humility does not seem to sell as well as messages of “you can do it”, “everyone can lose as much weight as they want” and “steely determination is all you need”.  What I can say is this though – it’s a good thing I’ve learned my lesson, and I hope you will too.

This is my first blog post and I think readers should understand the particular view I take on long-term weight loss.  In short, one of the things I believe is that commercialism should be taken out of the weight loss sector entirely.  I think it is profit and not fat, carbs or sugars that make us gain weight.  Commercial diet books are designed to sell product more so than they are there to create weight loss, and commercial diet programs are there to either produce short-term results that are not sustainable or create long-term dependence or “customers for life” as marketers call them.

My view is this  - if you want to lose weight long-term you need to prepare your mind for the journey so that you can make your own decisions and not someone else’s.  One thing I have noticed about weight loss is that so many people relinquish their own decisions and responsibility about their weight loss to so-called “experts”.  Now there certainly are some amazing people involved in weight loss who truly know their stuff and want to help people, and equally there are many dieters who do need guidance.  However, I feel it is necessary for people who want to lose weight long-term to come up with their own views on what works for them, and that if someone has any more than 25 lbs to lose, they will have to switch diets and tactics on a regular basis when they plateau.  Plateaus are times during the weight loss journey where what worked before to produce weight loss stops.  At this point a person must make decisions about whether to continue or whether to stay where they are.  That requires them to trust themselves and not someone else’s outlook, research or experience.  As such, building up trust in yourself, your intellect and knowledge is critical.

Three examples will point this out.  The first comes from Heather Robertson, a dynamo who has maintained a weight loss of over 170 lbs for at least five years, and runs a website and podcase called “Half Size Me”.  Recently, she was approached by a national magazine who wanted her to provide them with a diet based on her experience that could be printed in their publication.  Heather declined their request because what she did could not be summed-up in a formula or something like a plan guaranteed to make you lose weight easily.  She was told “you have a great story, but we can’t sell it.”  While Heather did refuse their request to provide an easy solution, I told her she should have said “Now you can see why my amazing story doesn’t include any diets from your publication.”  This anecdote shows the fact that those who achieve long-term weight loss cannot simply summarize or even guarantee that what they did will work for others.

The second example comes from Dr. Yoni Freedhoff in his book “The Diet Fix.”  Yoni, whom I have met twice is a world-renowned rock-start when it comes to weight loss, and rightfully so.  He’s passionate, articulate, knowledgeable, effective at what he does and humble.  Yet his book says “What if after 10 days, you could change your relationship with food forever?  What if in 10 days you learned how to ‘eat just one’?...  What if in 10 days even so-called danger food could be your friend?”  After this battery of promising, yet rhetorical questions, are asked, he says “I know – it sounds too good to be true.  And I’m often the guy quoted in the media as saying ‘If it sounds too good to be true, it probably is.”

I can’t help feeling that Yoni and/or his publishers have succumbed to the notion that it is necessary to make claims such as this to sell a diet, thus placing commercial and profitability interests above your own.  While the tips in Yoni’s book are excellent and should be adhered to as basic common sense – and while he does not promise to make you lose 100 lbs in 10 days - I feel that the rhetoric provided here by him is what is wrong with commercial weight loss plans.  Even the best people approach the line of making grand promises, blur it and then retreat to sell more product.

The third example comes from what I am seeing on some websites that make “absolute” guarantees about behaviour (“Completely eliminate all your bad eating habits”, “Never snack again”, “Banish all your cravings”).  I see posters on these sites who express significant distress over the fact that they are unable to always follow a diet plan.  Some posters even indicate the presence of psychological trauma or other conditions that makes them vulnerable to low self-esteem, thus intensifying the feelings of failure and fueling the very binges they are trying to avoid.  I cannot stress enough to everyone good weight management is rarely about “never” or “always”.  It’s about knowing and trusting yourself and learning how to manage cravings correctly – and you do that by learning how to trust yourself, not by banishing behaviour that is deemed bad by someone else.

My hope in throwing my hat into the weight loss arena is to say this – recognize that everyone in the industry is out to make a buck, and there are a lot of bucks to be made.  If you want to achieve mediocre results, you will buy in to the full promises, or even half promises that are made to sell product.  One of the first things you must do on your long-term weight loss journey is trust yourself and no one’s rhetoric.  If you plateau on a plan, or can’t follow it, change it and don’t give up.  Diets that make promises set you up for failure in two ways.  Besides making claims that are there more to sell product than they are to lose weight, if you do not succeed you run the risk of giving up, thinking the fault must be yours and not the author’s or the program’s since authors and programs make such “strong claims”.  To quote Yoni, if it seems to good to be true, it probably is, and I would add this… if you want to lose weight, only trust yourself.