Medication & Supplements

Weight loss medications are usually prescribed as a short-term intervention for people with a BMI of 30 or more. It is recommended that they are used in conjunction with physical activity and healthy eating. Such medications have been found to assist weight loss of around 3% to 7% of body weight over 12 months, but often carry side effects and contraindications that many people find unpleasant, or that have other physical or mental health risks associated with them.

Alternatively, weight loss supplements (i.e. orally administered substances that can take the form of pills, capsules, liquids, powders, bars, etc) are often poorly researched, if tested at all, and may not have any proven effectiveness. They also carry risks that can result negative and/or dangerous consequences on physical and or mental health.

Surgery

In addition to medications and weight loss supplements, bariatric surgery is becoming more commonly undertaken in the developing world, yet many people continue to engage in problematic eating behaviours even after surgery (such as binge eating or night eating syndrome), and some patients still regain some (or occasionally even all) of the weight. Furthermore, such a permanent intervention can impact other areas of a person’s life, including having social and cultural consequences. More research into this form of weight loss procedure is required to establish long-term effects on patients.

Diets

A large proportion of people have been on a diet or are planning to go on a diet… but do diets actually work? We have all either lost weight on a diet, or know of someone who has. But does this result in long term weight loss? Here are just some facts about weight and dieting:

• People can be healthy at most weights if they engage in healthy behaviours.
• Estimates of weight regain in the long term after dieting varies enormously, however it appears that a large proportion of people regain to their original weight, or gain even more than they lost.
• There are powerful biological responses that counter extreme weight loss efforts.
  • Calorie restriction has been found to decrease the rate of calories burned in the body.
  • Calorie restriction has been found to lead to a preoccupation with food.
  • Hunger inducing hormones increase when the body senses loss of fat and/or muscle.
• Yo-yo dieting and extreme dieting has been linked to not only increased body weight in the long term, but health problems such as insulin resistance, decreased bone density, increased blood pressure, heart problems, and inflammation.

So how would a mental health professional able to assist with healthy weight management?

Many people are looking for a quick fix or magic pill, but a complex problem involves more than that for long term success. Despite what you may have been led to believe, body weight isn’t just a matter of “calories in, calories out”. There are many factors, in varying degrees, that contribute to our body size and composition including genetics, hormones, culture, gender, sleep patterns, physical activity, and our thoughts, attitudes, beliefs, and behaviours. 

Mental health professionals are skilled in assisting people to identify problems and set goals, address unhelpful thoughts and patterns that contribute to weight gain, improve motivation, body image, and health behaviours, and decrease unhelpful or self-sabotaging behaviours such as bingeing or emotional eating. They can also help to improve sleep and other factors which contribute to weight and health.  

Some helpful ways that you can begin to address weight concerns include:

• Watch your language – change your conversations and how you talk about weight and your body.
• Reduce comparisons – delete or unfollow social media, blogs and groups that lead you to be dissatisfied or pre-occupied with weight and appearance.
• Improve exposure – access positive information and supports that benefit your self-concept & confidence.
• Focus on the right things – work on gradual, achievable, and sustainable goals and changes. Learn body positivity and acceptance.
• Give yourself a pep talk – acknowledge progress and use positive self-talk to improve motivation and mood.
• Nurture yourself – Find new or different ways to feel good and improve your mood, and reward yourself in ways that don’t involve food and alcohol.
• Have fun – find ways to engage in physical activity that you actually enjoy. Recruit a supportive friend or family member to do fun things together. Forcing yourself to do something you find boring or laborious won’t last.
• Eat mindfully – learn to truly enjoy your food and to listen to your body and the signs of hunger and fullness.

Healthy weight management and body image is possible and sustainable. There are a number of ways that you can access support if these are challenges for you, including seeing a suitably qualified clinician.

Helpful resources

• Health at Every Size approach: https://haesaustraliainc.wildapricot.org/
• ifnotdieting.com.au