Let’s Talk: The Struggle to Maintain a Goal Weight
- Jan 30
- 5 min read
By Dr. Nancy Fishman / Morgan Hill, Calif.
Happy February! Now that the beginning of the year is well behind us, many holiday celebrants are faced with the fizzling of arguably the most common New Year’s resolution: to get healthy! For many, this means striving to reach a preferred weight.
Americans spend gazillions of dollars each year on weight-loss programs, gym memberships, private trainers, and calorie-controlled prepackaged meals. There are many ways to reduce weight. The rise in the use of medications like Ozempic and Wegovy suggest a level of frustration people have experienced with more traditional methods. The fight to maintain one’s goal weight is often a “losing” battle. After investing money, time, and personal sacrifice to reach a successful outcome, why is it so difficult to succeed and sustain the glory?
Sometimes the goal weight is not realistic thus difficult to maintain. Healthy goal weight is heavily influenced by body type. Those who are considered endomorphs have larger bones, softer curves and typically carry more body mass than the published averages. People in this group must take into consideration their genetic makeup when finding a realistic goal weight.
Goal weight should not be arrived at randomly, but rather with the help of a physician who considers medical factors,age, and body type when calculating a patient’s healthy goal weight. Often it takes a bit of experimentation to discover the right number of calories you should ingest daily to maintain a goal weight.
Physicians’ calculations are rooted in science. If their prescriptions stood alone, people would be successful. But this is not the case at all. Personal history, personality traits, and free will are factors that complicate the challenge to retrain from overeating and failure to maintain goal weight. It is not so easy to merely consume a prescribed number of calories each day.
While there are many psychological explanations for the lack of success in maintaining goal weight, there are four categories I have observed over my years in private practice into which most people unable to maintain goal weight fall: 1) Concealment; 2) Need to be noticed 3) Deprivation, and 4) True desire.
The Concealment category includes those who either have a secret to hide or want to cover their bodies to be less conspicuous. For instance, people who have been sexually molested often surround themselves with extra body mass, subconsciously protecting themselves against unwanted advances. They often sabotage diets when they have lost too much weight and start to feel vulnerable. In other cases, people maintain an excess amount of body mass to prevent others from seeing more than they are comfortable sharing about themselves. Their body condition reflects a necessity for privacy.
The Need to be Noticed category includes individuals who struggle to be seen and heard, stemming from unmet childhood desires to be noticed by family and friends. In making themselves physically large, they subconsciously believe they cannot be overlooked.
The Deprivation category is fascinating! I have observed people falling into two groups:
Group 1 consists of those who feel as if love and resources, such as food, are endless. If you put a bowl of M&M peanuts on the coffee table at a party, they typically eat a few and are rarely conscious of when others are helping themselves or how many are left in the bowl.
Group 2 includes those who feel as if there is a finite amount of love, attention, and resources, such as food. When a bowl of M&M peanuts is set on a coffee table surrounded by other snackers they don’t hesitate diving in and grabbing their share while acutely aware of how many everyone else is claiming. They feel anxious when the supply is dwindling and reach for more.
People in Group 2 have what I call Deprivation Syndrome, a condition that contributes to the fear of not having enough. I see this as either a part of one’s nature or as a consequence of actual real-life experience, such as growing up in a family that has struggled to put food on the table or having a parent who withholds love and attention.
Like people in the Concealment category, those in the Deprivation category have major roadblocks that prevent them from sustaining healthy a goal weight. Only with therapy to explore the origins of these roadblocks, and with diligent treatment, can they overcome lifelong obstacles.
I’ve had many patients over my years in private practice who present with weight loss goals. There is often a familiar decades-long pattern of following fad diets. A certain amount of success is achieved, but my patients have typically reported how uncomfortable they have become as the pounds dropped. It was only after extensive work delving into past traumas and discovering the roots of problem that they were able to heal and sustain success in weight management.
Finally, the True Desire category is unlike the first three. People I have observed in this category LOVE food. They consider themselves foodies. They definitely live to eat. They wake up in the morning thinking about food, where to shop, what to make, and when they will eat next. They appreciate the culture around food: the socializing and sense of community. Simply put, eating food is pure joy. In fact, people in this category have little motivation to lose or maintain weight. Food is far more important.
When patients ask me to help them figure out why they cannot lose or maintain their goal weight, I first want to know if they fall into the True Desire category. When it is clear to us both that food is top priority, I ask them if they would like to challenge the cacophonyof voices telling them to lose weight. Why succumb to the social pressures to look a certain way? You cannot imagine the relief they feel when asked, “Wouldn’t you rather just enjoy your life with all the eating experiences you desire?”
Coming to the truth about one’s inability to maintain a healthy goal weight is complicated! Starting with a realistic goal that matches one’s body type is crucial. If the struggle persists, consider that it is not the diet program, nor the amount of exercise to which one commits. If this is a chronic, lifelong battle, there are likely to be issues beneath the surface--psychological roadblocks--that prevent lasting success.
This column is devoted to psychological topics that speak to the human condition, such as relationships, family, love, loss, and happiness. The ideas, thoughts, philosophies, and observations expressed here are personal and not meant as professional advice. Names and identifying information have been changed to protect the privacy of real people.
Dr. Nancy Fishman moved to Santa Clara County in 2016 from Michigan, where she was a practicing psychologist. Currently, she is a strategy consultant to individuals, families, businesses, family law attorneys and their clients--working on coping, managing, reorganizing, pivoting and innovating. She is the founder of Forgotten Harvest, one of the nation’s largest food recovery operation, and is also the creator of Silicon Valley’s A La Carte food recovery and distribution initiative. Nancy lives on a family compound with her husband, sisters, brother-in-law, and a pack of dogs.
OZEMPIC--and most all of the other silver bullets to lose weight may work for a short time, even surgery may work for a short time but in the end it is self discipline that gets permanent results and most people do not have it. --J.T.