Why I Don’t Provide “Weight Loss Counseling”

As you can imagine, I get a lot of inquiries about weight loss counseling.  Many people reach out to me after having tried dozens of different diets, supplements, pills, books, shakes, and on and on, over the course of 5, 10, 25 years.  Frustrated and often at their highest weight, they come to me and want to finally experience that quick weight loss that’s been eluding them.  They are often confused when I tell them, up front, that I don’t “do” weight loss counseling.  In fact, if a client is ONLY interested in weight loss I give them a referral to another dietitian or give them my free advice on what they might consider next.  Are you surprised?

It isn’t that I’m not sympathetic to people’s efforts and desire to lose weight.  And it isn’t because I don’t realize that overweight and obesity aren’t risk factors for a host of diseases – in fact obesity is categorized as a disease on its own.  It’s also not because I don’t know how to help people lose weight.

The fact is, just losing weight isn’t enough to achieve long-term, sustained behavior change.  I’m sure you know people who have lost and gained hundreds of pounds over the years.  One of my (many) favorite sayings is “if nothing changes, nothing changes.”  This is so true with weight loss.  Just because someone changes the amount of calories that they eat for a period of time doesn’t mean they have changed their habits.  They may have just gone through a period of sustained abstinence from the things that caused them weight gain in the first place.  The way they think about food in relation to their health may not have changed at all.  Moreover, recent research suggests that the more rapidly we lose weight, the more fiercely our bodies try to hold on to calories by slowing down our metabolism.  Part of this is likely due to muscle loss during rapid weight loss, but changes in hormones and hunger/satiety signals may also contribute.

Dieting is also bad for your emotional health.  Being in a state of deprivation and denial can lead to depression, grouchiness, and melancholy — it may also lead to overeating later, contributing to a nasty cycle of weight loss, weight gain (yo-yo dieting) and shame.  On the other hand, a way of eating that focuses on delicious foods that happen to also be uber nutritious (such as the Mediterranean Diet) can lead to better mental health.

My goal for every person I work with is that they learn to embrace a healthy lifestyle that moves them from where they are – perhaps being overweight, undernourished, low energy, sedentary, and/or depressed – to a vibrant lifestyle fueled by nutritious foods.  Not only that, I find that many people who are overweight are also struggling with other issues that, though they may not seem related, absolutely are.  Weight loss, while often a side effect to the changes that I help people make, is not the goal on its own.  In some cases, stopping weight gain or eliciting modest weight loss may be as effective for reversing or preventing health issues as weight loss might be, and they may be more sustainable.  Working within my clients’ specific preferences, health history, and dietary needs, we create a plan to clean up their diet, making it super nutritious, address whatever digestive health issues they may have, develop healthy habits, and teach skills needed for sustained behavior modification that really makes a long-term impact.  So while they may not be “skinny” they can still feel sexy and happy.

It’s not a quick fix.  Nothing in life that is truly lasting, meaningful, powerful is easy, but you’re worth the effort.