top of page
  • Dr. Jenna Daku

Beyond the numbers on the scale: Why weight management doesn't fit with eating disorder recovery

I am a Health at Every Size (HAES) practitioner for many reasons, but mostly because it embodies my belief that everybody (and every body) deserves respect and compassion just as they are. That is important for me on a personal level, but also on a professional level because I take my ethical responsibilities as a psychotherapist very seriously. I have interpreted these responsibilities to mean that I am committed to honouring my clients’ lived experiences; being compassionate and non-judgemental; empowering people to make informed, growth-promoting choices that will enrich and expand their lives; not causing harm to my clients, and promoting their well-being to the best of my power. I specialise in disordered eating and eating disorders, so that means that I work with individuals who struggle on a daily basis with negative thoughts and feelings about their bodies, and ultimately themselves, and who use food and exercise as ways of coping. Most of the people that I work with are trying to change their bodies and they wholeheartedly believe that losing weight is the key to lasting happiness and health - and that their inability to do so is a personal failure. This is problematic for many reasons, not least because happiness and health are multifaceted aspects of human experience that have very little to do with body weight. But also because I have heard from my clients how the sense of personal failure that accompanies failed weight management attempts leaves people feeling discouraged, ashamed, distressed, powerless, angry toward themselves, and more likely to avoid other health promoting behaviours like socialising, talking about their feelings, seeing the GP, and engaging in basic self care. As a witness to this, it doesn’t make sense, nor does it fit with my ethical framework, to collude with someone's desire to manage their weight when clearly it’s not working for them, it’s masking deeper problems with their relationship with self, and it’s causing them harm and distress. Fundamentally, their body isn’t the problem. The problem is that they don’t feel good within themselves - for many reasons that need time and space to bring to the surface and reframe - and they project those feelings on to their bodies. This process is encouraged through diet-culture, which promotes unrealistic and unhealthy ideals about bodies, food, exercise, and health. It tells us we “should” look a certain way, and that if we don’t is a personal failure and it means that we “don’t care about our health”. It shames people whose bodies don’t fit with the ideal. It puts the false idea in to our heads that if we were all to eat the same foods and exercise the same ways that we would look the same. Underlying this is the inherent idea that this would somehow “cure” the “obesity epidemic”. (Note my use of asterisks to further highlight bullshit). Diet-culture and the promotion of weight management contributes to weight stigma and fat phobia. These lead to discrimination, stress, anxiety, decreased access to (and quality of) healthcare, and negative health outcomes — some of which might actually *contribute* to higher body weight. This is all backed by a growing body scientific evidence, and even The World Health Organisation recognises weight stigma as a public health concern. From this perspective, I do not believe in weight management or the promotion of weight loss within the context of recovering from disordered eating. It doesn't make sense to me to tell one client to eat, and tell another to stop eating based on the size of their body. I have heard enough stories from my clients about how being on the receiving end of a weight management approach from other healthcare professionals promotes shame and guilt, contributes to body dissatisfaction, fuels disordered eating, and furthers the internalisation of unrealistic body ideals. I am passionate about supporting people to heal their relationships with food and body, and a culmination of research, personal experience, and honouring my clients lived experiences has led me to believe that weight management does nothing to support my work. Now, this doesn’t mean that I judge or shame my clients for wanting to lose weight. That too would be counterproductive and misaligned with my ethical framework. Instead I acknowledge their desire and pain and support them to understand that wanting to change their body is a reflection of a deeper unhappiness within themselves fuelled by toxic socio-cultural ideals. I explain some of the evidence that shows why weight loss efforts don’t work and how weight cycling is both harmful and often counterproductive, and then I ask them to put the idea of weight loss on the shelf while we work on the other layers of their experience. Initially, this can feel frustrating for them, but as a therapist I believe it's my job to offer them a space that is safe from the pressures of diet-culture so that they can start to build confidence, untangle unhelpful coping strategies, reconnect with their bodies, and explore their place in the world. These nuances are also way more interesting -- and that's because my clients are human beings, not numbers on the scale x

155 views0 comments
bottom of page