Weight loss programs and diet plans are a dime a dozen! And there is a reason why the diet industry is worth $72 billion in the US: statistics show that nearly 95% of those who go on weight loss diets will gain weight back within one to five years! There are amazing diet programs out there and there truly is something for everyone, however, why can’t people keep the weight off?
I was taken aback recently when reading, The Body Keeps the Score by Dr. Van der Kolk. In chapter 9 he talks about the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study and its relation to health. What struck me was learning that obesity/disordered eating (and other lifestyle adaptations such as drinking, smoking and drug use) are often the underlying solution that people use to escape the pain or trauma in their life.
Challenging Patients to Examine Life Stressors
Discussing trauma and life stressors is not something that primary care doctors touch on or ask about when seeing patients. Dr. Felitti himself (author of the ACE study) discovered that of the thousands of patients with detailed medical records at Kaiser, few had ever been asked or had documented the trauma in their lives from childhood. To add to this, he even received flack from other doctors in his field of Bariatric medicine (weight loss medicine) for even considering asking these questions. His colleagues responded to his suggestion that underlying trauma plays a role in obesity with, “patients will fabricate anything for their failed lives”, or “how can you believe such patients?”
In my practice, a very important part of my intake process is to ask women, “how much stress and what types of stress have you had over your lifetime?” This question always gives me so much information, not only about the degree of stress that may be challenging the body, but also the opportunity to connect with my patients. In talking about life stress with patients l learn a lot about them. However, it also provides a moment for patients to witness their response to the question and I acknowledge how significant it is.
As a naturopathic doctor, I honor the tremendous importance of how interconnected the body is. We cannot separate our mind, emotions, and physical health. We try to do this, and most people can do this for about forty years and then our health changes. It is during our fourth decade of life that often patients are sitting in my office and saying, “The things I used to do to lose weight just don’t work anymore!”
Case Study: Childhood Trauma Affects the Weight Gain/Loss Journey
In 2013, a 61-year-old white male walked into our office weighing 349 pounds with the chief complaint of low libido and fatigue. He is a high-powered business owner and life/work balance is very challenging for him. He also had high cholesterol and his family history revealed the early loss of his mother to Diabetes. Men usually don’t talk much about their childhood traumas, however he did indicate there was a lot of trauma and stress in his childhood as well as in his current life. We worked together for years with rebounding weight gain and loss and resolving other health concerns. In 2019 he was able to keep his weight under 280 pounds consistently but with great effort and inevitable gain/loss cycles. It was at this point that he reached out to me and said, “I am ready to start counseling with someone, as you suggested years ago, on why I am overeating.” He admitted that he had childhood trauma that he realized may be playing a role in his inability to keep weight off.
Physical, Mental, and Emotional Health Contribute to Weight Gain
There are many ways to lose weight. Not only is weight management related to calories in and calories out, but it is also a function of what types of foods you are eating. This is demonstrated by the fact that those who are more sedentary can eat a caloric restricted diet and not lose weight because they may be eating the wrong types of foods for them! It is also why an uber athlete can eat a vegan diet high in carbohydrates and be lean. The number of ‘dieters’ has dropped in recent years due to a societal shift in acceptance of larger sized bodies. This is wonderful! It is just that, acceptance, and the attention to emotional health as it contributes to your physical health can be a key component in the ability to keep weight off.
In my practice, addressing not just the diet plan, the physiology of the body (thyroid, blood glucose regulation, adrenal health, etc), but also the mental and emotional health are keys to optimal health and healing. You are guaranteed to find direction and guidance in all aspects of health under my care.