Wednesday, September 19, 2007

"You should stop losing weight"

In my practice I get to see a great many people lose a great deal of weight and I've noticed two trends.

Firstly it's usually somewhere between a 15 and 20 pound weight loss when folks start noticing, but it's the second trend I want to talk about, the, "You should stop losing weight" trend whereby if you lose enough weight, folks will start telling you to stop.

In my experience it happens at somewhere around the 15-20% mark (i.e. a 30-40lb weight loss if your starting weight is 200lbs). Now there is a difference in terms of how starting weight affects this phenomenon and the higher the starting weight, the less likely this phenomenon will occur but as an anecdotal rule, if your starting weight is less than 250lbs and you lose more than 20% of your starting weight, somebody will tell you to stop. They'll often even do so despite the fact that you may still want to lose more weight and may still have a significant amount of medical risk associated with your weight.

Sometimes they'll even come right out and say you look bad.

I've got two theories about this. There's the less likely theory - jealousy, but honestly I don't believe that plays a big role for most folks. I think the more likely theory is the fact that consciously or perhaps unconsciously as a function of evolutionary biology, we interpret weight loss as reflective of illness.

The fact is that many major and sometime fatal illnesses have a wasting away component to them and I wonder if we as a species have it hardwired in us to recognize weight loss as a sign of illness. Many of us too have personally watched friends and relatives waste away and seeing a friend or a relative lose weight may trigger memories and emotions that less than pleasant.

For all those obesity researchers who may be reading my blog, I think this phenomenon would be a fascinating study and it's certainly not one I've read about. There'd be two ways to study it. One with a prospective study whereby the folks losing weight keep track of when they first run into someone whose concerned about their weight loss or perhaps an easier study using photographs of folks as they lose weight with captive audiences and well designed questions.

Anybody out there experience this phenomenon?

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  1. Crystal, RD6:25 am

    I have witnessed this, and I agree that sometimes the fear of illness and wasting comes into play. I have had people tell me that someone has said this to them, and I have had my patient's spouses express this about my patient. I even had one older man who had lost weight at a very reasonable rate and was still moderately overweight report being told this by his physician who told him to stop because he looked "gaunt". I gently explained to the man that all of my patients who are older have wrinkles and saggier skin around their face and that he perhaps was not noticing it because the excess fat was padding these areas. He definitely did NOT look any more "gaunt" than any average man his age would look.

    I also have another theory about this pheonomenon...we have forgotten what a healthy weight looks like. I, a dietitian I might note, weighed 245 lbs. I now weight 195 lbs. I do "carry my weight well" perhaps due to being very physically active, but I am clearly in need of continued weight loss. People say to me "you look great, you don't need to lose more weight" My husband lost weight after an illness, gained weight and sits very active,healthy, and fit at a BMI of 22. His relatives are forever telling him that he should gain weight, that he looks ill. I would love to post a picture, he clearly does not look ill. He is a healthy weight, a perfect weight I might add. (not just based on BMI but waist/hip etc).

    It is a sad sign of the times when we base a health weight on how a person looks, especially when we think that a healthy weight looks too thin!? Have we really become so comfortable with seeing overweight all around us?

  2. I have encountered this. I started at 280 and I am down to 200. I would like to be 185-190 and I have said so to those who ask what my goal is. Everyone invariably tells me to stop losing weight, that I have lost too much, that it's unhealthy, that I am sick, etc. My wife, m co-workers, my friends, some even get angry that I would consider losing more weight. It's a bizzare attitude considering that I lost my weight by changing my lifestyle. My response to them is that my body will stop losing weight when what I put in equals what I need and I'm not going to eat more just to appease them.

  3. Theresa10:40 am

    I belong to a weight loss support group and began at 230 pounds (5'2"). Once I achieved 155 pounds EVERYONE told me to stop. It was not just the odd person either. People who barely knew me would say "you must be at your goal by now! Any more would be too much". This of course caused me to falter and struggle. It was 'confirmation' to these people that my body was saying I was skinny enough. Hmmm. 5'2" and 155 pounds on a small frame is hardly skinny. Even my doctor agreed than every pound counts but a BMI of 25% was high enough and that was 136 pounds. This really did create a mental block and I'm still hovering between 155-165 pounds five years later. I'm comfortable enough to fit into a size 12 which is the normal size so my motivation is sure not there. This is a great observation Doctor!! Thanks!

  4. I could write a book on the subject! Going from 330 (or more.. that's as high as my scale went) to 165, I really found out who my friends were. Some (maybe not surprisingly, ones who had weight issues themselves) tried to sabotage me by constantly buying me McDonald's, bringing over chips, etc, even though I explained to them that I would really prefer they not. It's sometimes uncomfortable when you exceed other peoples' expectations of you. I was really conscious of my potential to make other people feel badly about themselves and their own struggles.

    On another, similar note - my sister, who had always known me overweight, had a hard time looking at me. She wouldn't look me in the face, and when I asked her about it, she said I made her uncomfortable, that I didn't look like myself and she felt like she was talking to a stranger.

  5. Anonymous3:34 pm

    This may happen, but I think most people applaude weight loss, especially a big, dramatic loss of weight.

    The question I have is how normal is it to keep off such weight? Not very, from what I've read.

  6. I completely agree! Just because one is overweight does not mean they are unhappy or unattractive.

    Thanks for posting this!

  7. Anonymous1:22 pm

    (Hand shooting up) I have! I actually found this blog by googling the title of this blog.

    About 8 years ago, we moved, and although I was already overweight, I promptly gained 50 pounds and kept it on.

    So as of Sept. 2007 I was a 5'5" seriously obese female weighing 220. Since then I have lost 61 pounds (it now being June 2008).

    No one noticed my weight loss at all until I lost 50 pounds. At the 55 pound mark, people starting commenting and saying to stop loosing weight, and asking if I am ill.

    I think that people are not use to seeing me thinner.

    I have at least 9 more pounds (according to ALL of the online bmi calculators) to go to be in the normal range, and I'd like to loose about 30 more pounds!

    So, now I just agree verbally, and continue on...

    By the way, no one told me to stop gaining weight....

  8. Anonymous12:06 am

    I have been told to stop losing weight, and that I should gain the weight back that I had lost.

    The reasons stated for this is because these men found me more attractive at the higher weight. One was even so vulgar to say that my 'rack' was more attractive then.

    I understand that some men are attracted to larger women, but I am attracted to a healthier me.

  9. Great topic for discussion, with some great feedback.... can understand both sides of the theory but generally speaking if someone loses 20% of their weight, one would think if they were ill so to speak than they would not be at work or visiting friends going to the gym etc....

  10. Great post Yoni,

    I think it could only affect our results in losing weight in which case it has for some if we listen to what they say.... unless people give us encouragement with our goals or advice from our docter i would not listen to their opion...

  11. mmmm interesting question i think there it is more common then what it used to be to see more over weight people.. so yeah i agree i think we have gotten comfortable with that visual..

  12. interesting. i read a recent article that supports the theory, in older women at least. apparently it is, in considerable part, a reaction to where women tend to lose weight as they age. women who've gone through menopause tend to lose more of the fat deposits in their faces. this makes them appear significantly older than when they've that bit of extra weight as the skin isn't as well supported.

    i'm not sure it's the same for younger folks. by personal experience it's very rare for a younger woman to be told to stop losing weight when she has been overtly trying to. and if the likelihood of illness is a factor, as you suggest, then that would probably follow since the diseases which cause significant weight loss are relatively uncommon in younger individuals.

  13. Anonymous11:01 am

    I lost 45 pounds for health reasons - I had high blood pressure and osteopenia and I started eating healthy and exercising more. At 5'6" and 135 now I look and feel so much better! But when I got down to 150 people started saying I was anorexic. It was so mean because you start to believe them and you can sabotage your plan. Two guys at work sat me down and said I was getting "gaunt." I asked another coworker if I was gaunt - what a strange question - and she said NO! The only positive reinforcement I got was at my dance and yoga classes.

    One woman I don't know very well started screaming at me on the street saying don't lose too much weight!! She went on and on until I told her my height and weight, which was still 20 pounds too high, and she shut up.

    I sometimes told people that I had stopped losing weight (not true) and was just firming up. Or, I say my doctor says I'm doing great and I look and feel really good, thanks.

    Then I lost more weight and it stopped. Weird.

  14. Anonymous11:35 am

    I should add that I don't think it's a hard-wired concern about people wasting away. I think people do this for the same reason that they say you look fine when you're clearly overweight. They say don't lose too much or you look fine, when you still need to lose, just because of all the societal taboos about saying people should lose weight.

    The jealous people say nothing at all.

  15. There may have been merit to some of the "gaunt" accusations as you were losing. I remember when Alton Brown of Food Network did his episode of Good Eats on his weight loss, I thought he looked a bit too thin and a whole lot older. But now it's been a while and he does not appear to have gained back weight so much as his body may have recomposed a bit as he maintains. Sorta makes sense to me that at some point the body shifts to preserving the most needed fat stores, e.g. SOME visceral fat to serve it's metabolic functions and insulate organs, and burning the least needed stuff like cheek fat.

    Even maintaining my weight within a rather tight range for a long time now, I can "look" 10 lbs lighter or heavier if that makes any sense.

    But I would say there's a fair amount of jealousy that factors into "helpful" advice at times too.

  16. Anonymous12:30 pm

    Hi Carbsane,

    I think that's true, but I wasn't gaunt at all. I asked other people and had a picture taken. I was definitely not gaunt and still a little chubby actually and also, everybody says I look younger! (I'm 52) And, somebody else expressed concern because she said she could see my collarbone. I was actually quite proud of that and it's perfectly normal to see a collarbone. Also, her own collarbones show, more than mine.

    I agree about the jealousy but that's so funny. If a jealous person says I'm too thin they might as well say I'm too rich, haha (neither is true).

  17. anneli11:14 am

    HI, I am 20 years old and 2 years ago I weighed 164 (i am 5'7). The doctor told me I could loose some weight. I am so glad he told me that..I was so determined that i started going to the gym every other day, and eating very healthy. I then met several friends really into running, and got into that.. now i run an average of 7 miles 3 times a week, 10 miles once a week, and go to a spinning class once a week. I eat very healthy not only because I want to look good, I feel so much better inside when I eat healthy, and I want to live a long, healthy life. I am now 140 pounds.. and I feel better than ever! But SO MANY PEOPLE have a problem with my lifestyle. They are always making fun of me for not wanting to eat things like pizza and french fries because they say "well with the amount you exercise, it doesnt matter!" But they just don't get it, I actually like healthy food, and It makes me feel better. THey also say that I am too skinny, which is not true. according to BMI calculators I am about 21... which is in the healthiest range. Yet these people won't shut up. I believe that the American public has gotten used to seeing unhealthy habits and overweight people everywhere, too put it harshly.

  18. Thank you so much for such a post!
    People did start telling me to stop .. It's not that I still "need" to lose weight, but I still "want" too.
    I feel that most of them just want to stop you because they don't like seeing you like this, whatever this is! It's just not their business as long as I'm not harming myself.

  19. I think it is related to people wanting to give out look great. I love your hair....even if your hair does not look that good. It is easier to tell you to stop losing weight, enjoy life, have a chocolate, or a donut...blah blah than to support your goal of a healthy weight. It isn't as much "fun'. When they express concern about losing too much or how you did it...if in a healthy way...they are misinformed and too caught up in most of America's unhealthy lifestyle. Was told just yesterday by coworker offering chocolate that I shouldn't lose too much. I've only lost 10lbs and kept it off for 4 months. It is not rapid. Still bmi indicating overweight. You are right. Would make a great topic for research. The psychology of the sabotagers!

  20. Anonymous5:26 am

    I agree that it is mostly about people being unused to the new look. I am female, 5'4". I started trying to lose weight one year ago through healthy eating and exercise. My starting weight was 117 lbs, now I am down to 95 lbs. I would still like to lose 5 lbs but I have been getting comments about how I am looking skinny and malnutritioned. The reason I keep going is because I am apple-shaped, weight tends to go off everywhere else first so I still have stubborn fat around the middle to whittle down. I reckon to get a completely flat midsection, I would need to lose 5-10 more lbs.

  21. Anonymous11:21 pm

    i have experienced this i started losing weight in feb 2013 because i had a spike in my blood pressure 140/85 so i just started to watch what i ate and the weight was coming off the nurse at my college clinic told i should stop losing weight and dont lose too much and im like but im still the 200s my blood pressure has came down alot my reading are alway 109 -117 systolic over75 dystolic so i guess she could be worry bout my pressure idk i have now lost 60+ lbs im 213lbs .im not even trying to lose weight now but it just keeps coming off every week

  22. I sill have 4 kilos to lose. Once I will reach 48 kilos, I will not go further. I don't want to go underweight.