Note: “Weight loss” can be a tricky subject. The quest for improving health through losing weight can quickly become a struggle, especially with body image. I never encourage weight loss as a goal. Instead my focus is integrative and holistic, and creates meaningful healthy changes to routines, behaviors, and lifestyle, of which achieving a healthy weight is a byproduct.
Key Takeaways:
Weight loss should be about more than a number on the scale - instead weight loss should be thought of as a byproduct of living a healthy life.
Weight loss is best approached from a holistic perspective and should include healthy lifestyle changes like nutrition, exercise, thoughts, and behaviors
Medication for weight loss is not a first line treatment and should never be prescribed without therapy and other interventions like exercise and nutritional counseling.
Weight loss is a common goal for many people, but it can also be a frustrating and overwhelming process. As an integrative provider, I believe in a holistic approach to health, including weight, that takes into account not just physical factors, but also emotional and psychological ones.
Step one toward weight loss
The first step in any weight loss journey is to adjust our perception of weight and health. Healthy weight is drastically different than what is portrayed on TV and social media. Being a healthy weight is more a function of how we feel and how our body is operating than it is a number of a scale.
Along the way we’re going to have to do some body image work, including letting go of negative self-talk and focusing on the progress you are making. It's important to celebrate your successes, no matter how small they may seem, and to approach weight loss as a journey to optimal overall health rather than a destination quantified in pounds.
One way to cultivate a positive mindset is to live a life that is more in line with our internal values. Together, we will explore this as a function of motivation but also a force of stability when times get rough. For some people, values may be about improving their health and reducing their risk of chronic diseases like diabetes and heart disease so that they can spend more quality time with loved ones. For others, it may be about a sense of personal accomplishment related to setting and achieving goals. Whatever your reasons may be, getting in touch with values is critical to long term success for weight loss.
Healthy weight loss through nutritional psychiatry
Another important aspect of weight loss is nutrition. Rather than focusing on fad diets or restrictive eating plans, I encourage my patients to focus on whole, nutrient-dense foods that provide the body with the fuel it needs to function at its best. This means incorporating plenty of fruits and vegetables, lean proteins, and healthy fats into your eating habits while limiting processed foods and refined sugars.
I never encourage limiting food groups, counting calories, juice cleanses or other gimmicks. Our bodies need every food group. Counting calories turns obsessive quickly. Juice cleanses are dangerous. Fad diets don’t work. Get the picture? We are talking about making lifestyle changes for the long-term, not partaking in get rich quick schemes.
I’ve talked about HAT foods (here and there foods). It is so important that we enjoy food and are able to enjoy the food we love. So yes, you can and should always be able to have a slice of cake at a birthday party or indulge in an ice cream on a hot summer day – and you nor anyone should feel guilty for that! What I am talking about here is not prohibiting foods. Instead we are going to fill most of our nutritional needs through healthy foods so that when you do have the donut or cookie, there’s no shame and you can confidently enjoy it!
The link between nutrition and mental health is important. What we eat can impact how our bodies operate, including microbiome in our digestive tract, hormones, and more. Over time, poor nutrition can lead to things like depression, anxiety, and other mental health disorders. Nutrition from a psychiatry perspective means fueling our bodies – and minds – with high quality food so that we can thrive physically and mentally. This propels us toward overall wellness and helps us achieve a healthy weight.
Exercise as a tool for health, including weight loss
In addition to nutrition, physical activity is also key to weight loss and overall health. Let’s think of our body as a car. We want to give our bodies good fuel so that we can perform our best physically and mentally. Like cars, our goal here isn’t’ to aimlessly burn fuel hot-rodding down the street wasting expensive gasoline – instead exercise should be a means of keeping our bodies performance ready. Exercise is a function conceptualizing our bodies as high powered machines that need to be used to keep them from prematurely needing repair.
Also, exercise should be something you enjoy and that feel sustainable for your lifestyle. At first this could mean taking daily walks or beginners fitness class. Also, working to incorporate more movement into your daily routine, such as taking the stairs instead of the elevator or parking farther away. Exercise is compounding, meaning what we do today, tomorrow, and the next day all add up in an exponential way.
Together we will develop attainable and realistic exercise goals that suit your needs and individual situation. Ultimately, improved health and weight loss will be a byproduct of our exercise planning. Remember, fitness doesn't mean having a 6 pack or having 10% body fat. In fact, those have nothing to do with fitness! Fitness is about being healthy from a physical perspective.
Weight loss treatment must include psychotherapy
It's important to address any underlying emotional or psychological factors. As you may remember, integrative psychiatry demands that we include a holistic treatments, like psychotherapy. In therapy we will explore stress, anxiety, depression, or trauma in the context of healthy weight loss, but also generally speaking. Because of the deep connection between body image and weight loss, it is really important to have a healthy relationship with ourselves as a part of any weight loss or wellness journey. Body image is something I've struggled with, so I understand how important it is to manage.
Stress can lead to overeating or making unhealthy food choices, so learning stress management techniques like meditation or deep breathing can be helpful. Similarly, depression and anxiety can make it harder to find the motivation to exercise or make healthy food choices, so working with a therapist can help you develop coping strategies and find ways to stay motivated. Every weight loss plan must include therapy.
Medication for weight loss
In some cases, medication may also be helpful for weight loss. However, it's important to work with a trained provider to determine if medication is appropriate for you and to carefully monitor any potential side effects or risks.
Medication for weight loss should never be a first line or singular treatment approach. Anyone who suggest otherwise is providing unhealthy advice.
Weight loss should always be slow and controlled, so the use of medications to quickly lose weight is not a healthy practice. Studies show that regardless of method, weight loss should never be more than a few pounds per week at most. Using medication to quickly drop weight dramatically increases the risks of rebound weight gain but also encourages an unhealthy to weight loss in general.
The bottom line for medication used for weight loss: yes there are options, but they shouldn’t compromise safety or health.
Conclusion: Integrative psychiatry and weight loss
Ultimately, weight loss is not a one-size-fits-all approach, and what works for one person may not work for another. The most important thing is to approach weight loss with the right might set and to make changes that are sustainable and supportive of your overall health and well-being. A holistic psychiatry treatment plan for weight loss includes nutrition, exercise, therapy, and more. Medication should only be used where appropriate and should not be a monotherapy.
With dedication, persistence, and a holistic approach, achieving and maintaining a healthy weight is possible!
If you have questions about integrative psychiatry, are interested in seeking care, or are interested in learning about how to practice integrative psychiatry in Washington DC, please reach out to me via email at ryan@proactivepsychiatry.com. I am working to spread the word about integrative psychiatry, so feel free to repost this blog, just be sure to cite my post!