Mar

26

2021

Exploring Lockdown Weight Loss Issues In Therapy

In this article we’ll consider the issues that may arise for therapy clients as media messaging focuses on the need to lose weight gained during lockdown, and how counsellors can explore this – including spotting any red flags for disordered eating or eating disorders.

Exploring Lockdown Weight Loss Issues In Therapy

With the roadmap out of lockdown in our awareness, there’s a sense of hope in the air. The sun has been shining, people are getting vaccinated – freedom is in sight. And then, inevitably, the discussion around needing to lose weight gained during lockdown kicks off.

Perhaps we shouldn’t be surprised when programmes like This Morning run “Lose Your Lockdown Pounds” considering the usual diet focus towards the summer. However it still feels depressing that immediately following this excitement around freedom, we’re being told to first change ourselves to ensure our bodies are socially acceptable. If we’re in a position to be excited (many will still be shielding until they have been vaccinated), it seems such a shame that has to so quickly be followed by pressure and body shaming. The nature of these diets being focused on rapid weight loss, and the “deadlines” set by the roadmap, also adds a sense of urgency that can feel stressful.

This feels like something we need to understand as therapists – being aware of the impact of such media messaging, and also so we can work safely with clients who do want to lose weight, holding knowledge of the diets they may be pursuing and also perhaps questioning the pursuit of weight loss at all.

Image of a road through a forest with a light shining down at the end. As well as excitement for lockdown ending therapy clients may feel anxiety over weight gained.

The road out of lockdown can bring hope, but also anxieties. Clients may be affected by media messaging around weight gain and weight loss.

Do we need to lose lockdown weight at all?

There’s a predominant cultural message that if weight is gained, then we should be seeking to lose it – and that’s what we’re seeing in the media currently. We need to be questioning this belief which isn’t based on fact but instead fatphobia. Weight gain is not inherently bad and weight loss is not inherently good.

However, even for the most body positive person, feeling and seeing their body change can be hard and can take processing, which we can help with. There are ways of coming to a place of acceptance, rather than seeking change as a solution. Our recent blogpost on the best books on body image is a good place to start – for ourselves but to recommend to clients too. If you’d like to examine your own relationship with body image, we have some ideas on how to do so and why it’s important.

If clients do want to lose weight, perhaps feeling the impact on their health (or not wanting to buy a whole new wardrobe!) – or for whatever the reason, that’s their choice and absolutely ok. We don’t want to go the other way and start shaming people for doing what feels right for them. It’s just worth questioning how they plan to lose weight and keeping an eye on how this is for them – perhaps suggesting consulting with a doctor or nutritionist where appropriate. Alternatively clients may want to pursue health-promoting behaviours and perhaps explore intuitive eating if they wish to work on their relationship with food.

Bloggers Fiona Longmuir and Tara Costello pose in front of Protein World's tube advert in 2015 which was banned for being body shaming and triggering. Eating disorders are not just caused by body image issues but adverts like these have an impact that we can explore in therapy.

Bloggers Fiona Longmuir and Tara Costello pose in front of Protein World’s tube advert in 2015 which was subsequently banned due to overwhelming backlash at its body shaming messaging. We can see how the media almost promotes an annual binge and purge cycle, with winter and summer messaging equating to a feast then famine approach.

The physical and emotional experience of dieting

We also need to be aware that dieting may be physically and emotionally challenging. The diet that This Morning featured on 26th February for example was Michael Mosley’s fast weight-loss programme over 21 days, with adults consuming 800 calories per day. For reference, according to the NHS the recommended daily calorie intake is 2,000 calories a day for women and 2,500 for men. The NHS provides guidance on very low calorie diets, explaining the limited criteria under which such a diet should be followed.

They explain how this diet can lead to short term weight loss but that it is likely that weight will be regained after the diet ends. There can be physical side effects from this diet too, which may include feeling hungry but also symptoms such as headaches, dizziness and feeling low on energy.

As well as possible physical discomfort there can also be an impact on mood – with hunger leading to fluctuation of serotonin levels, which can cause low mood, irritability and anger which is more difficult to control (yes, being “hangry” is a real thing). For our clients who already struggle with emotional regulation low-calorie diets such as this one could prove challenging.

The link between fast weight loss diets and eating disorders

For obvious reasons, very low calorie diets are not suitable for those with an eating disorder history. Even hearing these diets being promoted and explained can be triggering to those with, or vulnerable, to eating disorders.

When Michael Mosley’s Channel 4 documentary How to Lose a Stone in 21 Days aired eating disorder charity Beat announced they would keep their services open later to support those affected, which resulted in a 51% increase in contact. Caroline Price, director of services at Beat, stated to The Indepedent that “Research has shown that dietary restraint, including the restriction of calories, has been found to be a risk factor in the development of an eating disorder.”

This is the issue – it’s not just a case of those with eating disorder histories avoiding this diet. It’s also about those who attempt this diet then falling into consistent disordered eating. The National Eating Disorders Association (USA) reports that “35% of “normal dieters” progress to pathological dieting and that 20-25% of those individuals develop eating disorders”.

How very low calorie diets can contibute to an eating disorder developing

On a calorie deficient diet we can see how consistent deprivation could continue and develop into anorexia. At a time of the world perhaps still feeling largely out of our control this may add a vulnerability – alongside whatever else is going on in the individual’s life and history. Sticking to the diet may bring a sense of accomplishment when it has been rare to feel that over the past year. Even the side effects like feeling weak can provide a buzz in the same way as self-harm for some.

Equally, we know that restriction is a big risk factor for bingeing – so in some cases this could develop into Binge Eating Disorder or Bulimia, if there is shame or distress in having not stuck to the diet. There are other forms of disordered eating and eating disorders aside from the most common ones which may present too.

“You have to suffer to be beautiful”

Who remembers being told as a child, perhaps while getting their hair done, “you have to suffer to be beautiful”? This is another insidious cultural message that we may unconsciously hold onto. Clients may be believe that possibly suffering during the process of dieting is acceptable for the outcome, which we can explore.

Education around how these diets work, including side-effects and sustainability, can ensure choices are made based on accurate information. Dr Joshua Wolrich’s new book will be a helpful one to recommend on this. When fully informed there may be more questioning of whether this suffering is really worth it, and whether the outcome will be what they’re expecting and hoping for.

Food, guilt and shame

Another cultural message we need to be aware of is how ingrained it is to feel, or express, guilt at eating more indulgent foods – with people talking about being “naughty” for having a sweet treat. In the This Morning segment that followed the weight loss information on 26th February they shared a “guilt-free” Victoria Sponge with less than half the usual calories (God bless Alison Hammond for proclaiming “I can have twice as much!”)

Again we need to think about what this does to mental health if we are categorising foods into guilt-inducing or guilt-free, good or bad, as if they have moral value or, on their own, will be detrimental. Shame will influence eating behaviours, whether fuelling under or over consumption, but can also influence capacity to speak openly and seek support. Secrecy can also feed into disordered eating.

A woman holds two orange halves in front of her eyes. With eating disorders like orthorexia there can be an obsession with clean eating. We need to be aware of red flags for disordered eating in therapy.

“Clean” eating can also spiral into eating disorder in the form of orthorexia. The word clean implies that other food may be impure or dirty. Shame and guilt is inherent in so much of the language around food. Slimming World’s “syns” are another example of this.

Our role as therapists in supporting clients feeling pressure to lose lockdown weight

We know that eating disorders don’t just stem from body image issues, but factors like bodily changes, media messaging around body shaming, and especially the rapid weight loss diets being promoted can contribute to disordered eating and we need to be aware of this.

Ultimately, we support our clients autonomy but also their wellbeing – and that may include being informed about popular weight loss plans and what these involve. It’s not about us telling clients they shouldn’t lose weight but being mindful of both intentions (what is the motivation, hope and expected outcome? Some clients may believe they’ll be happy once they’re a size 12 – how true might this be?) and method (is the weight loss speedy or slower paced? What’s the impact on their mental and physical health?).

After a year of living in such a limited way, with a sense of collective trauma and loss, the last thing we need is added guilt or pressure. It’s not surprising many of us will have gained weight and this isn’t something that is inherently problematic. Also, adapting to life without restrictions, wonderful as it sounds, will already be challenging. So let’s help our clients take some of the pressure and urgency off and know that no, they don’t have to lose lockdown weight.

Anxiety over lockdown loosening and disordered eating in therapy clients

Coming out of lockdown we can be mindful of, and enquire about, how clients feel with the loosening of restrictions. For many clients body image concerns may be something that are on their mind and we can help explore this. For other clients there won’t be thoughts around image but altering eating behaviours can be a way for them to deal with anxiety over entering back into the world again, providing a sense of control.

In both cases as therapists we can process any pressure or anxiety being experienced, look out for disordered eating red flags and explore cultural messaging and individual feelings around lockdown, weight loss and body image. We hope you’ve found this article helpful in considering these issues – if you have and believe it may be of worth to your peers please do share the link, and feel free to share your thoughts in the comments.


Learn about disordered eating and eating disorders at our upcoming event:

Disordered Eating or Eating Disorders: Communication, Disconnection and Food

Saturday 24th April – online (via Zoom)
With Professor Julia Buckroyd, Yeva Feldman and Linda Cundy

We all have a relationship with eating. Food is essential for nourishment, health and survival. How and why does our relationship with food sometimes become unhelpful, complex, chaotic, tortuous and even life threatening? This conference looks at some of the issues at play when our relationship with eating becomes less than helpful.

In this one-day conference we will look at how eating can be seen as a means of communication, a way to cope with and survive trauma, and the link between food, attachment and loss.

>> Discounted Earlybird booking available until 3rd April

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Receive free training updates, special offers, and expert articles straight to your inbox! You'll also get a 25% discount off a full price ticket for your first online event.

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