Why Would Somebody Lose All The Weight and Then Gain It Back?

Nobody really wants to be fat …that’s why we try over and over again to lose weight, only to gain it back.  Even bariatric surgeries have substantial re-gains.

We don’t know a single dieter or surgical patient who has suffered with the burdens of obesity, lived a lifetime of quiet desperation, a life plagued with obesity shame, dashed diet dreams and self-blame …that doesn’t desperately want to be thin … and then they remarkably accomplish that impossible dream and lose all the weight. We don’t know anyone that willingly wants to gain it all back, that is the last thing they want,  but too often that is the heartbreaking reality. (must see video)

The Heartbreak of Ali Vincent

So, I ask you, why would a person that has the passion, diligence and fortitude to finally achieve their lifetime dream and lose (let’s say) 100 pounds regain their weight? Why wouldn’t they simply lose a couple pounds when they start regaining weight, instead of waiting until they completely relapse? After all, these are the same people that have proven their hardiness and will power by losing all that weight… it just doesn’t seem to make sense.

Shame Based Psychological Disorder Leads To Weight Regain

Shame is a very powerful and painful emotion. An obesity shamed person believes/knows they will be found unacceptable by many in society. The overwhelming force of lifelong pernicious shame causes heartbreaking emotional feelings of disgrace, failure and self-blame. A person who feels this kind of profound, crippling shame wants to hide from everyone.

Bariatric clinicians at The American Association of Bariatric Counselors have identified a frequently undiagnosed shame based dysfunctional disorder that is pervasive amongst many obese patients that can help explain relapses: AVOIDANT PERSONALITY DISORDER DSM-5 30.

Shame Reduction Leads Weight Reduction

Obese individuals with Avoidant Personality Disorder, often consider themselves to be socially and sexually undesirable and personally unappealing. As the diagnosis suggests, the main coping mechanism of those with avoidant personality disorder is avoidance.  They will avoid any situations where they fear being ridiculed, humiliated, rejected, and disliked.

This chronic disorder is so deeply rooted, that shame riddled obese patients will avoid the pain of confronting anything that conjures up their obesity shame …like the two or three pounds they gained, visits to your office/clinic, self-monitoring, using the scale, exercise etc.  This is what leads to high program attrition. Shame and this insidious disorder elicits automatic negative emotions, irrational thoughts and ultimately lead to the avoidance behaviors that can explain how a minor weight gain can become a full blown relapse.

Reducing shame and avoidance can be more important than reducing calories to prevent obesity relapses. Best Practices: How To Treat Avoidant Personality Disorder; (specific to obesity) will appear in our next post. 

Download AVOIDANT PERSONALITY DISORDER DSM-5 301 PDF