One of the first things I do when a client asks me for help around their health and fitness goals is assess their mental health history. I’m not a mental health professional, but I’m trained to detect when someone’s challenges go beyond the scope of my practice as a health coach. For example, if someone is actively struggling with depression or an eating disorder, it’s my responsibility to make sure that they are referred to a licensed professional who is trained to deal with that specific issue. I also explore their mental health history to see if it may be tied to their current physical state.
The weight loss and fitness industry tends to focus solely on weight loss methodology. This involves attempting to regulate the food we eat, and encouraging exercise. But very few health professionals check in with their clients around their mental and emotional well-being. This is unfortunate, as studies are finding there is a direct correlation between someone’s mental health and physical well-being.
I was abused as a child, which affected the way my brain was hardwired. Yes, exposure to various traumas at an early age will affect the physiological development of the brain. This hardwiring pre-disposed me to depression and anxiety as I got older. As a result, food became a coping mechanism for emotions I hadn’t learned to process. But my issue wasn’t just about food. Exposure to trauma and stress, especially in childhood, also affects our bodies.
In the late 90s, there was a study done which found a correlation between adverse childhood experiences and increased health risks as an adult (watch this TED Talk). This study came about when a health professional at Kaiser running a weight-loss clinic realized many of his patients had been sexually abused. It was eventually unconvered that stress hormones released during adverse experiences in childhood can predispose them to various health risks, including obesity.
While the brain is especially impressionable in childhood, scientists studying neuroplasticity are finding that our brains remain malleable beyond our youth. This means trauma & grief (loss, illness, abuse, rape, etc.) experienced in adulthood also impacts the physiology of our brains. And stress hormones (like cortisol) negatively impact insulin sensitivity, making it harder for the body to process carbs and subsequently leads to weight gain.
So if we’ve known since the late 90s that obesity can be linked to trauma, why is it so often ignored by proponents of fitness and health? Well for one, I think the topic can be uncomfortable for some people. Listening to a person’s story around trauma & suffering requires a high degree of intimacy, vulnerability, and compassion. Secondly, I believe that it has to do with this country’s consumer-driven culture. If we make obesity about people being lazy and undesirable, we can get people to spend money on weight loss products (a quick Google search showed me that the weight-loss industry as a whole was worth $64 billion in 2014). There may be other factors involved, but I think these two are at the forefront of the problem, and require immediate attention.
Now, I’m not implying that everyone who is struggling with obesity has some type of severe mental health challenge or trauma to cope with. What I am highlighting, however, is in addition to educating people on healthy lifestyle practices, we also start checking in with them around their mental and emotional state of well-being. If a person‘s unwillingness to exercise is linked to a depressive episode, then it’s the depression which requires attention, not their exercise habits.
Until health conversations become holistic and less weight-centered, we will continue to see people struggling to attain the physical well-being they so desire. And until health practitioners (and society as a whole) cultivate and utilize compassion and acceptance instead of shame and guilt, we will continue to alienate those we claim to want to help the most.