When weight loss is a sign of struggle, not success.
This is for anyone who has experienced unintentional weight loss, and not felt great about it. And for anyone who has assumed our weight is a choice, let me share some of the shitty parts of weight loss that are rarely discussed.
Whilst we are encouraged to consider possible reasons for weight loss that go beyond dieting, it continues to be a celebratory milestone, a silver lining or something to envy. Because of this, it remains acceptable to comment on another person's weight. In this blog, I’ll be talking about this from the perspective of a neurodivergent thin person (me) who finds weight loss (that is not linked to an eating disorder) distressing. I am more than familiar with comments like “I wish I had your metabolism, I’d love to have [insert body part they dislike about themselves], like yours”, or “you need to eat more, get some fat on them bones of yours”.
I have no wish to compare the experiencs of skinny folks vs fat folks here. I can only comment on my own experiences and the experiences of others who chose to share them with me. The fact that weight can “fall off” a person really quickly can be alarming for that individual. And as I will explain, not easy to put back on.
There are many reasons for unintentional weight loss and difficulties maintaining or gaining weight. These reasons are often put into one of three categories; (1) medical conditions, (2) life events or (3) mental health, meaning many of the overlapping complexities and nuance get overlooked:
The people managing chronic conditions who consequently lose weight because they experience pain, emotional distress, have digestive problems or are dealing with the side effects of prescribed medications.
The people who suddenly become debilitated because of an accident, job loss or change in financial circumstances.
The people experiencing emotional hardship due to grief or depression. This might be where eating disorders sit.
Of course, we cant put life experiences into separate silos like these. And whilst I appreciate ticking boxes can have a place in identifying appropriate support options, we need greater consideration of the individual experience. Too many assessment processes are based on neurotypical perspectives and don’t consider ableism (in addition to sexism, ageism etc). So they continue to reinforce the concept of “normalcy” and personal responsibility to correct differences that are considered undesirable.
Neurodivergence is associated with “unwanted extras”. People are described as making unwarranted noises, behaving unecessarily or being too demanding, as if our bodies are supposed to respect some arbitrary measure of acceptableness. But that’s not how bodies work. Especially for those who are forced to exist in a non-inclusive world, leading to feelings of shame, guilt and failure .
Neurodivergent folks are at greater risk of heightened and persistent anxiety. For many, this has the effect of lowering appetite and desire to eat. Add in interoception and executive function differences and eating enough becomes incredibly hard. Disliking or fearing eating because it is overwhelming and distressing is miserable and frightening.
The energy we use when in an anxious state is so often underestimated too. Our energy needs are significantly increased when our nervous system is activated; our brain is in high alert and our body is poised in protective mode. Gram for gram, the brain consumes vastly more energy than other organ. Not just for thinking (or rumination) but because its overseeing everything the body is doing when stressed. So when our energy intake is not enough to meet these needs, our body will break down any stored resources (carbohydrate, fat and protein) we have available. Hence weight loss occurs.
Neurodivergence remains misunderstood. It continues to be classed as a disorder, associated with lacking intelligence, having no feelings or value in this world. Needs for support and accommodations (especially around food) are seen as laziness, a result of not trying hard enough, and therefore unnecessary. The result is weight loss is not given the necessary attention and support it needs, exacerbating burnout, poor mental health and low self esteem.
Our culture glorifies weight loss. Appetite loss is twisted into something to strive for and has become a commodity, with no regard for the distress or harm caused.
The side effects of some ADHD and mental health medications include appetite suppression. We are told not to worry about it, because “hey, you get to eat more, lucky you!” as I have been told. I've also been told “you can make a simple meal [a sandwich] so we cant help you”.
When I have shared my distress at not managing to maintain my own weight; feeling weak and inadequate, I have been met with “yeah but I could cope with that if it means I lost X amount ha ha”. Aside from feeding my “I’m not good enough" voice (isn't it my job to know how to fix this), essentially being told to stop complaining, emphasised yet again that people just don’t understand me.
Today, physical appearance is central to defining our identity. Whilst I value we are more than our bodies and I am here for finding self acceptance, society does not make this easy. At all. Body dysmorphia is more common with neurodivergence and I’m tired of the onus being on us to change how we respond to these situations. It is not our fault, (it’s a collective problem that requires a collective solution) but that door of self blame swings wide open.
Challenging the dominant narrative that weight loss is not always healthy and not always a good personal outcome can make you vulnerable to inaccurate assumptions and judgement. It opens you to criticism and questioning; both of which are extra challenging if you struggle with confrontation or rejection of any kind (whether actual or perceived.
I’m not disputing that all sorts of difficult feelings can come up when you see someone is unhappy or showing signs they are struggling. It is human to feel sadness, guilt, pity, helplessness…And the need to say something positive or offer a solution to help them feel better is a very human response. But it’s important to be open to considering what you say, may well not provide the outcome you intended.
Let me explain the possible impact of offering words without truly listening (assuming the intentions are coming from a place of care and kindness:
I don’t want to understand you.
Your lived experience is not valid.
Your needs don't matter.
I think it's OK to project my own weight / self worth issues onto you.
Thin is best, no matter the cost to your mental health.
My opinion is most important.
These are not OK.
Please, never assume that weight loss is always desired, is a good outcome for someone or that they have benefited from it. You likely have no real idea what a person has gone through.
Assuming disabilities and differences are reversible or curable, or an inability to change is a matter of choice or complacency is actually ableism.
Instead, let’s be here for others:
Listen and acknowledge rather than presume.
By all means ask someone how they are feeling, but for a neurodivergent person, this can be an incredibly difficult question to answer. Providing context and specificity can help.
Stop commenting on other peoples’ bodies.
Challenge your assumptions about body size and health.
Educate yourself on neurodivergence.
I hope this has given some useful insight. If this resonates, please know you are not alone. And if you’d like to talk with someone who gets (and I have a bumper pack of supportive ways to help), I invite it you to book a free 30 minute online chat with me.