A Client Interview: I Can't Meet My Weight Loss Goals

I recently interviewed a close friend, a female physician (let’s call her Doc), about a topic that I know affects many of us: weight loss difficulties. After struggling with her weight her entire life, Doc started an exercise routine and lost 80 pounds - incredible, right? 

But now, Doc finds herself in a plateau, stuck for the past year, and not seeing a change in the number on the scale. She’s frustrated that her efforts aren’t leading to results, and that frustration leads to self-destructive behaviors. To Doc, it feels like it doesn’t matter what she does because the scale just won’t budge.

This is a super common problem. Women work so hard and nothing happens. 

This is Doc’s story. She lifts weight three times a week with a personal trainer, and she’s the strongest she’s ever been. She eats healthy, practices portion control, and limits eating out. But here’s the struggle: Doc will go for a couple of weeks sticking to her routine, see no change on the scale, and get so frustrated that she’ll go out to eat five times in one week. 

Doc has committed the time and money to go to the gym, get a trainer, plan what she eats - what else can she do to be successful? She is working hard, sacrificing a lot, and getting no return on her investment, if you will.

“I know that there is more to health than the number on the scale, but for somebody who has fought weight their entire life, that is the epitome, the judgment, the objective standard by which all of us judge each other,” says Doc. 

So, let’s talk about evidence and facts, because that’s what will allow us to generate new thoughts. 

Fact one: Doc is dedicated and committed to her eating and workout plan. 

Fact two: The number on the scale is exactly the same. 

Fact three: Doc’s blood work is favorable, despite her BMI falling into the obese category. 

Fact four: Doc can do a plank for more than three minutes and bench press 200 pounds - the best it’s ever been in her life. 

I asked Doc, “Let’s say the scale did not exist. Would your view on your progress be any different?”. Her answer? “Probably.” She’s reached amazing goals, bench pressing 200 pounds! “The idea that I can do that blows my mind,” says Doc, “But what’s frustrating is that when other women look at me they see a woman that is overweight and short and curvy. In my mind, I have that I will never be a single-digit side. I have to shop in the women’s plus section.”

Doc is torn in what feels like a trade-off. She’s performing well in the gym, but her size isn’t going down. In fact, it may be going up. She knows she shouldn’t care what society thinks, but she can’t help it. 

In order for Doc to make changes and reach goals, she has to examine her thoughts.

The main thought she’s dealing with is that not getting positive reinforcement from the scale makes Doc feels like what she does and how she eats doesn’t matter, because nothing changes. 

And this one seemingly innocent thought triggers a lot of negative feelings and thoughts for Doc. It makes Doc feel frustrated, upset with herself, and guilty. She feels like a loser, like she hasn’t succeeded. She worries that she’s sabotaging her husband, too, when her frustration leads her to stray from her eating plan. 

Out of these feelings comes eating more, eating out, making unhealthy food choices, coming up with excuses not to go to the gym, and a lack of excitement about working out. 

See what’s happening here? Doc’s The thought leads to feelings that lead to actions that make the thought come true.

So, then, Doc and I examined her expectations. Her main expectation is that if she commits to diligent exercise and an eating plan, she should be able to make the scale move. And that’s fine. But I encouraged her to think about timing. Because so often, we want immediate results, which can be a barrier to making change. 

She admits it herself, saying “I’m definitely into instant gratification.” So what if Doc changed her expectation, believing that it will take a long time for the scale to move. Does that change anything? Doc says, “Potentially. It gives me a longer time to reach a goal and it might promote me to not fall down, so to speak, as often, because instead of seeing it week to week I’d be looking at months or even longer.” 

I asked Doc, “What if we threw the scale away and the only goal were to be really strong? Does that change anything for you?”. Doc didn’t hesitate to say yes. “It took me a year to be able to bench 200… I know that it’s not going to happen overnight but I know someday I will reach that goal.”

Does the fact that Doc’s actively getting stronger change the feeling that eating well and exercising are a sacrifice? Says Doc, “I know all those things that I’m doing are contributing to my success. I know when I’m not eating healthy that it hurts my ability to weightlift or that it hurts my recovery.” 

When Doc thinks the thought, “Everything that I’m doing right now is changing me,” it makes her happy. When she’s happy, she sticks to her plan because she knows she’s succeeding. There’s that positive reinforcement she was looking for. And the result will be more success. 

Wanting to be consistent will eventually buy her time, and the scale will move down. Instead of using willpower and sacrificing, Doc will want to be doing what she’s doing. She’ll exceed her goals and remain happy and satisfied.

I asked Doc, “Are you willing today to adopt the thought, ‘this is all worth it’?”. Doc agreed, saying “It’s totally a different outlook. I can succeed and just change the focus of my goal.”

By shifting focus from the scale to her strength, the weight loss will be an added bonus because of Doc’s consistency. She’ll reach every goal she wants to because she’ll be operating from a place of happiness. 

Once Doc buys into the thought that her commitment to her healthy lifestyle is worth it, she’ll stick with her plan and not feel the need to overeat. Says Doc, “I’m just gonna take the scale and toss it in the closet.” It’s not a bad idea. Intuition can guide her. 

Before our conversation, Doc placed herself on a 2 or 3 on a satisfaction scale out of 10. Afterward, she was at an 8 or a 9, feeling motivated to move forward with her plan. 

Setting Realistic Goals for Your Body Type

Before you can set health goals, you have to understand your body type. Because we are all so incredibly unique. Embracing your individual body, no matter how it looks, is the first step to setting goals that help us work toward optimal health. 

The first thing you should do is take this body type quiz. It will help you understand which you have of the three main body types: ectomorph, mesomorph, and endomorph. Ectomorphs tend to be naturally thin, like the kind of people who can eat whatever they want and stay slim. Mesomorphs tend to easily build and hold on to muscle. And endomorphs tend to hold on to a little bit of additional body fat. 

The important thing to know is that no body type is better than any other. They can all achieve optimal health. This system is just a tool for helping us create lifestyle plans that will maximize our success.

So let’s talk about setting GOALS. No, my caps lock button didn’t just malfunction; GOALS is an acronym. Each letter represents a principle that helps you get closer to optimal health. No matter your body type, these will apply. 

Whether you’re trying to lose weight, gain weight, or you’re already at your natural, healthy weight, GOALS will allow you to arrive where you’re supposed to be naturally. Instead of the stress of setting numeric goals, committing to these five principles, practicing patience, and getting the help of coaching will allow you to easily arrive at your goal over time. When you do it this way, you can sustain your results forever. 

If you’re not reaching the goal that you chose toward your optimal health, then one of these five principles is most likely off. This system can allow you to reflect and optimize, helping you meet your goal.

So let’s get into it. 

Our first principle is G - Get hungry first. Because the first step in becoming an intuitive eater is understanding your hunger cues. You learn when you have true hunger and when you are full. Instead of focusing on what foods you “should” be eating, you tap into your hunger scale and listen to your body, which tells you what you need. It’s worth keeping in mind that this can vary from day to day, especially when you exercise. 

Next is O - Omit two bites. The idea is that when we’re eating and can take about two more bites of our food, that’s a good time to stop. It’s fighting our programming that tells us to clear our plates. Because food is good and we should enjoy it, sometimes we will take more than those two bites, and that’s okay, too. But if you can get G and O down, you’ll have a really good handle on becoming an intuitive eater. 

You’ll understand what your unique body feels like when it’s hungry and when it’s full. Then you can play around with how long it takes you to get hungry again. That’s how you’ll determine how often you should eat. Of course, everybody is different and it’s important to create a plan that fits with your lifestyle. This takes having an honest conversation and deciding what you really want, as well as adjusting your hunger scale for whether you’re trying to maintain, lose, or gain weight. 

A stands for Allowing our feelings. Because sometimes, when we have stressful, overwhelming, or anxiety-inducing feelings, we’re more likely to partake in unhealthy habits such as eating too much when we're not hungry. That’s called emotional eating. 

But if we can allow our feelings and sit with them, we’ll be in a good position to avoid emotional eating. And though it may sound simple, it actually takes a lot of practice. Because feelings like boredom and restlessness are uncomfortable. They require slowing down and working through our thoughts, which doesn't come easily in our fast-paced world. So we use something external, like online shopping, alcohol, and food, to slow us down. That’s called buffering - not allowing your feelings. But on the flip side, learning how to allow your feelings will make you less likely to emotionally eat.

This takes practice and often requires breaking old patterns and habits. You may have unintentionally conditioned yourself to include emotional eating into your routine, like using a snack and a glass of wine to help you relax after work. Trying to avoid that requires using willpower, which leads to decision fatigue over time and giving in to the old habits.

Instead, you have to practice sitting with your urges and realizing you don’t have to act on them - or push them away, either. Instead, you allow your feelings to be there. If you can commit to this, you don’t have to force yourself to live by any other rules. That’s what leads to long term success, even in the face of vacations and parties and restaurants. You’ll only have to rely on yourself and your intuition. Trusting and understanding your thoughts and feelings will set you free. 

The next piece is L - Loving to move. This is referring to exercise to love how you feel, not how you look. Exercise has so many amazing benefits and everybody needs it in their life, especially as they get older. The best exercise for your body type is the one you’ll do consistently. So find an activity you love. 

I also urge you to make strength training a priority. Unfortunately, women face a lot of barriers to strength training: intimidation, lack of education, fear of getting hurt. These are all valid concerns. But there is something so powerful about connecting your mind and body to be your best. 

It’s worth addressing that if your main goal is to see the number on the scale go down, exercise may not help. If you’re like most people who are concerned with their weight, a mesomorph/endomorph combination, you won’t necessarily see a huge drop on the scale when you strength train. You’ll add muscle, but you’ll also be hungrier, which will lead to eating more. But instead of losing weight, your body composition will shift, transforming your body completely. 

So find an activity you love and commit to it, even if it’s just five to ten minutes a week. You’ll feel better and will probably want to keep doing more and more. 

Our last principle is S - Stop perfectionism. Because a lot of people seem to take the all or nothing approach, thinking that if they can’t do something perfectly, there’s no point to doing it. If they mess up on their diet, or if they don’t have time to exercise an hour a day, they think they might as well not do it at all. But this type of thinking just sets us up for disappointment. And when you feel disappointed in yourself, you’re not very likely to follow a healthy routine. 

But it’s important to know that all you can do is your best. The intuitive approach is geared toward long term sustainability. Success isn’t about the day to day, but the overall trajectory to achieving our goals. 

So become aware of your unique body. Set realistic goals. To start, pick one realistic goal that will bring you closer to optimal health. From there, use the GOALS system, which encompasses nutrition, exercise, and the mind work required to succeed. I hope this makes you feel amazing about yourself, because you deserve to live your best life.

No Matter What I Do, I Cannot Achieve a Normal BMI

A complaint that I often hear is, “I can’t achieve a normal BMI no matter what I do.” A lot of ladies have heard that the mid-range of the BMI chart is the healthiest, and are concerned that they’re not there.

If this has been a concern of yours, I want to let you know that there is another way, and the first step is to understand how your body works. It will change and enrich your life.

What BMI Is Before we decide how much attention and value we’re going to put on the BMI scale, we need to understand where it comes from. In the early 19th century, a Belgian mathematician - not a physician - created the BMI scale as a quick, easy way to measure the degree of obesity in a general population.

The chart came about as a jumping-off point for physicians, who see a lot of people, but when it comes to our health, it may be best to evaluate a little differently. The BMI Chart is Flawed See, falling in the normal range of the BMI chart does not guarantee health.

A 2016 study in the International Journal of Obesity showed that more than 30% of people in a normal BMI range were not healthy in terms of cardiovascular and metabolic health markers like cholesterol and hemoglobin A1C levels. On the flip side, 50% of overweight people and 30% of obese people were considered healthy in terms of their labs and studies.

Another major flaw of the BMI scale is that it doesn’t account for fat versus muscle. Many athletes with 8% body fat register as obese on the BMI chart. What this tells us that maybe we should be focusing less on the number on the scale or the BMI chart. Alternatives to BMI Because, sure, there is a place for BMI as a jumping-off point for the general population, but you have to decide what’s best for you, too. Because maybe you were never meant to be in the low-to-mid BMI range.

Once you can release that and realize that it is okay, you can open your eyes to opportunities for different goals. So what other types of goals can you set? First, there’s body composition. You can measure your body fat with a DEXA scan or calipers. Your result might surprise you. Many people in the mid or low BMI range, especially those who aren’t exercising, may have higher body fat.

Another option is waist-to-hip ratio. Studies show that women who hold their fat in their lower body tend to have better health. Waist circumference is another marker. For women, less than 35 inches is considered favorable, with studies showing that people in that range have better cardiovascular health.

Where Do We Go From Here? Letting go of BMI and weight doesn’t mean giving up. In fact, just the opposite. So what can you do instead? The first step is awareness. Knowing your body type will help you to set realistic goals. Realize that no one body type is better than another. When you take care of your health, any body type can find fitness and pure health and look amazing. When you embrace body acceptance, understanding how you are different and unique, that’s where the magic happens.

The next step is intuitive eating. All of us can arrive at a natural, healthy body weight when we learn to become intuitive eaters. If you can be patient and take the time to slowly become an intuitive eater, you’ll find a weight that is natural and healthy for you. Trusting yourself will allow you to know how to feed your body when it’s hungry and how to stop eating when it’s full.

Then, find an exercise routine that works for you. Because there are hundreds of proven benefits to exercise. Note that if you put on muscle easily, it’s possible that exercise may increase your weight. You may have to choose to sacrifice BMI for healthier body composition. But I urge you not to stop exercising, especially strength training. Many women avoid strength training for different reasons: we’re intimidated, overwhelmed, we don’t know what to do.

But even if you go with an easy, basic plan, strength training will keep you healthy and strong well into old age. When you take the time to exercise, you’re saying “I’m worth it.” You build an amazing relationship with your body. If you’ve shied away from it, now is the time to start. It’s never too late. None of this is elaborate or fancy or new. Maybe you’ve heard it all before. But now, it’s time to embrace yourself for your unique being and put it into practice.