Weight Loss Series-Part2

Positive Behavioral Change:

A better Goal than just Weight Loss

Part 2 of a 6-part series on weight loss

Health and body size are not inherently related to each other. We cannot look at a person’s body shape and size and know whether they are “healthy.”  We talk about health in such black-and-white terms in our society, but this is a gross oversimplification. When pressed, most people can’t actually define what “healthy” is.  If you are a “normal” weight, you are probably healthy.  If you’re “overweight” or “obese,” there is an automatic assumption you must be unhealthy.

This is incredibly shortsighted, and most of our health care system rests on the flawed assumption that weight = health. The heavier you are, the unhealthier you are.  Research has emerged to undercut this position, yet the social implications and medical assumptions remain. Weight is our nation’s blind spot.

And, being told to “lose weight” is about as effective as being told to swim to China when it comes to providing motivation and support for weight loss. Perhaps worst of all, we are given the errant sense that weight is the key to unlocking health and longevity—that, somehow, our ability to shed pounds is more indicative of our health than our ability to learn, implement, and maintain positive behavioral changes

Often the treatment for obesity (the incorrect treatment, I might add) is to automatically tell someone to eat less and to exercise.   So, if diet and exercise are not the most important part of weight loss, what is?  Positive behavioral changes – the 4-R’s of behavior:  your Reaction, practicing Restraint, having Resilience and being Realistic.  I know these are big, boring “R” words and you are wondering what they have to do with weight loss but read on…

Reaction: In modern society, where high calorie foods are easily accessible and being sedentary is common, weight loss is especially challenging.   Setting clear values is the first step towards behavior changes.  Once these values are set, it’s much easier to stay on track and keep motivated – especially when your thoughts are not always helpful.   The longest relationship you will have in your life is the relationship with your mind, but your mind isn’t always your friend.  It’s not that your mind has bad intentions; your mind is programmed for survival but some of its methods aren’t beneficial in a modern world.  Survival occurs by focusing on the negative – like fear, past failures or hurtful words.  This negative focus is to protect you – but does it?

Here are some examples of modern thoughts you may have that don’t help you on a day-to-day basis.

Everyone thinks I am fat!… I don’t look good in these jeans!… I don’t deserve [fill in the blank] until I lose weight!… No one will love me unless I lose weight! 

How do you get out of this negative spiral?  Notice these unhelpful thoughts, but don’t believe them, and don’t try to fix them.  Why?  You can’t control what pops into your mind, but you can control your reaction.  Notice the thought, then ask yourself if it helps you follow your values or reach your goals.

To move away from these negative thoughts, start with little checks in the day – Am I buying into an unhelpful thought? Does this thought serve me?

– If no – let it go, and you are on your way to a positive behavior change.

– If yes – you are being swayed by this negative thought, and you will continue in the same negative cycle.  Work on recognizing your thought as negative – then work on realizing you don’t have to change/fix your thoughts.  To help further, ask yourself – is buying into unhelpful thoughts causing me to behave in a manner inconsistent with my values and goals?  What matters are the small acts that will provide your life with meaning.  Ultimately your mind is a mischief maker – recognize that and move on.  Choose to live your life to your values, even when it’s difficult or uncomfortable.

Restraint: is the ‘how’ we manage a moment of wanting.  Permissive thoughts are triggered from certain behaviors such as sitting on the couch watching Netflix.  If you snack every time you watch Netflix, then the act of sitting may trigger feelings/thoughts of wanting – “I have been so good all week, certainly I deserve to have [fill in the blank]; I have been so off track lately it doesn’t matter, I will eat what I want.  These permissive thoughts will lead to the consumption of food that you don’t need.  Some people will recognize these thoughts as permissive and be able to have restraint and not eat, while others may only feel the wanting and work on autopilot which leads to eating.

Recognizing the permissive thought – wanting – is the first step, then acknowledge the thought is present, and finally choose to act on it.  This may look like: “I recognize I have been good all week, and I could go ahead and eat this, but having food at night does not match my values or goals of being an energetic parent and to enjoy what I want to do with my life.  This impulse to eat is an obstacle to this value.” 

Working on restraint is not a short or easy journey but this change in thinking, from permissive to restraint thinking, is important to long term weight loss (notably to keeping it off!).  Practicing restraint is choosing a healthier choice over an unhealthy choice – even if it’s hard.

Resilience:  Is the ability to get knocked down and get up again – it can also be called perseverance or consistency.  There will be lots of setbacks in your weight loss journey; life is hard and there is so much out of your control.

When you’ve had a hard day, are faced with a stressful event or are battling with the kids and just want to eat a block of chocolate or don’t want to work out…resilience is what will keep you going. It is central to your health and wellbeing, and there is a growing body of evidence that shows its importance.

The main thought that occurs is “I don’t think I can do this, it’s too hard.”  You need to ask yourself what evidence do you have this is true – your past weight loss efforts?  So now ask yourself what evidence do you have that you can succeed?  Have you ever been supported by a comprehensive treatment focused on healthy food, and the 4-R’s of behavior – with the help of medications to help with the wanting?

The new balanced thought might be “Wow, what a great reminder that I don’t feel good now, both physically and mentally.  But I have way more support than I ever have.”

Setbacks don’t reflect your success, they are a learning opportunity – look at them as a reminder that what you are struggling with is difficult, but you’ve got this.

Realistic:  are your goals realistic?  Is your focus on the scale?  Are you forgetting other important markers to health – sleep, lab markers, energy, anxiety or stress?   If you continue to focus simply on weight loss as a health cure – we see time and time again a return to old habits with no gained healthy outcomes.  However, if we teach healthy food relationships through positive (helpful!) thoughts, intuitive eating, smart exercise, and body positivity, you will have the skills needed to make healthy choices without shame and to maintain them for the behaviors’ sake.

When choosing your weight loss doctor, you need to be sure you see a physician specializing in behavioral weight management – practicing the 4-R’s.   Dr. Karen McGee has the tools to help you isolate the underlying causes of your weight gain.  Dr. McGee practices the 4-R’s and helps you take control of your weight so you can enjoy better long-term health and well being.



  1. Lillis, J. (2014). The Diet Trap: Feed Your Psychological Needs & End the Weight Loss Struggle Using Acceptance & Commitment Therapy (1st ed.). New Harbinger Publications.
  2. Wang, Z. (2020, March 7). Relationships among weight stigma, eating behaviors and stress in adolescents in Wuhan, China. Global Health Research and Policy. https://link.springer.com/article/10.1186/s41256-020-00138-3?error=cookies_not_supported&code=bca7efd4-e3ec-4515-87e1-43d46e140e39
  3. Reel, J. J. (2012). Is The “Health at Every Size” Approach Useful for Addressing Obesity? Journal of Community Medicine & Health Education, 02(04), 1–2. https://doi.org/10.4172/2161-0711.1000e105
  4. Noble, M. (2020, April 9). What is Health At Every Size? Made on a Generous Plan Coaching. https://www.generousplan.com/what-is-health-at-every-size/
  5. Tylka, T. L. (2014, July 23). The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss. Https://Www.Hindawi.Com/Journals/Jobe/2014/983495/.
  6. By Mandy Beth Rubin, LPC, GoodTherapy.org Topic Expert. (2017, August 8). Why Positive Behavioral Change Is a Better Goal Than Weight Loss. GoodTherapy.Org Therapy Blog. https://www.goodtherapy.org/blog/why-positive-body-change-is-better-goal-than-weight-loss-0808175
  7. Tomiyama, A., Carr, D., Granberg, E. et al.How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med 16, 123 (2018). https://doi.org/10.1186/s12916-018-1116-5
  8. Forman, E. M., & Butryn, M. L. (2015, January). A New Look at the Science of Weight Control: How Acceptance and Commitment Strategies Can Address the Challenge of Self-Regulation. Https://Www.Ncbi.Nlm.Nih.Gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314333/


Dr. Karen McGee, ND

Integrated Health Clinic
Clinic number: 604-888-8325
Website, www.integratedhealthclinic.com