I think one of the secondary gains of being overweight is that you have less energy. This may seem like a loss, and in many respects it is, but less energy for anxious people means less anxiety. Running out of energy means less worry, so if you run out of energy more quickly, you worry less.
I really, truly think that every fat person you see has many layers of emotional baggage they need to lose before that weight will finally come off and stay off. They are fat because there are benefits for them–good reasons for them–for being fat, over and above the fact that food–particularly fat and simple carbs in combination–will calm you down. I think that combination specifically and measurably reduces cortisol levels.
So in my considered view, all clinical obesity needs some clinical psychology more than dietary advice. They know what to do. They just have good reasons not to do it.
And I am one of them. As in most things, I’m stuck in the middle. I’m not fat, but I’m not skinny. I’m not athletic, but I’m not really out of shape. I’m always caught between competing intrapsychic factions.
I think this is where I am going to make my stand, though. It’s measurable, and a whole lot of things have to happen right to make lasting improvements–which is to say gains in losing.
Near as I can tell, my lean body mass is about 190, so I can reasonably shoot for 225-230 as a long term maintenance goal. I will advise when I hit it. I lost 15 pounds and kept it off when COVID hit, and now have maintained another 15 pound loss for a couple months. So now I’m going for the next level.