I've Been On A Weight Management Programme. Here's Why It Didn't Work.

This article contains mentions of disordered eating, suicidal thoughts and weight loss.

The trainee GP looked at me with terror in her eyes. After years of tears and suicidal thoughts, I had plucked up enough courage to see a doctor. “I think I have depression and binge eating disorder” was the sentence that caused her to freeze. My faith in her helping me was fading rapidly, as the silence between us grew longer. 

She hastily left the room, returning with a leaflet. It was for a weight management programme that combined just six weeks of therapy with months of fortnightly meetings. It wasn’t the mental health support I’d hoped for; more like a doctor-approved Slimming World, something I’d already tried and failed at. But it was all I had, so I called them.

The therapy was disastrous the first time around. I wasn’t ready for it, and cut it short. Months after, I requested more. The second attempt was helpful, but just as we were getting to the good stuff, the six weeks were over. I asked, but there was no pathway to provide me any more support.

Going to the group meetings was different. Back then, I was still heavily invested in diet culture. I believed losing weight was the key to happiness; that all my problems would disappear and my life could finally start, if only I could be thin.  

Every other Thursday I’d drive to a grim, artificially lit community centre, sit with a dozen other fat people, and talk about why we were fat. There were people of all ages; young mothers, middle-aged businessmen, older people with wheelchairs. Some were only there to lose weight to qualify for bariatric surgery – an unthinkable last resort for me, but one they’d been pushed to after years of dieting failure. All of us had a common goal: escaping the fleshy prison we’d built for ourselves.

The sessions varied. There was one on portion sizes, and how an extra cup of tea a day adds up to hundreds of calories worth of milk over a year. There was one on “mindful eating” – a particularly cringeworthy experience where we were given a single raisin, and listened to our muscle-bound group leader talk soothingly about the taste and texture of it, letting it go gloopy and foul on our tongues before we could finally swallow. We asked whether we should try fasting, if fruit juice is actually bad for you, and if it’s okay to eat after 6pm. There was far too much focus on the minutiae of what we were putting in our mouths, and not a scrap of critical thinking about weight stigma, or the socio-economic factors that contribute to our health.

Most embarrassing was the exercise. For twenty minutes we walked around the room, doing light aerobics and stretches. We watched each other’s rounded figures shaking and sweating, heads down in humiliation. I was training for a 10k at the time, and played netball three times a week. For me, exercise wasn’t the problem – even if it was, I struggled to understand how a few minutes of walking every fortnight would really make a difference. It felt more like a ritual designed to induce shame over our bodies than to help us feel good about them.

Just like Slimming World, there were regular weigh-ins, and we kept a food diary. Any progress I might have made was reduced to nothing but a number on a scale. To focus on weight is to ignore so many other factors that contribute to our health. The Health At Every Size movement is an example of a different way of thinking – it challenges the assumption that to be thin is to be healthy, and advocates for a more compassionate, holistic view of health that people of any weight can work towards.

That the government’s new “obesity strategy” includes expanding weight management services, and doctors even being incentivised to prescribe them, deeply unsettles me. I worry about the long-term impact on our self-esteem and mental health of treating bigger bodies as a problem to be solved. I worry about fatness being further demonised, and how that will increase the discrimination that fat people already face when they see their GP. I worry how many more lives will be lost – not because of Covid-19, but because of the often fatal consequences that come from living in such a fatphobic society. 

I finished my sessions around 20lbs lighter. That might sound like a success, but as is the case for so many who go through these programmes, it didn’t last. Four years on, I have gained that weight back and more. A weight management programme didn’t bring me health, peace or happiness – but finding a way to stop hating my body, treat it a little more kindly, and forget about weight loss certainly has.

Sophie Butcher is a freelance journalist.