ABSTRACT

Accept Yourself! begins with a functional assessment of clients’ previous experiences with efforts to control their bodies and improve their self-image. Even after clients understand the research on weight and shape reviewed in Chapter 1 and with clients during the informed consent process (see Chapter 13), many often still believe that their personal failure to lose weight and achieve control over their bodies is the result of poor motivation or personal failings. Partly, this is the result of cultural programming related to weight and shape, which suggests, contrary to the available evidence, that weight is under one’s personal control. However, this belief may also be based on clients’ personal observations and experiences of weight loss in the real world. Even though, as we have already discussed, for the average client, weight loss efforts are ineffective and may even lead to weight gain over the long term, effortful weight loss in the short term is clearly possible, and many clients have achieved it repeatedly. When asking clients to add up the number of pounds they have lost on diets over the course of their lives, cumulative losses of hundreds or even thousands of pounds are not unusual. In addition, even though long-term weight loss is clearly ineffective for the average client, on an individual basis, weight loss treatment outcomes are highly heterogeneous, with standard deviations in weight loss as large or larger than means (MacLean et al., 2015). Thus, clients often know people who have successfully lost weight, whether in the short- or long-term. Clients may take others’ experiences as a barometer for what is possible for themselves, and temporarily or permanently successful weight losers may also work to convince clients that they need only try harder or try their effective approach to lose weight for good this time. This combination of factors: cultural messages about weight and shape control as an attainable goal, personal experiences of repeated temporary weight loss, observation of others’ successful weight loss, and pressure from others to emulate their successful permanent or temporary weight losses, all combine to make it difficult to abandon weight loss efforts, even when they are obviously ineffective.