Something I will be doing this spring is writing a personal statement for an application to grad school, and defining what I want to do is something I think about a lot. I am passionate about degenerative disease prevention via lifestyle change. There are a lot of things I can say that engage negative emotions, but what I think is important is hunting down regain. And what we know is that regain is largely psychological in nature. What is needed is an understanding of mental health, and even mental wellness, which I define as the robust expression of brain activity above and beyond the absence of mental illness.
The hard part is not getting too detailed. But as an analogy, fitness doesn’t have to wait on a problem free body. If you can’t run, you walk. If you can’t walk, you swim. You find a way to move your body that doesn’t stress the problems you already have. They say 5% of Americans experience clinical mental illness, but I think a far greater number struggle with lesser degrees of mood or learning problems, since only 5 to 20% of people who lose weight are able to maintain their reduced weight, and research shows that depression and disinhibited (emotional and/or binge) eating are the main reasons people regain. It would seem that self-medicating with food (or alcohol, which is empty calories) goes hand in hand with regain.
Mood problems are one thing, but learning disorders can also contribute to disorganization and lack of motivation, when consistent and structured eating is necessary for successful weight maintenance. Both attitude and motivation can benefit from understanding cognitive behavior models. To extend the fitness analogy, one would be like strength and the other like cardio. I would say attitude is more like strength in that things need to be overcome, and motivation is like cardio because it involves consistency.
And then I’d say a third leg is harder to define, but is where we move into the realm of mental wellness. It’s about creating a new identity as a weight reduced person. For me, this has meant embracing physical health to the extent that I am now going back to school and moving toward a role in primary care or research and education. It is a bit extreme. Some people embrace athletics, fashion, or cuisine. Lifestyle change must be about more than eliminating the bad; it encompasses nourishment, building the body, and thriving mentally.