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Week 11

Welcome to the eleventh week of the BTF weight loss and wellbeing programme.

To read the advice, tips and suggestions from our experts please follow the links to this week’s articles below. The other resources you can use are:

  • Expert advice - learn more about thyroid disease and weight management from our medical experts
  • Patient stories – find out about how other thyroid patients have managed to successfully lose weight and improve their wellbeing
  • Community - share your weight loss journey with other people who are taking part in this programme by joining our closed Facebook group

Body image

Thinking back to the start of the programme when we talked about looking at the reasons you want to lose weight; did any of them focus on body shape/size?

Despite people listing many various reasons for losing weight, I have heard countless times how people will only be happy once they’ve got to a certain weight/size. I hear this even when they have lost weight and have an improved quality of life. So why does your happiness depend on and have to wait till you are a certain body size/shape?

Our society’s diet culture, values our weight, shape and size over health and wellbeing. It is a set of pervasive beliefs that worship being thin and places this as the pinnacle of success and beauty. This leads a culture where appearance and body shape are more important than physical, psychological, and general wellbeing.

Unsurpisingly, this leads to people believing that they need to be a smaller weight and be like the images they see on social media and in magazines. In our weight management service we know there is no right’ body size/image and therefore focusing on making healthy lifestyle choices is more important than following restrictive diets.

Body image is defined as a person’s attitude towards their body and their perception of it. It is influenced by family, friends, media and, life experiences. Take some time to:

  • Consider factors that have influenced your body image
  • Consider your genetics
  • Consider what you do like about your body
  • Identify activities that help you feel good in your body
  • Reduce body checking and avoidance
  • Consider the features that make other people attractive. Is it always purely their appearance? Or is it also their personality, attitude and actions?

For more information about body image see the resources of the Centre for Clinical Interventions (see link at the end of the article).

Body neutrality

You may have heard terms like body positivity and the importance of loving all parts of your body. Outwardly stating that we are body positive can be difficult and make us feel like frauds when we might not have such a loving outlook on our body.

Body neutrality is a movement to help us steer away from self-hate without the pressure of having to love our body. Instead, it is about working towards respecting our bodies but not giving too much energy to positive or negative thoughts about it. Body neutrality has its foundations in what your body does, not how it looks. While we may not like our stretch marks and skin folds, we appreciate that our body sustains us and keeps us alive. For further information about body neutrality see the I Weigh link below.

Body neutral affirmations:

  • Thank you, body, for taking care of me today
  • My thighs help me walk
  • Thank you belly for holding my organs
  • My arms allow me to hug the ones I love
  • My weight does not define my worth

Weight stigma

Weight stigma is a negative attitude towards, or belief about others because of their weight. These negative attitudes come from stereotypes and/or prejudice towards people living with overweight and obesity. Internalised weight stigma is negative beliefs about oneself due to weight or size. This can affect the image we have of our bodies.

How can this come about?

  • Comments (intentional or unintentional)
  • Seating (public transport)
  • Discrimination due to weight or body shape
  • Healthcare assumptions (it must be your weight that is causing the back/knee pain)
  • Media stereotypes

How can we challenge weight stigma?

  • Speak up in healthcare settings to ensure full understanding
  • Help to educate others in different body shapes and sizes
  • Avoid stigmatising language e.g. “fat”
  • Obesity is not a lifestyle/behaviour choice.

Can you think of a time you have experienced weight stigma? Take some time to reflect on your experiences and what you would potentially do differently next time.

Self-esteem and assertiveness

These are two large topics which we aren’t able to cover in this short programme, however I will signpost you to some good resources to get you started. Often we want to make health lifestyle changes but life events prevent these intentions becoming a priority. Sadly, many people we see in our weight loss service regard themselves and their life in a negative and critical light (low self-esteem), which often leads to them putting others’ wants/needs first and neglecting their own (passive). So weight loss, or making lifestyle changes, never really happen. And when people don’t make changes, they can feel like a failure which can add to those unhelpful thoughts and this cycle of yo-yo dieting.

People who have high self-esteem value themselves, their lives and their wants/needs and can communicate this in an assertive manner.

PASSIVE – puts the wants/needs of others first and neglects their own.
ASSERTIVE – respects the needs of themselves and others.
AGGRESSIVE – respects only the wants/needs of themselves.

In a scenario at dinner a friend says, ‘Are you having dessert? I would like one but I don’t want to eat one on my own so I will only have one if you do’ If you don’t want one (for whatever reason), but don’t communicate this and say ‘Okay I’ll have one’ you are being passive. An assertive way of communicating your wants/needs whilst respecting your friends could be ‘I don’t want dessert. You have one if you want one. I might grab a coffee and/or a spoon, so you don’t feel like you’re eating it on your own.’ Have a think about the times when you’ve put the needs of others first and done things you didn’t necessarily want to do.

Getting the balance right is hard. But keep working at it. Having better self-esteem is good for our mood and if we are able to meet most of our wants/needs we can work towards our healthy lifestyle goals.

References

Living with a thyroid disorder: looking after your psychological wellbeing:
https://www.btf-thyroid.org/psychological-wellbeing-booklet

Body image and body dissatisfaction:
https://www.cci.health.wa.gov.au/-/media/CCI/Mental-Health-Professionals/Eating-Disorders/Eating-Disorders---Information-Sheets/Eating-Disorders-Information-Sheet---04---Body-Image-and-Body-Dissatisfaction.pdf
https://iweighcommunity.com/

Self-esteem:
https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Self-Esteem

Assertiveness:
https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Assertiveness

Playing sport with a thyroid disorder

Can I play sport to the same standard as others who do not have thyroid disease?

The short answer to this question is yes. Over the years there have been many examples of athletes who live with thyroid disease and compete at the very highest level of sport. These include Adam Groucher and Galen Rupp of the USA, world class runners who were at the very top of their game during the Olympics in 2000, 2012 and 2016. However, if you live with thyroid disease, there are several factors which may influence your performance on the sports field, in the gym or in the pool.

The first and most obvious factor is how well your thyroid disease is managed. If you have hypothyroidism and your TSH is outside of the normal ranges, you may experience the debilitating symptoms of an underactive thyroid. As these can affect even day-to-day activities, it stands to good reason that it could dramatically affect sports performance. An uncontrolled and poorly managed thyroid condition can inevitably impact sports performance. But when thyroid replacement is optimal people’s ability to participate in sport should be similar to anyone without thyroid disease.

How playing sport helps me live with thyroid disease

As discussed in previous articles, playing sport offers the same benefits as exercising at the gym or at a local exercise class. We know that being more active extends our lives, reduces risk of type 2 diabetes, heart disease, stroke, mental health problems like depression and improves quality of life overall. Playing either individual or team sports also provides further benefits in the form of social contacts. Sport allows for individuals to meet and be physically active with others through a shared interest and making friends is much easier when participating in sport. You already have a sport in common which can lead to new friendships and new social opportunities.

Thyroid disease can sometimes cause us to go into a shell and lose social contact. Sport can be a great way of getting back out into the world to be active and make build friendships. Ultimately playing a sport, whether individual or team improves social and psychological health. Even in individual sport we are likely to meet others in training sessions or around the sports club. Being part of a club or team can give us a sense of belonging, adding to vital health benefits of being more active.

Taking up an old sport

It is sad when we have to give up a sport we love due to the symptoms of thyroid disease. But returning to sport can be achievable once thyroid hormone levels are restored. If you already have a sport you wish to return to then great, find a social sports club and join it. If you are unsure which sport to take up, why not participate in a taster session? The important thing is to find something you enjoy and look forward to. This will help you to keep doing it and keep improving our health.

Watch

Jonathan Hayes discusses some reasons why weight loss is so hard:

  • Looking at the big picture
  • The food environment
  • Portion distortion
  • Good food/bad food
  • Emotional eating/comfort eating
  • Social pressures
Week 10 info Week 12 info