Lose Your Weight Loss Goal

Dr. Rich Joseph, MD MBA
Dr. Rich Joseph, MD MBA
10 minute read
January 4, 2023
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Among New Year’s resolutions, commitments to personal health–from getting more exercise to swearing off sugar—make up half of the top ten. An estimated one in five Americans identify weight loss as their biggest goal for the coming year.

I’m a physician who specializes in medical weight management. And for everyone eager to drop excess pounds come January 1, let me offer some hard-won wisdom: stop focusing on your weight.

An individual’s weight – and even body mass index or BMI (a ratio of weight to height) – is, at best, a mediocre marker of health status. Most scales offer scant visibility into percentage of lean muscle mass, the amount of visceral fat surrounding internal organs, or even the circumference of the abdomen, all of which are more meaningful health metrics. A large subset of people, in fact, have elevated BMIs and normal biomarkers of metabolic health. Conversely, just as many people have low and average BMIs, but abnormal metabolic function that manifests in insulin resistance, liver inflammation, and high triglycerides and cholesterol.

It’s true that excess fat mass (what’s called adipose tissue) can negatively impact nearly every bodily system, increase risk of disease, and affect daily functioning — from exacerbating joint pain and impeding restful sleep, to fueling the inflammation that underlies type 2 diabetes, cardiovascular disease, and numerous cancers. But the accumulation of fat mass is driven by a multitude of factors, many of which are outside an individual’s direct control, such as genetics, food access and additives, adverse childhood events and sustained trauma, hormones, environmental toxins, and even prescription medications.

For some, this excess fat mass causes obesity, which is a chronic, relapsing, neurobehavioral disease that disrupts normal appetite and satiety signals and alters the body’s set point. And despite promises from a prevailing diet culture and seductive wellness fads, there’s simply no quick fix for obesity because there’s no quick fix for the complex array of contributing causes. In fact, to focus on weight alone only perpetuates the falsehood that obesity is a personal failing, therefore intensifying feelings of guilt, general self-loathing, and even depression.

Even if you don’t suffer from obesity, we’ve all had the experience of dieting aggressively for a special occasion or going on an exercise kick after the New Year or a milestone birthday. But as we know, these well-intentioned spurts of weight consciousness almost inevitably give way to weight regain. The cycle of loss and gain for months and years can be incredibly unhealthy – both physiologically and psychologically.  

There’s no question that losing weight often confers positive benefits for both your physical and mental health. But when we focus solely on weight, we lose sight of the primary purpose of good health: to fully engage in a fulfilling life for as long as we can. Approaching health with this goal in mind forces very different conversations beyond the scope of a scale: What do you need to more fully engage in your life? How is your health enabling or preventing you from living your best life? What ends are you trying to achieve by losing weight?

These tough questions, however, set the foundation for durable behavior change, the holy grail of better health. Maintaining a healthy and comfortable weight necessitates building new habits, routines, and thought patterns. No matter what modern medicine can provide — weight loss surgeries, space-filling devices, or semaglutide shots — the most meaningful prescription is a lifestyle you can sustain, adapt, and enjoy for the duration of your days.

  • This New Years, my medical advice is to ditch the perennial, popular goal of losing weight. Attaching your sense of accomplishment and self-worth to an outcome over which you lack total control — such as the number on a scale — is a perilous strategy. Instead, define why you want to be healthier so that when the going gets rough, tedious, and uncertain (as it will), this north star will guide and anchor you. Committing to health and wellness in our frenetic and obesogenic world is a worthy, albeit uphill climb. If your summit is sustainable weight loss, turn your attention to the daily decisions that inch you forward. Revel in the climb itself.
  • As you get going and sense the urge to go faster and bigger, beware that motivation can be a fickle, fair-weather friend. Because inspiration often cedes to old habits, start by setting and celebrating small victories: parking a little further from a storefront, doing ten crunches after you brush your teeth, turning down the extra soda or glass of wine. Motivation may propel, but discipline maintains momentum.
  • Finally, consider replacing resolutions with intentions. Resolutions focus on fixing what’s broken and apply pressure that forces an all-or-nothing mentality, too often ending in feelings of failure and shame. Intentions, conversely, guide daily actions and grant the self-compassion needed to be resilient.

So… as for that ten pounds? Forget it. This year let’s strive for gains in health over losses in weight.

 Rich Joseph, MD, is a practicing physician at the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston, MA, as well as the Chief Medical Office for Restore Hyper Wellness®.

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