I and my colleagues are angry and disappointed that a weight loss consultancy company advertised for “weight loss counsellors” in Therapy Today, the main journal from the British Association of Counselling and Psychotherapy (BACP). This Company is selling Very Low Calorie diets based on milk shakes and “treat” such as “protein bars” to help people supplement the boring shakes with tid-bits that will help “keep them on track”.
Weight loss counsellors are paid according to their success in motivating clients to stick to the programme and to buy the Company Products. So, the counsellors are invested in tricking, or persuading or coercing people to stick to the programme. Why wouldn’t they? After all there is money in it for everyone except for the poor client who will be led to think that what they are doing is good for them.
As for the company (Cambridge) – having a “trained counsellor” on board means that their diet is legitimised. The “trained counsellor” can deal with the psychology while the diet helps with the fat. Win-win all round for everyone concerned.
Can you see what is going on? It is horrible.
Extreme weight loss plans like Cambridge can be dangerous, can lead to eating
disorder behaviour, and liver damage. They are guaranteed to cause runaway
weight regain in most people who embark on programmes like this in hope and
desperation. There is a high risk that a person will end up fatter than they
were before they invested their hard-earned money on a quick fix solution to
their weight issue. I know that most of
you don’t want to read this, but diets like this don’t work. Extreme calorie restriction teaches the brain
that there are famines to come and your weight thermostat tends to rise. There
are other ways to bring the thermostat down but this deserves another blog.
So, you might argue, would a counsellor help someone to avoid that kind of risk
and somehow help a client stick to the diet and maintain the weight they have
lost? Perhaps they will tweak your
emotional life or do some work on your early adverse experiences. Perhaps a compassionate buddy will help you to
be the 1 in 100 success case from a milkshake diet.
Think again.
I train many fully trained counsellors to work with
eating disorders and obesity. Up to half
have serious eating disorders themselves, regularly go on and off diets and are
struggling to control their own weight. Weight and eating issues simply do not
form a good-enough part of the general counselling curriculum. So, after they qualify, many counsellors stick
eating disorders and obesity on their marketing material, but do not (yet) know
what they are doing. Some of them think
(wrongly) that obesity and disordered eating is all about trauma. It is not.
I don’t want here to argue a case against all diets, because many people who
control their weight do adjust their eating habits and manage their weight
reasonably well. There is a difference between lifestyle change and the
thousands of weight loss plans out there. However, a weight loss plan that
relies on calorie restriction, fasting, or carving macronutrients out of your
life though, works in the short term but makes things worse long-term. The only
people who might be suited to a short term fix like this is someone suffering
from Diabetes Type 2 – and only then under medical supervision. To impose this
kind of diet on the public is harmful. Liver damage, gallstones, reactive binge
eating, bulimia nervosa are common side effects, not to mention the stress of having
to eat differently from the people you love.
For a counsellor to understand the psychology, the
neuroscience and the physiology of eating and weight problems requires a large
amount of additional specialist training. If you don’t use a counsellor with
this training is like asking a GP to conduct brain surgery. You just wouldn’t let
him or her loose on you. And, to harness
counsellors to sell diet Milkshakes for weight loss is not only wrong, it is
wicked. For counsellor to engage with this
is also unethical unless they can prove their appropriate
qualifications.
For one thing, agreeing with a client that they “need to lose weight”
contributes to the weight stigma that may have led to their problems in the
first place. People exposed to stigma find it harder to motivate themselves to
eat well, and to engage in activity. They engage in more emotional eating and
are likely to be black and white in their thinking. They divide food into good
and bad, if they eat a good food, they are worthy people and if they eat a bad
food they call themselves weak-willed and greedy. Restrictive diets plus stigma
forces a client into a very all-or-nothing relationship with food and with
themselves.
I and my colleagues from the NCFED have spoken several times to the BACP advertising department and their Ethics team to express our opinions. We have also dredged up evidence to demonstrate to the BACP some of the dangers of extreme liquid diets.
The advertising department has ignored us, and as for the Ethics Team, we have had nothing other than an undertaking, since disappeared, to alert counsellors to the ethics of promoting themselves as weight loss consultants without appropriate training. It seems that counsellors have to promise to regulate themselves and they do not. On a counselling forum recently that clients do not read, one counsellor confessed to having a binge eating client. She wrote “I will deal with all the other things and leave the binge eating alone”. I was horrified – the binge eating was probably causing all the emotional fallout that this poor client was experiencing. The counsellor should have referred the client straight to an eating disorder specialist but thought that it was not important. Maybe she just needed the money.
On another Facebook page peopled by counsellors, it
was suggested that obesity was caused by trauma, and most of the members agreed
that this was so. When I tried to explain that there are alternative
explanations of why people gain weight, I was shouted down. There are a lot of
charlatans out there and some of them may be the Cambridge counsellor
consultants.
If you want to work with a proper weight change counsellor, you need to find a
person who is properly trained to work with body image and the psychology of
eating. You will need someone who understands the effects of weight stigma including
the stigma that a rises in the counselling space, and to understand the physical
and mental health effects of engaging in dieting practices. Obesity is a very complex condition and its
association with mental health is also complex and bi-directional. A Counsellor
more than anyone should be aware of fostering the belief that weight loss is
desirable and will bring happiness and success in life. While it is true that weight change can
greatly improve QOL, there are good and bad ways to achieve this and it is not
a quick fix.
As part of their ongoing training, the counsellor will have done a great deal of work on their own relationship with food. Quoting an eating disorder advocate – “there’s a sad irony to advertising weight loss consultancy to the very people who are key in helping others with their mental health”.
By encouraging this KIND of dieting, especially restrictive diets like the Cambridge one, Therapy Today/ the BACP are contributing to the harm caused by the diet industry and are encouraging eating disorders. This is unacceptable and unethical.
My plea to counsellors is this. Please do not associate yourself with the Cambridge Weight Loss plan. If you really want to help people who struggle with their relationship with food and their weight, without implying stigma about their size and shape, get proper training. I am certain that you will never again want to promote a milkshake diet. And let the BACP know how you feel about their behaviour and their failure to rise to the concerns of people who work on the coalface with eating and weight.