I’m sure this might be true for some women, but it doesn’t tally with my personal experience at all. It’s always felt like a lazy assumption trotted out by the self-help industry or clueless GPs: “You can’t control your appetite, cravings, or eating patterns? This is most likely due to childhood trauma and societal pressure. Let us sell you a mountain of books and years of therapy to help with that!” Or, “There’s nothing medically wrong, and many of my other patients manage to stay slim, so clearly this must be a psychological issue.” Ugh, no. It’s not that simple.
Maybe I have strange friends and family, but I know plenty of women who seem to have a healthy relationship with food and their bodies. They enjoy their food and wine without any weird must-eat-like-a-bird or snippy comment portion control antics or orthorexic tendencies, no obsession with skinniness, but still conscious of staying healthy and able to rein it in before their weight spirals out of control. When I read those legendary threads on MN about competitive under-eating or 'MIL/DM serves tiny portions to women', it’s a dynamic I just don’t recognise from my circle. Yes, I know a few women like that, but they’re very much not the norm in my experience and everyone else thinks they're crackers!
There’s always been social pressure for women to be thin. I’d even argue that being fat used to be far less acceptable than it is now. But the global obesity epidemic is a much more recent phenomenon. Do all these people with weight problems have mental health issues that make them overeat? Or is there a more likely physical root cause, possibly triggered by the constant availability of tasty food and more sedentary lifestyles? I’m not saying therapy isn’t helpful - it absolutely should be offered to those who feel they’d benefit - but I’m tired of it being pushed as the solution. Just because we don’t fully understand the mechanisms behind appetite and weight gain yet doesn’t mean there isn’t an underlying medical problem.
I had an interesting chat somewhat related to this with the psychiatrist who diagnosed my ADHD. He specialises in adult ADHD, particularly in women, and said weight issues and binge-eating disorder are very common among women with ADHD. He mentioned that he was working with women in clinical treatment for food addiction and BED and had found that a very significant percentage likely have undiagnosed ADHD. According to him, their disordered eating was at least partially explained by dopamine-seeking behaviours. And of course, that ruins your metabolic health over time, making everything 10 times worse.
For me, this explanation fit perfectly with my own history of weight struggles. I was a chubby child and teenager, with dopamine-seeking behaviours (not just food, impulsive shopping and other things too!) for as long as I can remember. But I had an idyllic and incredibly happy childhood, where I was never made to feel my worth was tied to my appearance. My mum, who has always been very slim but never judgemental about my weight, cooked fresh, healthy meals. I was always out riding horses or playing sports nearly every day. Objectively, there’s no reason I should have been overweight.
Yet, I remember being five or six years old, secretly raiding the fridge for cheese topped with butter or sneaking into my granny’s sweet drawer for chocolate and biscuits. This crazy appetite and these cravings have always been there, and nothing before Mounjaro has made a real difference. Low-carb diets helped a little, but the relentless food noise never went away. I’ve managed to lose significant amounts of weight and get to something normal-ish several times, but it’s always been so exhausting that I eventually cracked and put it all back on and then some.
I tried Ritalin, which helped with other ADHD symptoms but wasn’t a magic bullet. My psychiatrist felt therapy wouldn’t solve the problem and actually recommended weight-loss surgery (a hard no from me!). This was before Wegovy and Mounjaro - I wonder what he’d say now.
I’ve always believed in taking responsibility for myself and owning my choices. Not being able to fix this has been massively frustrating, on top of the obvious health issues and the impact on my life in general. I have no idea if Mounjaro will be the long-term solution - everything else has failed eventually - but for the first time in my life, I don’t have this constant deafening food noise that always brought things crashing down. For that alone, I’m so grateful for this drug.
Sorry for the essay, btw!
@RobinEllacotStrike
Thank you so much for your wonderful uplifting post - it really means a lot. You’re absolutely right that it’s important not to beat myself up about a past I can’t change. I'm generally an eternal optimist and never down for long, but it’s great advice to consciously focus on what makes me happy instead of getting bogged down by guilt.
I don’t love exercise enough to find real fulfillment in it (maybe that’ll change one day), though I do enjoy walking, swimming, and sailing. But I’m a huge interior design geek! We’ve bought a plot of land and are currently planning our dream house, so there’s loads to look forward to and get excited about (even if the financial side is a bit daunting). On top of that, I have the loveliest, most supportive DH, who sensed I was feeling a bit down last night and cheered me up in no time. So really, I have so much to be grateful for.