Dear DOCTOR Owen:

My friends, work colleagues, and mother tell me that I’ve lost too much weight and need to stop my diet. I’ve lost 70 pounds, but must take off another 30. My marriage weight was 115 pounds. I’m 32 years old, am 5'3" tall and currently weigh 160 pounds. Even with 30 pounds more to lose, I will still weigh 15 pounds more than when I married. Why do these people do this to me? Have they forgotten how I used to look?

Weigh Too Thin

Dear “Thin”:

The comments these people have made are universal to someone who has lost considerable weight. It always amazes me when this occurs. It is so predictable that I warn my patients to listen for such remarks and be prepared. Invariably, many of their stories are just like yours. That is, people will start making the comments long before the patients reach their goal weight—which is usually the same weight they carried when they were younger.

I do not know why people make these comments in every case. Usually, it starts with work colleagues, followed by friends, then mothers, and finally siblings. I warn my patients to listen closely when they begin, and to critique the comments as to “Who is asking?” “What physical changes seem to cause them the most concern?” “Why might they be asking these questions?” “How could my weight loss and change in appearance threaten them?”

• Figuring out work colleagues’ responses is simple. Changes in your appearance simply intimidate them, or make them feel less dominant or less “in control” at the workplace. You may become better looking than they are, which will prompt the boss and others to treat you better. You are displaying discipline, which is desirable in an employee. At a subconscious, instinctual level, this is frightening to them. You might displace them in the hierarchy and even end up in a very high management position! Such reactions are seen in virtually every animal species.
• Friends require more understanding, as their reasons are a little more complicated. While they also may be threatened by your improved attractiveness, the dynamics of the friendship may also change. Instead of being depressed and needing comfort, you may now be the one who is confident and able to give empathy. While subtle, this changes the power structure of the relationship. In addition, the place and frequency of your contact may change. Perhaps you are no longer apt to go to the pizza place to talk and gossip. Or, your choice of restaurants may be irritating—not only because it changes their food preferences, but it also makes them feel guilty that they are not taking control of their own weight and health.
• It is somewhat easy to figure out your mother’s reaction. She wants you to follow her plan for your success and still thinks she should dictate what you should do: “Lose weight.” Now that you are losing it, she has lost her authoritarian role in your life—which may be the most important role she has ever played in her short life. This may create a void, and it hurts.
• Your siblings have different reasons than any of the above. Sisters usually become jealous because they see that you are in control, look good, and have lost some of your mother’s control, or hold, over you. You may even be in line for hand-me-downs or an inheritance! Brothers, on the other hand, usually don’t care and will rarely comment one way or the other.

In every case, without fail, people make snide comments because it is they who have lost something—and it isn’t the weight you have lost! They feel threatened. Do not feel flattered that they are concerned. Rather ask yourself what they have lost.

Your leanest adult weight, assuming you were lean, is still your “lean” weight. Your body does not gain muscle with age. In fact, you will lose muscle and lean tissue after age 35 if you do not take hormone replacement or lift weights. While some people may increase redundant stretched skin, it rarely amounts to more than 15 pounds. Therefore, every pound of fat above this weight is fat. Do not be led into believing otherwise.

Your choice of finishing your weight loss at a higher weight is OK. While you increase health risk with each pound gained, there is smaller statistical risk with weight 20% above your leanest weight. The risk increases rapidly above 20% over “lean” weight.

If you really want to get these people off your back, ask them: “Why does my weight loss threaten you?” That’ll pretty much take care of them.