Illustration by Christopher Silas Neal
To help his patients find their true narrative, Robert Kushner, MD, clinical director of the Northwestern Comprehensive Center on Obesity in Chicago, has them complete a simple drawing called the life events weight graph. Patients chart their weight starting typically from age 18 to the present. Then they plot the events that marked each year: college, marriage, pregnancy, demotion, sick child, empty nest, and so on.
The point of the graph is to show at a glance how complex weight gain is, and to free patients from shame about their weight. “Women realize, There are real reasons this happened to me; it wasn’t just lack of willpower,” Kushner says. “It puts people on solid ground to make a change.”
That’s what is happening to Donna, 61, a Chicago real estate agent who recently started working with Kushner. Donna’s graph (below) reflects an upward trajectory with lots of zigzags (thanks to yo-yo dieting) and three steep climbs—one after each of her two pregnancies and another after chemotherapy treatment for breast cancer threw her abruptly into menopause. “Seeing all that in one place, it made sense that my weight had climbed to more than 200 pounds,” she says.
Many patients are also surprised to find a fair number of valleys in their line graphs—periods where they maintained a healthy weight. “Ask yourself what you were doing that was successful,” says Kushner. “Then see where you regained and ask what got in the way.”
Ultimately, the graph reminds us that weight is the result of how we deal with stress, navigate change, and make time to take care of ourselves. “Weight loss is not about what you put on your plate,” says Kushner. “It’s about how you live your life.”
Here’s how to tell the story of your weight:
Take a blank sheet of paper and draw a horizontal axis labeled “Time” and a vertical axis labeled “Weight.” If you prefer a freeflowing style: Simply chart what you’ve weighed since high school to the present, allowing the line to express the pattern of your weight over time. If you prefer an analytical style: Fill in specific ages along the horizontal axis (marking every half decade or so) and specific weights along the vertical axis, from 100 pounds to your top weight. Plot the points for specific weights at specific ages as you remember them, then connect the dots. To finish: Write down significant life events as they occurred along your weight timeline.
To interpret the story of your weight, ask yourself the following questions:
1. What is your overall weight pattern?
- Is it progressive weight gain (shaped like a staircase)? The typical 10-pounds-a-decade pattern usually has multiple causes.
- Is it a “rapid-cycling” or yo-yo pattern (line showing rapid ups and downs)? This is usually a sign of emotional eating, compulsive behavior or an underlying mood disorder. “I usually recommend these people see a therapist,” Kushner says.
- Is there a specific inciting incident behind your weight gain? Ask how the incident affected your ability to take care of yourself physically and emotionally.
2. Are there any causes of your weight gain that you haven’t addressed yet? Every life event on your graph is an underlying cause of weight gain, and must be addressed. When you look at your life events in those terms, is there anything that surprises you? For example, even happy events like getting married or earning a promotion can be the tipping points leading to weight gain.
3. Are there any common themes affecting your weight gain? For instance, are the causes primarily biological (pregnancy, menopause, going on medication), emotional (relationship issues, feeling isolated, increased stress) or lack of time (common among caretakers of aging parents, for instance)? Biological causes can often be addressed with education (seeing a nutritionist or personal trainer), whereas emotional causes might involve changing your relationships.
4. Were there times you felt in control of your weight? What was working for you at that time? Were you keeping a food journal, or cooking more at home? What would you have to change about your life today in order to sustain some of those habits?