You can lose all the weight you like, but until your self-image catches up with your new, thinner body, you're in danger of gaining it right back. O reports on the phenomenon of phantom fat.
Sandra Blakeslee reentered her body one afternoon about 15 years ago. As a young woman in her early 20s, she had gotten heavy and, like many who struggle with weight, thought of her body with loathing and shame. This persisted even after she discovered exercise in her 30s, became slim and fit, and managed to maintain her weight loss. Intellectually, she knew she was in shape; emotionally, she still believed she was plus-sized. "I felt there was an iron plate between my head and my body," she says of those years. Then, when she was 50, she was taking a long, solo bike ride into the wilderness of New Mexico, and as she ascended a trail everything shifted. "Suddenly, it was like I was hit by lightning. My body completely changed." She had an image of herself as a beautiful 16-year-old girl—the girl she had once been and long ago left behind. "I started to cry," she recalls. "It was a sense, all of a sudden, that I was in a body I didn't hate."

What had happened to Blakeslee, a science writer who is now 64, was that her image of her body and her actual body shape dramatically and instantaneously got in sync. Even though she had long ago left her excess weight behind, until that moment in the wilderness, she was still dragging it around with her in her head. Her experience was the basis for a chapter in her latest book, The Body Has a Mind of Its Own. (Her son, Matthew, is her coauthor.) Blakeslee describes how for some people with weight problems, the warring maps in their head between what their body really is and their emotion-laden mental image of it can sabotage successful dieting.

Margo Maine PhD, says she has seen many patients who've lost a lot of weight continue to experience what she calls "phantom fat"—it's analogous to the phantom pain an amputee can have in a missing limb. Maine, a Connecticut psychologist specializing in eating disorders and coauthor of The Body Myth: Adult Women and the Pressure to Be Perfect, says she's had patients who continue to wear what they call their "fat clothes"—though everyone tells them they need to go shopping—because they still feel that layer of flesh around themselves. Sometimes after patients lose weight, they have trouble emotionally letting go of their outsize presence because it served as a shield against social interaction. "It's scary to be their new size," Maine says. "They might feel more noticed and be embarrassed by the attention their bodies are getting."

When dieters come to Judith Beck, PhD, a cognitive therapist and the author of The Beck Diet Solution: Train Your Brain to Think Like a Thin Person, one of the first things she does is have them work at accepting their bodies—whatever stage they're at. "They may decide keeping the weight off isn't worth it. They've done this hard work and they don't feel any different," she says. Beck tells a client to take advantage of the more objective vision of family and friends by asking them to cut pictures out of magazines of real women who are her size, or to point out in crowds women whose bodies resemble hers. Beck suggests looking at the magazine pictures frequently and saying, "This person is similar to me." Seeing one's body shape reflected in a stranger won't trigger all the emotional associations of seeing a photograph of oneself.

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