Since using weight loss medication, Allie Olivares has quieted the voice of her eating disorder in her brain while getting more comfortable running around with her six-year-old.
But her 80 pounds of weight loss while taking Wegovy has not come without challenges of its own, she said.
āI still deal with a lot of body dysmorphia,ā said Olivares, who lives in Philadelphia. āIāll look in the mirror, and itās almost like a funhouse mirror where like one minute Iāll look at myself and be like, āOK, yes, like I see myself for how I am.ā
āIāll look away, and Iāll look back and suddenly my body just looks much larger.ā
Olivares says she has had a positive experience with the GLP-1 agonist medication, which mimics hormones in the gut involved in insulin regulation and appetite. It is also sold under the brand Zepbound for weight loss. But she warns that losing weight is not a cure for everything thatās not right in your life.
Sure, many people approach Olivares differently in a small body, but even those āniceā comments are a double-edged sword, she said. They often make her feel as if she was not acceptable before the weight loss.
āIām the same person. Iām a mom. Iām a designer. Iām a wife. Iām a daughter,ā she said. āI do all the same things. Itās just the package in which I come in is smaller now. So why am I being treated differently?
āIt definitely reinforces this feeling of āAm I only worth whatās on the outside?āā
The experience Olivares had after losing weight isnāt unique. New York City psychologist Alexis Conason warns that people should not expect the work to be limited to decreasing a number you see on a scale.
Body image is not always tied to body size
If you have a negative voice in the back of your head that picks your body apart, it may not go away when you lose weight, said Conason, who is also a certified eating disorder specialist.
āBody image is not a reflection of weight. Body image is about the way that we see and feel about our body internalized,ā she said.
Many people try to lose weight hoping to feel better about their body, only to find that they still donāt once they have lost the weight, Conason said. And that could lead to a dangerous cycle of continually feeling as if the answer is to get even smaller.
Conason recommends separating your efforts to improve your body image from any efforts you might take on to lose weight.
āMany people are able to work in therapy to accept their body and improve their body image even without losing weight at all and feel much better about themselves,ā she said.
Itās crucial that you build a better relationship with your body independent of its appearance because those thoughts arenāt always dependent on your size, said Dr. Genesis Ettienne, a licensed mental health counselor and marriage and family therapist in the Miami metropolitan area.
āSelf-confidence is a muscle that you have to flex,ā regardless of your weight, she added.
The comments donāt stop
Since her weight loss, Olivares has found that many of her social interactions begin with a comment about her body.
āNoticing the weight loss is one of the first things (people) say to me when they meet me,ā she said.
While there is a part of her brain influenced by diet culture thatās happy that people see her body is smaller, it also can make her uncomfortable, Olivares said.
āPeople tend to see weight loss as an invitation to publicly comment on peopleās bodies,ā Conason said. āOur bodies are so personal and really should not be objects for conversation.ā
Itās important not to comment on peopleās bodies, she said ā even if it is about losing weight.
On one hand, seeing a body doesnāt tell the whole story. Perhaps that person lost weight because of an eating disorder, grief or some other distressing event, Conason said.
On the other, even if the weight loss is seen as positive, commenting on peopleās bodies can make them feel more on display, which can feel overwhelming and intrusive, she added.
Ettienne said she hears every day how her clients feel as if their weight loss has become the entirety of their storyline in the minds of the people around them.
What you can do about it
That is where it is essential to communicate boundaries around whether and how you are comfortable talking about your body with others, she said.
Maybe your approach is a direct conversation to say, āI know I lost weight. I donāt want to talk about it.ā Or it can be something lighter to brush off body-centric conversations, she said.
Direct conversation can be easier when you are closer with the person, Olivares said, but for others, she tends to try to casually pivot the conversation away from body talk.
Olivares also has to work hard to deal with her body dysmorphia, she said. And that can mean avoiding mirrors for a bit.
āIf youāre not going to be able to see yourself in reality, itās OK to disengage from a harm-reduction perspective,ā Olivares said.
Usually, she finds that her dysmorphia is connected to other behaviors or feelings, so she encourages people going through similar experiences to dedicate time to sit with it and ask themselves where it is coming from, she added.
āEven if youāre physically in a smaller body, if youāre not addressing the mental framing (of) body dysmorphia,ā Olivares said. āIt can be really hard no matter how small you get to see reality.ā
If you are struggling with body image or a cycle of feeling as if you must lose more and more weight, seeking professional help is the best next step, Conason said.
āLooking for a licensed mental health provider who specializes in eating disorder care is really the best thing to do,ā she added. You can find resources and referrals at The National Alliance for Eating Disorders.