SACRAMENTO, California -- When Anne Miranda goes shopping for new clothes, she has to remind herself not to reach for a size 16.

Now a slim size 6, Miranda said she still sees herself “as a fat person” despite losing nearly 34 kilograms three years ago. Adjusting to her new figure has been difficult at times, she said. So has keeping off the weight.

“It was like Christmas every morning, putting on clothes and having them fit or even be too big,” she said of the period following her drop in weight. “I don't want to go back to where I was.”

Miranda, 57, traveled from her Folsom, California, home to midtown’s Fleet Feet running store last Tuesday night to listen to local therapist Armando Gonzalez give a talk about the psychological impact of drastic weight loss.

Gonzalez, who offers weight-loss counseling under the name Dr. Mondo, spoke just weeks after the release of new research about NBC reality show “The Biggest Loser” revealing that the majority of contestants who shed serious weight during the program gained most or all of it back after returning home. A New York Times article on the finding has caused outcry among viewers, leaving many weight loss hopefuls to wonder if they’re fighting a losing battle.

Gonzalez was not part of the recent study, but he conducted his own research on “Biggest Loser” contestants while writing his graduate dissertation in 2009. He conducted interviews with “Biggest Loser” participants and found that about 50 percent of people kept the weight off, while the other 50 percent gain it back.

While the new study focuses on the physiological factors that follow drastic weight loss and make maintenance difficult, such as sluggish metabolisms and low levels of leptin (a hormone that makes people feel full), Gonzalez’s dissertation and his work since have revolved around the psychological struggles of people who experience the “yo-yo effect” of weight cycling.

A report this week from the American Medical Association found that 38 percent of American adults were obese as of 2014, up from 34 percent in 2006.

“Of course we're struggling to maintain our weight, because we’re only treating a symptom of this experience,” Gonzalez said. “Teaching someone how to eat and teaching them how to exercise, the calories in/calories out equation, don't get me wrong -- that matters. ... But in order to keep the weight off for good, you’ve got to get to the root of your struggle with food.”

The current weight-loss conversation in America is too much about self-control and not enough about motivation, he said. While someone might be able to train themselves to cut out junk food to reach an end goal, those habits won't stick once that goal is achieved unless they make a real change to the way they view that particular vice, he said.

Gonzalez speaks often about his own weight-loss journey and how he has historically turned to food in times of stress and loneliness. After years of being the “funny fat guy,” he became determined to get in shape but constantly battled weight fluctuation. He gained and lost 34 to 45 kilograms more than a half-dozen times during the course of a decade, he said, before getting to the mental root of his problem.

“It’s not just because I like cheeseburgers,” he said. “There’s a deeper relationship that I have cultivated over time with that food, and understanding that is going to be the key to making different choices, and the key to me finding self-care in new areas separate from food.”

In addition to his private therapy practice in midtown, Gonzalez offers a self-designed online program called “Roadmap to Weight Loss,” which breaks the weight loss process down into eight stages. The program’s eight modules guide clients through each step of weight loss, from finding an “anchor for change” or motivation to get healthy, to “rewriting your story” or coming to terms with a new identity after the kilograms drop.

Gonzalez said bringing psychological support to Sacramento organizations that help people lose weight is one of his main goals going forward. Too often, he said, trainers know how to help clients shed weight, but are not equipped to prepare them emotionally for what happens next.

Losing weight should be viewed as a drastic life change, akin to getting divorced or having a child, Gonzalez said. He found in his “Biggest Loser” interviews that people who lose large amounts of weight in a short period experience a lot of stress around their new identities. They might start receiving attention from potential romantic interests or be treated differently by their partners or even strangers on the street, he said. All of those changes, if not handled with care, can cause people to revert to their old habits as a way of coping.

“We have confetti and streamers, like on ‘The Biggest Loser,’ come down from the ceiling when you lose weight and we think, OK, great, see you later,” he said. “But the reality is there’s more than meets the eye from that transition. And there’s a problem with us not viewing weight loss as a life transition.” (Tribune Content Agency)

By Sammy Caiola

The Sacramento Bee