Transformative Learning Theory and long-term weight loss maintenance

analyses of participants’ narratives in this study reflects their engagement in a

process of transformative learning, facilitated through their participation in the ITAND Programme, as comprising seven phases of transformative learning.

In this study, Mezirow’s phases were present to varying degrees. In addition, the experiences of the participants in this study included other ways of learning and knowing, as described by Clarke (1991). Especially relevant in this study were psychological processes in the understanding of self in which participants engaged. The seven phases of transformative learning that emerged in this study are

described in the following subsections.

5.3.1 Phase 1: The experience of a disorientating dilemma. Participants in this study experienced the attainment of the paradigm transformation essential to weight loss maintenance as being enabled by having to face a disorientating dilemma. This dilemma represents the first of three key themes of Mezirow’s TLT experience, namely an experience that did not fit with the participants’ pre-existing meaning structure.

The disorientating dilemmas that the participants experienced were most often incremental, involving a gradual recognition over time of a disconnect between their weight-related meaning system and their real-life experience.

Many participants constructed their narratives in a way that expressed their disorientating dilemma. The structure of the narratives emphasised that every

dimension of their lives was defined by their pre-ITAND Programme weight. This was illustrated by the way narrative headings were named, with each heading

demarcating a phase of life that was adversely impacted by their weight prior to their participation in the ITAND Programme.

For example, Brenda constructed her narrative by splitting her weight journey into “early years, school, university, and adulthood”. Beneath each heading she

describes her difficulties with weight as defining each of these important

development phases. These headings are followed by the heading called “Weight- Winners”.

Caroline organises her adulthood into subheadings, as follows: “How it all started”, followed by “Overweight Child, Overweight Adult”. She interrupts this narrative with a chapter on “the impact of the ITAND Programme”.

All the participants’ narratives end with the impact of the ITAND Programme, and accounts of their transformed life experiences after the ITAND Programme. Before

the ITAND Programme, all the participants’ stories were constructed as weight narratives. After the ITAND Programme, the stories were reconstructed to reflect the change in their identity and their taking agency for actualisation in all dimensions of their lives.

The ITAND Programme emerges clearly from the participants’ construction of their narratives to serve as a resolution to their disorientating dilemma of reaching the end of the road in terms of diets, as well as providing the insight that diets were

compounding their weight problem and that weight was affecting every dimension of their lives, resulting in the experience of existential despair.

5.3.2 Phase 2: Experience of a “defining moment”. The “defining moment” refers to a turning point in life where something happens to direct the actual transformation (Devine & Sparks, 2014). For most participants in this study, their defining moment was the simultaneous realisation that diets had failed them and that an anti-diet paradigm existed, which offered completely new and different meanings, processes, and strategies for attaining permanent weight loss maintenance.

In this study, the participants construct their narratives as having a turning point, which functions as a defining moment, or epiphany. The defining moments are characterised by a number of features. The first feature is the presence of a compassionate leader who functions as a first layer for the participants to accept themselves as they are; in the context of this study, the compassionate leader was me. The second feature is the ability to separate their identity from their weight. This enabled the participants to recognise other areas in their lives where they were successful, such as career, and motherhood, which provided the motivation for them to disrupt their destructive thought patterns, and to enter a state of self-introspection and self-knowing. A major epiphany, which served as the defining moment for most participants, was the insight that their previous solution (diets) had in fact been an obstacle to their attempts to permanently overcome their weight problem. Finally, knowing that others were also facing these struggles added an additional layer of self-acceptance. All these factors contributed to the participants’ experience of a defining moment, which was characterised by their immediate decision to enrol in the Integrative, Transactional, Anti-diet Programme (ITAND Programme) on which this study is based.

5.3.3 Phase 3: Self-examination and psychological insight. Participants in this study experienced that self-introspection, gaining insight, and working through the complex web of causes for the development and exacerbation of overweight and obesity, was an essential process in the journey toward achieving long-term weight loss maintenance.

A process of self-reflection contributed to the participants shifting their paradigms from the dictates of diets to an anti-diet paradigm that is more integrative of psychological insight.

Ruth stated that, “Comprehending the psychology behind my weight issues felt like an epiphany and the weight began melting off of me, pound by pound, week after week, month after month and eventually I returned to the naturally thin size I was always meant to be.”

Kate explained that, “My daily life’s experiences had been related to the way I

looked, which in turn related to how fat or thin I was. I did not trust anyone who said I looked good, as I did not feel good about myself and so there was no way they were being honest. I believed that ANY discussions around weight were related to me, hoping I would get the message. In general conversations, comments about how one looked, were the equivalent of saying ‘what wonderful weather we are having’ – to them it was a passing non-committal statement, to me it was gut-wrenching.”

For Kate, not only her daily life was shaped by weight, but every experience – every conversation she heard spoken about weight – was constructed according to her weight narrative.

Furthermore, these problems are constructed as impacting on many seminal relationships, including significant others, family members, and friends ... Lesley reflected that, “Being fat, my father despised me even more. If I could only get this hunger under control maybe my father would love me.”

Brenda describes how her weight was a central issue in her marriage. “At the age of 29 I met my future husband, and married him at 30. My weight became increasingly unacceptable to him – he wanted a thin wife.”

5.3.4 Phase 4: Paradigm transformation. After experiencing a disorientating dilemma and attaining insight into the causes of their weight problems, this next phase involved critical self-examination, and a critical assessment of epistemic, sociocultural, or psychological assumptions.

Participants experienced discomfort with their epistemology and reviewed its validity given their experience of diets. This process involved critically examining diets and the meanings and assumptions on which diets are based. The ITAND group process facilitated critical discourse and enabled a paradigm shift away from diets to an anti- diet, transactional analysis, intuitive eating paradigm. In this phase, participants recognised that their discontent was shared, and that others had negotiated a similar paradigm shift. The participants experienced the paradigm shift as all-encompassing, and comprising three dimensions of perspective transformation, namely,

psychological changes, involving understanding the self; convictional changes, in which their beliefs were revised; and behavioural changes, relating to changes in lifestyle.

Many participants juxtapose their experience of engaging in the ITAND Programme to their previous experience with diets.

In this phase of the programme, the participants viewed the importance of a

compassionate and inspiring leader as a major differentiator during critical discourse. Lesley described it as follows: “it came into my darkness like a beacon of light.”

The embodying of hope was important to the process. Participants had to develop trust in the belief that they were able to lose weight.

Ruth stated that, “Maureen provided me with insights and a new understanding about my relationship to food that just made so much sense and shared it in a way that I associate with all things Maureen – with beauty and grace. Maureen is one of those women other women should aspire to be. She inspired me, she encouraged me, she was incredibly kind to me and she never made me feel like she was judgeing me.”

It is important that a leader is constructed to hold important insights, to be

compassionate, and most importantly, not to judge. This allowed for Ruth to accept herself and to gain sufficient insight to take control of her weight.

The approach of the ITAND Programme was very different to the participants’ previous experiences of weight loss programmes.

Caroline recalls: “Those meetings, looking back now, were semi-cultish. The head (name of weight loss programme) lady would always give a ‘pep talk’ and brag of how she had lost weight so easily, so therefore you should also be able to. It was so shaming and humiliating.”

In their experience, previous programmes in which they had participated were perceived as being focused on shaming participants. Such an approach is the complete antithesis to the ITAND Programme, in which I offered a story of struggle, enabling the participants to empathise and identify, as opposed to losing weight “so easily”, which was no longer a view they could relate to.

Many diet programmes were also perceived as shaming people who cannot lose weight through their prescribed methods. Brenda, emphasising the shaming nature of traditional weight loss programmes, stated that, “I was terrified of the woman who ran the class because I couldn’t stand the disappointment on her face if I hadn’t lost the required 1 kg minimum for the week. I felt useless and worthless.”

5.3.5 Phase 5: Acquisition of processes and skills to enable long-term change. It was evident that all the participants engaged in the process defined by Mezirow (1991), namely that of planning and implementing a course of action, and acquiring the skills necessary to do so. Participants describe their acquisition of knowledge and skills as an essential process for enabling the changes that allowed their long- term weight loss maintenance. The anti-diet strategies that participants illuminate as mediating long-term weight loss maintenance include transactional analysis, intuitive eating, exercise, nutrition education, and behaviour modification strategies. The participants perceived their acquisition and mastery of these strategies as central to their achievement of long-term weight loss maintenance.

5.3.6 Phase 6: Lifestyle transformation. The participants’ continued implementation of their newly acquired processes and skills enabled the

internalisation of competence, and the improvement in their self-esteem. During this phase, the participants’ new perspectives determined and allowed the integration of

new behaviours in their lives. This resulted in permanent behaviour change, and is reflected in the participants’ attainment of a holistic lifestyle transformation.

5.3.7 Phase 7: Personal transformation. The participants’ experience of personal transformation was constructed in their narratives as significant positive changes in self-esteem, autonomous self-directedness, and a permanent change in identity. Personal transformation was demonstrated through their re-integration into their lives, on the basis of new conditions that were defined and shaped by their new paradigm perspective.

In describing her personal transformation, Brenda states: “I would go as far as to say [the programme] saved my life! It certainly saved me from the old destructive me.” The programme allowed Brenda to move away from destructive thought patterns and she was able to be “saved” from herself.

Linda says that the ITAND Programme “gives me the opportunity to come to terms with who I am so that I may embrace innate talents and capabilities, without wanting to be someone else.”

The programme allowed the participant’s focus to shift from weight to focusing on the talent and capabilities she already possessed, thus allowing an acceptance of self. Linda later says, “the process of losing excess weight took me on a journey of self- discovery … it changed my approach concerning the value I place on my body, health, and self-worth.”