Shrink

The psychology of weight loss.

Are you a People Pleaser?

How the inability to say "no" can lead to health consequences

One common behavioral pattern I have seen over and over again among people who are unable to lose weight or otherwise manage their health is the People Pleaser.  A People Pleaser is one of the nicest and most helpful people you know. They never say “no.”  You can always count on them for a favor.  In fact, they spend a great deal of time doing things for other people. They get their work done, help others with their work, make all the plans, and are always there for family members and friends.  So far this sounds like a good thing.  Unfortunately, it can be an extremely unhealthy pattern of behavior. Consider the story of Janet.

Janet is a 42 year old mother of 2 boys, 11 and 13. She works full-time as a nurse.  She is 50 pounds over weight and hasn't lost any weight after 10 weeks in our weight loss program, so we sit down to figure out what might be wrong. She says she hasn’t started exercising or keeping a diet journal and she continues to eat fast food several times a week.  She tells me, “I'm too busy.  My only chance is to get up at 5am and go walking but I then get up and realize how much there is to do.  I find myself getting distracted making lunches, getting on the computer to respond to emails, and other things around the house. I can’t exercise after work because I have to drive straight to the boy’s games.  Jack has soccer on Wed and Sat.  Jason has baseball on Tuesdays and then karate on Friday. By the time we get home we are starving so I just throw something together quick or get drive thru if I haven’t planned dinner in advance. After dinner I feel guilty and start planning dinner for the next day, after that it’s probably 9pm and I’m ready to crash.  I also have to make it out to the nursing home to see my grandmother twice a week, which I fit in on the weekend or a day the kids don’t have a game.  I’m exhausted. There just is no time.”

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Janet is a People Pleaser.  All of her time revolves around taking care of other people.  When she says she has no time to exercise, she is right.  She definitely can’t exercise if she wants to keep to all of these commitments.

Why am I a People Pleaser?  Typically, the intense need to please and care for others is deeply rooted in either a fear of rejection and/or fear of failure.  Fear of Rejection is the underlying feeling that, “If I don’t do everything I can to make this person happy they might leave or stop caring for me.”  Fear of Rejection can come from early relationships in which love was conditional or in which you were rejected/abandoned by an important person in your life (parent left or was emotionally unavailable or inconsistently available).  Fear of Failure is the underlying feeling that “If I make a mistake, I will disappoint people and/or be punished.”  Fear of failure can arise from early experiences with severe punishment for even small mistakes.  People who had highly critical parents may develop a people-pleasing pattern.  Early experiences with harsh criticism or punishment can lead to significant anxiety upon attempting a task.  Even though the parent or other important person in your life who doled out the criticism may no longer be in your life, anxiety is an emotion that can live on for a very long time.  To deal with that anxiety, we do everything we can to get things right, finish the job, and make sure everybody is happy.

Regardless of the origins, consistently putting others needs above your own can develop into the following 5 pretty bad consequences.  I suggest some solutions for each.

1.  Neglect self – People Pleasers devote very little time to taking care of their own health.  Their efforts towards taking care of others usurps time they need to be active, de-stress, plan healthy meals, etc.  As a result they may be more prone to health problems.  If you are a People Pleaser your heart is in the right place. Wanting to take care of others is not a bad thing and if more people had a little bit of what you have, the world would be a better place.  However, you cannot do this at the expense of yourself.  A balance is needed.  Consider that taking care of yourself makes you better equipped to take care of others by giving you the energy and vitality to do it even better than you are now.  Imagine you are driving a Red Cross truck delivering food and water to hurricane victims.  If you are in such a hurry to get to every single victim that you don’t stop once in a while to refuel the truck, eventually you will be stalled on the side of the road helping no one.  Think of the time you put into exercise, de-stressing, and eating healthy as your fuel stops.

2.  Passive aggression and/or resentment – Over time, Janet is likely to find herself silently angry at the people in her life.  Her desire to be kind will suppress that anger but unexpressed anger often turns into passive aggression.  We are being passive aggressive when we make sharp comments, crack sarcastic jokes, or make subtle actions that let a little of our negative feelings seep out (e.g., doing the favor but in a half-assed fashion). Making matters worse, mounting resentment is the biggest destroyer of relationships.   Communicating your feelings is the only way to avoid resentment, although it requires taking the risk that the other person might not be happy to hear that you are upset or they may not take responsibility for what has upset you.  The outcome doesn’t matter as much as the fact that you spoke up for yourself.  Speaking up also puts people on notice that they will be informed when they have done something that has upset you. This alone can make people tread more lightly.

3.  Reduces ability to enjoy other people and activities  - At one point Janet made the guilt-laden confession that she didn’t even enjoy going to her son’s ball games.  She said she feels so stressed while she’s there, thinking of all the things she still needs to get done that it takes away from her ability to enjoy the game.  I really can’t imagine that her son doesn’t pick up on his mom’s lack of enthusiasm.  Your level of engagement in an activity or a person is impossible to hide.  What message do we send our loved ones by being present but disengaged?  Being present but disengaged is not better than being absent.  By attending less frequently and recharging herself in the interim, she would get more enjoyment from his games and be more of an active and engaged participant in her son’s life.

4. Stress and Depression – the definition of stress is having more demands than you can handle.  People Pleasing can turn into a vicious cycle of chronic stress and unhealthy behaviors.  If you have the constant feeling like you are too busy and doing everything for everyone else but yourself, you might be stuck in this cycle.  Stress and depression can be medicated but that won’t break the cycle.  If pulling out of the cycle seems overwhelming, identify one small place you can start.  Identify one responsibility you have taken on that you can cancel to free up some time for yourself.  Work from there.  Find one person in your life to share your plan with and ask them to help you implement it.

5. Be taken advantage of –  By always saying yes to requests for favors, people may begin to take advantage of your kindness by asking for more than is reasonable.  Even worse, you may become the target of exploitive people because they will quickly see that you can’t say no and take as much as they can from you.  Even people who are generally not exploitive may take advantage because they don’t realize that you are overtaxing yourself and have difficulty understanding where your boundaries are because you have set none.  Either way, requests from other people will become overwhelming.  We teach people how to treat us by the behavior we accept or reject from them.  If someone takes advantage of you, it is only their fault once.  After that it is your fault for not teaching them different.  Teaching different means setting boundaries about what you can and cannot do, and what you will and will not accept.  Once you have established this, sticking to it is important.  The other challenge is that if everyone is used to you saying yes, they may feel disappointed or angry when you begin to say no.  It is extremely important to ignore feelings of guilt. You deserve to take care of yourself, it is nothing to ever feel guilty about.  Keep reminding yourself of the Red Cross Truck.

Sherry Pagoto, Ph.D., is an Associate Professor of Medicine, Division of Preventive and Behavioral Medicine, Department of Medicine at the University of Massachusetts Medical School.

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