Not all changes happen at the same speed. It’s common for people who have lost a dramatic amount of weight to not “see” the transformation in the mirror because their physical body has shifted faster than their mind can keep up. This mental disconnect now has a name: “ghost fat” or “phantom fat.” It may even be on the rise, as more people experience rapid weight loss with drugs like Ozempic. Here, everything you need to know about phantom fat syndrome, how to outsmart it if you have it and how to avoid it in the future.
What is phantom fat?
Ghost fat gives people the sense that they are larger than they truly are. Researchers described it as a “mind-body lag, in which the patient’s internal body image lags behind the external changes.” Phantom fat is also sometimes referred to as vestigial body image.
Who is affected by phantom fat syndrome?
Phantom fat often follows major weight loss, when people are in a state that researchers describe as being “ex-obese.” In a 2018 study published in Wiley Journal of Clinical Nursing, many women were unable to see their substantial weight loss even 18 to 30 months after bariatric surgery.
Susan Mackey, a First for Women reader who lost 116 pounds following weight-loss surgery, is familiar with the phenomenon. She shares, “Here’s the problem: When I’m buying clothes, I’m still buying stuff too big. Mentally, I know I’ve lost weight. But I don’t always see it. That’s pretty common for people who lose weight.”
Phantom fat overlaps other body-image issues
Phantom fat occurs when overweight people don’t recognize they have reached a healthier weight. But it overlaps with other body-image conditions where healthy-weight people can’t recognize they have dipped into dangerous underweight territory. Addiction expert Vera Tarman, MD, host of the podcast Food Junkies, says, “This phenomenon is evident in the eating disorder community, but we call it body dysmorphia. The person sees themselves as fat even when they look deathly thin.”
Body dysmorphia is common among women, especially athletes and dancers. Julia Konner, MPH, is a former collegiate Division 1 student-athlete, coach and author of Perfect Balance. She shares, “Phantom fat is, unfortunately, a very normal and common phenomenon. When you are losing weight, both your body and mind are under stress. This stress is beneficial to get to a healthier weight, but it can also impair the reality that you have made huge changes in your life.”
Why does phantom fat syndrome happen?
“Body image isn’t purely based on physical reality—it’s shaped by years of personal experiences, societal influences and internal dialogue,” explains Supatra Tovar, PsyD, a clinical psychologist, registered dietitian and fitness expert. “Even after reaching a healthier weight, the brain may hold on to old self-images due to deeply ingrained thought patterns.”
Those old beliefs may have been ingrained in society and reinforced by the media. “Many women internalize societal ideals of beauty, which can perpetuate feelings of inadequacy even after weight loss. If self-worth is tied to appearance, external changes may fail to address underlying emotional struggles,” says Tovar. In short: “Rapid physical changes can leave the mind struggling to align with the new reality.”
How doctors are recognizing phantom fat
Fred Pescatore, MD, has experienced ghost fat himself and now looks for it in his patients. He shares, “For my weight-loss patients, I have started to recommend cognitive behavior therapy. I truly believe this can help them navigate their ‘new world.’ They have to learn to align their inner thoughts with their body image.”
He understands that, especially for those who have felt judged or ridiculed, “it takes time to overcome the stigma of your weight.” Weight loss experts also recognize that some patients carry extra weight as a form of protection following trauma, and those old feelings may not immediately disappear with weight loss.
How to outsmart feelings of phantom fat now
If you’re struggling with phantom fat syndrome, consider these steps…
Try a mirror mantra
“Our brains prefer what’s familiar, even if it’s not helpful, making change feel uncomfortable. So, the brain tends to cling to familiar feelings from the past,” explains Danielle Gerlach, a life and mindset coach for women in midlife and the owner of Untethered Purpose. Her advice: “Start each day by looking in the mirror and affirming your progress. You could say, ‘This is my body now. I am proud of how far I’ve come.’’ Gerlach explains, “Focus on gratitude for your body rather than judgment of its appearance.”
Visualize yourself as you are
“Close your eyes and imagine yourself moving through the world as you are now. Picture yourself confident and proud of your body,” advises Gerlach. Try this for two to three minutes daily to help your mind align with your physical reality.
And be sure to compliment yourself, too. “Each day, write or say aloud one thing you appreciate about your body.” For example: “I feel great in this outfit.” She explains, “This fosters a mindset of gratitude rather than critique.”
Reframe outdated mental patterns
“Encouraging individuals to challenge and replace negative body-related thoughts can help realign perceptions,” says Tovar. “For example, if someone feels they still appear overweight, prompting them to focus on concrete evidence of progress—such as increased energy or improved fitness—can reshape their self-image over time.” She adds, “focusing on physical capabilities such as strength or mobility fosters appreciation and acceptance.”
How to prevent feelings of phantom fat in the future
If you’re embarking on a weight loss journey now, here’s how you can help your brain evolve its view of body image and reduce your risk of phantom fat syndrome:
Keep old clothes for comparisons
“You may be tempted to throw away old clothes, but they are a good reminder of how far you’ve come and how different your clothes look and feel now from before,” says Konner. So keep some old clothes and pull them out to compare to your new size. The size labels provide indisputable evidence that a change is occurring in your body.
Take progress photos
Take new photos of yourself each month in the same place with the same lighting and angles to look at the stark contrast over time, says Konner. It’s another way to “help your brain by looking at the tangible differences in yourself.”
Tune into tiny physical changes
Sometimes it’s hard to think of our whole body as something new. So try breaking the body down into smaller parts. Konner explains, “You may think you look fat, but can you feel certain bones that you couldn’t before?” Look for a more visible collar bone, or wrist bones or rings that fit more loosely on fingers. She adds, “Keep affirming yourself of all the progress you’ve made. Be kind and patient with yourself, and most importantly, proud.”
Challenge yourself
“One way to get your mind to catch up with your body is testing physical activities that you couldn’t do previously,” says Konner. “Pick something that you used to dread because it was so difficult or impossible and compare that to what you can do now. Do you feel less winded walking up that hill?”
By using these tips, you can vanquish phantom fat from your mind and live a happier life in the moment. Tovar reminds us: “True, lasting change occurs when physical, emotional and mental health are addressed together.”
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.