Recently, Susan* came to me for therapy because she was desperate to lose weight. Accomplished in many areas of her life, she was ashamed of her inability to manage her weight and had been plagued for years by yo-yoing hundred pound gains and losses. She had participated in many weight loss programs and felt like a total failure, never able to maintain her low weight achievements. She was clueless about healthful eating. When she stepped into my office the first time, she announced that food was her mortal enemy. She vowed to fight it to the bitter end, fantasizing a life without eating and wishing she could ingest all her nutrient needs by pills and through straws. Food was indeed her imaginary foe. She sought therapy as a last resort to help her stop binge eating because the diet programs hadn’t worked.
Defeating the Diet Trap
Susan had tried many diets and had participated in many weight loss programs. Each program formulated rules that dictated what she could or couldn’t eat. She often felt trapped by the diets and, at moments of stress, would rebel against the diet plan and binge on forbidden foods. She was battling, but not against the enemy within herself.
Understanding Hungry Feelings
In therapy I invited Susan to pay attention to her physical feelings. What was it like to feel hungry and was it like to feel full? We began to locate her specific hungry feelings – stomach hunger, heart hunger and mind hunger. Did Susan desire food because her stomach rumbled from emptiness (stomach hunger)? Did she desire food because her heart ached with loneliness or anger (heart hunger)? Or was she anxious or bored (mind hunger)? Susan learned, from paying careful attention, that hungry feelings come from many places in her body and that emptiness can’t always be satisfied with food.
Susan realized that feelings of emptiness can be emotional as well as physical. So, we needed to address her relationship with food in a psychological way. With the few exceptions of medical syndromes that prevent people from experiencing fullness, binge eating is an effort to pacify intolerable feelings. Understanding what was unbearable helped her develop alternatives to binge eating.
Stressful Emotions Revealed
Through our work together, Susan identified stressors and unconscious fears that triggered her binging. She binged after arguments with her husband (fear of loss of love) or after difficult days at work (efforts to contain her anger). She binged at the end of weekends (anticipatory anxiety about the upcoming work week). She realized that she consumed food to push down her anger, her frustration, and her anxiety. Because she had difficulty tolerating stressful emotions, she suppressed them with food. Unconsciously she was afraid that those emotions would veer out of control so she regulated them by binge eating.
We talked about times in her youth when Susan enjoyed eating because meals were either a social experience or a guilt-free solitary pleasure. We talked about significant people in her life who had healthy relationships with food and she vested them as role models for her new way of healthful eating.
Developing a Plan for Healthful Eating
Susan wanted a plan that would help restore her healthy relationship to food. She wanted to avoid another diet trap.I urged her to stop counting calories and to consume reasonable amounts of foods that were nutritious and delicious. We focused on her eating experiences – the bodily and mental sensations of biting, chewing, sipping, and swallowing food and drink. As she developed awareness of eating, Susan also tuned into feelings of hunger and fullness. Freed from the diet trap that required her to weigh and measure food, she could recognize when she was hungry and stop eating when she was full.
Food: Friend or Foe?
Food became Susan’s friend. It provided her with sustenance and pleasure. Healthful eating resulted in gradual and sustained weight loss. When she learned to identify different hungers and to respond to both her physical and emotional needs, she defeated the diet trap.