Most people think of weight loss as a body challenge. But the real work happens in the mind. A therapist and employee wellness consultant reveals the hidden psychological mechanisms of successful weight-loss treatment.
Anxiety and depression can often lead to unhealthy food choices and decreased physical activity, both of which can result in weight gain. While most people can indeed achieve weight loss by a change in nutrition and exercise, success is rarely sustained as long as the underlying emotional issues are unresolved.
Often times we turn to food to numb the uncomfortable feelings we're experiencing due to another stressor.
In 2006 I joined the counseling team at Wellspring Camps, a U.S. based organization tackling the epidemic of adolescent obesity. My first client was Jenny, a seventeen year old covered in black from head to toe, with so many piercings she made The Girl with the Dragon Tattoo look like Dora the Explorer. After sizing me up a long unblinking gaze, she began to tell me her story. What I heard made me want to throw my coaching manual out window. I had been prepared to provide all of the tools and skills necessary for the organization and planning of a weight loss program, but this was not the problem; at least not the core of her problem. What I heard was a story of shame and fear from a person who lacked a sense of being worthy of love and belonging. I listened, wrote down a few notes, and scheduled our next session before welcoming the next client. I spent the next few days listening to stories all surrounding the same theme of shame, fear, and worthlessness. At the center of it all was psychological fragility and vulnerability. These kids needed much more than an organized exercise and nutrition program; they needed a psychologically based solution. Figuring out exactly what tools would help them and others like them instantly became my life’s guiding mission.
IT'S NOT ABOUT THE FUC*ING FOOD!
Today I run a clinical practice and employee wellness programs in Toronto, which uses the principles of psychotherapy and cognitive-behavioural therapy (CBT) to target change by developing resources within the conscious and the unconscious mind. CBT aims to help people change their behaviour by changing their thoughts. As thoughts happen quickly and automatically, cognitive-behavioural strategies can slow down the thought process by creating a heightened awareness of them.
What I’ve learned is that while the abuse of food may be the presenting problem, it is often a symptom of another problem. Symptoms are the unconscious mind’s attempt to work through another problem, hidden from consciousness, but manifested in the form of unproductive or unwanted patterns of thinking, feeling or behaving. Dieting and exercise in these cases is like treating a brain tumour with aspirin. The growth causes severe headaches. Ignoring the cause, we try to cure the headaches by prescribing aspirin. And while this may alleviate the pain for a few hours, it will do nothing to remedy the underlying cause of the headaches. Food is used to avoid dealing with the questions at the heart of the problem. Successful treatment involves looking into the deeper confines of the mind to uncover and resolve the root of the problem.
A fairly typical example was Sarah, a highly competent legal professional who came to me after years of yo-yo dieting. She was 5’4, weighed 250lbs and wore baggy clothes to hide her figure. She revealed that she worked long hours at the office, came home for a quick family dinner, and then returned to her professional duties until midnight. As of the result of the sedentary nature of her job and lack of attention to nutrition, her weight began to creep up and was negatively impacting her life, both personally and professionally. The extra weight she carried made it difficult for her to be active, so she would often not participate in family activities. She felt disconnected from her husband and children, and began to isolate herself from friends. And while she remained a competent professional in the courtroom, she was carrying the stress associated with the weight into the office. The effects of the weight on Sarah’s family, social and professional life led to symptoms of depression, which continued to reinforce the poor food choices, decreased physical activity, and isolation.
Using my magic clicker, I caused a seatbelt to automatically strap itself around her, while the chair reclined, and a box of Kleenex popped up from the armrest; we were ready to work! Sarah began to open up to me. She told me difficult stories about her childhood that revealed a real lack of predictability, justice and unconditional love. It drew her to a life based upon order and rules. It wasn’t a surprise that she turned to law as a career later in life. Her overeating developed as a response to life challenges, and brought an immediate sense of relief. Our CBT work together involved identifying Sarah’s deep thoughts around not being good enough, showing her how to challenge these, and then replacing them with more adaptive, evidence-based statements.
IT'S ABOUT YOUR UNDERLYING BELIEF SYSTEMS THAT WERE DEVELOPED LONG AGO
As a result, for the first time Sarah felt able to choose an alternate course of action around food. Since our work together, Sarah’s weight has come down AND she’s been able to participate more in family activities. Sleeping has become easier, she’s lost the pain in her joints, and claims her energy levels are way up. She has become kinder and more nurturing towards herself and her body.
Food provides comfort and relief from stress, fear, shame and suffering. Underlying the stress and emotion we find vulnerability, which we numb with food (and drugs, alcohol, sex, shopping, and gambling). The problem is that we cannot selectively numb emotional pain with a couple of martinis and a Big Mac; we can’t delete the unpleasant emotions without turning off the good ones, such as joy, gratitude and happiness. When we do, the outcome is misery, which leads back to the martini and Big Mac, initiating a cycle of physiological and emotional damage.
The good news is that we do have the ability to change. The process, which starts from within, allows us to be deeply and vulnerably seen. We must believe that each of us has intrinsic value that is not contingent upon our so-called strengths and weaknesses, successes or failures. We must believe, that with our flaws and frailties, we remain worthy of unconditional love and acceptance, just as we are. When this happens, the struggles we face become more manageable and the desire for comfort food no longer becomes compulsive.