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The Inside Scoop
Weight loss from the inside out
by Sandy Silbermann, LCSW-C |
Janice, a 45 year old successful business woman is divorced and has joint custody of two adolescent girls. Constantly stressed, Janice doesn't have much time for herself. She is on a perpetual diet and in the past two years has tried two different weight loss programs. She lost 10 pounds altogether, but has now gained back 12. Currently she is 60 pounds overweight.
Lois is a 23 year old graduate student who lives by herself in an apartment. Weight has been a lifelong issue for her. She is now 30 pounds overweight. Although she has tried many different diets, none of them has worked for her. Depressed and lonely, Lois spends most of her time doing her schoolwork or watching television. She would like to date, but has never had a love interest.
| In general, when people have goals and the means to achieve them, and they do not do so, the reason is rooted in their emotions. |
Greta, a 31 year old homemaker, is anxious and depressed and fills her life with cleaning and errands, reading and watching TV. Her relationship with her husband has gotten progressively worse over the last five years. They either argue or hardly talk. Whenever Greta feels bad, she eats. Snacking is therefore a constant activity. She is now 35 pounds overweight and has gained 10 of them in the last year. Greta often thinks that she wants to lose weight, and sometimes starts a diet, but rarely stays on it more than a few days. Then, she blames herself for this failure, and eats more because she feels so guilty and bad.
George is 29 and is grieving because his relationship of three years has just ended. He is afraid he will not find anyone else, in part because he is 25 pounds overweight and feels unattractive. But, he loves to eat cheeseburgers and French fries, ice cream and cake. Whenever George starts to think how dismal his life is, he reaches for something to eat. Eating food distracts him and keeps him from feeling much at all. But, he is really frustrated and miserable and tired of feeling like someone no one wants to be involved with.
An astounding 65 percent of all Americans, according to the National Health and Nutrition Examination survey for 1999-2002, are either overweight or obese. Perhaps even more astounding is the fact that despite the large number of diet plans from which to pick, the multiple gyms and exercise routines available, and accessible advice from numerous experts, this number is growing.
Yes, despite all of the available information and encouragement, Americans are becoming more and more overweight. Strategies to address this problem are a booming industry. Reducing the prevalence of obesity is now one of the Surgeon General's national health objectives due to the significant health risks posed by being obese or even overweight. Clearly, the alarm has been sounded, but thus far the campaign to help people lose weight has not met with overwhelming success.
We all know what we need to do in order to lose weight--we need to diet; to watch our portions and our choices in food, and we need to exercise. It's logical, clear and seemingly simple. But, most of us--like Janice and Lois or Greta or George, find losing weight extremely difficult if not impossible. This is despite the stigma of being overweight. Despite the snide remarks, the insults and the stereotypical jokes. Despite the insidious treatment of the overweight as almost a different species as illustrated by the lack of seating large enough for many or the fact that only specialty stores carry certain larger sizes. Despite discrimination that can occur in employment and promotions. It is also despite the health risks which include heart disease, hypertension, diabetes, stroke and even some cancers.
Why can't we lose weight? Why can't we follow a diet and exercise plan to completion? When researchers seek to answer this question, their theories are aimed on a societal level. These include the tendency of affluent societies in which most are well fed to have a population with increased weight, availability of fast food, the large portion sizes, and sedentary life style.
But these theories don't do much to help Lois, George, Janice, Greta or the thousands like them. What gets in their way of losing weight and/or keeping it off?
As a psychotherapist, I can answer from that perspective. In general, when people have goals and the means to achieve them, and they do not do so, the reason is rooted in their emotions. This is just as true for people who want to lose weight as for people who have any other issue.
The emotional arena is largely ignored in the weight loss industry. When you have turned to the comfort of eating when you are depressed or anxious or lonely or bored, what can you do when that is no longer available? Change is difficult, even if it is a positive change. And changing one's very image- in the mirror, to the world, as well as internally to yourself- is a very tall order and can easily be overwhelming.
What is Janice to do when one daughter is stomping around and slamming doors, the other needs help with her homework, the dishes are still on the dinner table, there are no clean clothes for tomorrow, and she is running on only 4 hours of sleep? It is comforting for her to pick at that piece of cake or grab for that candy bar or piece of bread.
And Lois fills her empty hours in front of the TV, eating for the warmth and comfort it gives her. Doing something different is scary and means venturing out into a world she doesn't feel comfortable in, and it means taking risks and allowing the possibility of rejection and hurt. All of this is overwhelming and Lois somehow feels secure in front of the TV with a bowl of ice cream. Even though she feels depressed and guilty about continuing her problematic behavior, doing that feels safer than venturing into the unknown and making a change.
Greta is paralyzed by her fear of her marriage ending, even though she is desperately unhappy. She is afraid of being alone. Constant snacking distracts her, fills her time and keeps her from focusing on her fears. When she attempts to diet, she feels restless, extremely anxious and depressed. She feels better when she eats, and feeling her emotions is very stressful, especially when she isn't sure what benefits there would be in feeling bad.
George feels lonely and unattractive, and one of his major enjoyments in life is eating. He wants to lose weight but if he diets, he feels deprived and joyless. So, he either doesn't diet or he diets for a few days and stops. In the short run, he would rather eat than feel bad. In the long run, over eating just keeps him stuck in the same unhappy place.
There are thousands of other stories and individual emotional issues. Offering only a diet and exercise plan as the solution to being overweight ignores our humanness and our needs and wants. (While losing weight almost always is accompanied by emotional issues, it is not true that being overweight is a sign of emotional problems any more or different than any other person, regardless of their weight. In addition, accepting oneself and choosing to remain overweight is a perfectly valid adult choice.)
People need to know that losing weight is going to be tough and that they will most likely have to overcome emotional obstacles in order to succeed. They need to know that they will probably go through difficult, perhaps excruciating, emotions. People certainly need to know that they need and deserve support and guidance when they are going through this. More than that they need to know that emotional support and guidance are essential components of any weight loss plan and the lack of these, in my opinion, are one of the main causes of failure.
For these reasons, I believe that psychotherapy and/or hypnotherapy need to be standard parts of most weight loss plans. People need to know that, with help, they can get through the obstacles, lose weight, and come out the other side feeling freer and better, even though the journey may be hard and long.
They need to know that if they believe they need to work on this but don't, not only are they stuck with a weight problem, but they are also emotionally stuck. And until they can recognize those emotions, face them and work through them, they will remain trapped in themselves.
Sandy Silbermann, LCSW-C is a psychotherapist who uses both psychotherapy and hypnosis in her private practice in Silver Spring.
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