Frequently Asked Questions
Q: What is psychological treatment of obesity and how does it differ from weight loss programs or work with a nutritionist?
A: Psychotherapeutic treatment of obesity is not to be confused with weight loss programs. The focus of obesity treatment is self-regulation. Some people may eventually begin to lose some weight as a result of improved self-regulation. Participating in a weight loss program, working with a dietician or undergoing bariatric surgery may be incorporated into the treatment plan when appropriate.
It is important to realize that many people who suffer from obesity have lost weight episodically, but they have not yet treated their obesity or eating regulation problem. A “diet” – what we eat, is not obesity treatment. A “diet” is a specific method or means by which we hope to achieve a physical process of weight loss. In contrast, psychotherapeutic treatment of obesity addresses cognitive, emotional and behavioral patterns that perpetuate the problem on a long term basis. Naturally, in order to lose weight, we must change our eating habits. For some individuals, these changes are sustainable and promote long term health and weight maintenance. However, for many individuals who suffer from obesity, behavioral change alone is often insufficient from a long term perspective. One must alter many life patterns in addition to eating choices, such as:
Patterns of thinking about food
Patterns of coping with stress
Acceptance of limitations
Prioritization and decision making processes
Emotional modulation and containment
Interpersonal issues that contribute to difficulties in eating regulation.
Q: Does every person who struggles with obesity need psychotherapy
A: No. People who struggle with obesity are very diverse. Obesity affects men, women, adolescents and children from all walks of life. People with a genetic inclination living in an obesogenic environment will naturally have more difficulty regulating their eating habits according to their energetic needs than others. This is why it is important to make individual assessments- in order to ascertain which components contribute most significantly to the problem and perpetuate it. Some don’t need or won’t benefit from therapy at a given point in time, while others may benefit from therapy, but can also manage on their own. Still, others may have a very hard time making sustainable changes without psychological help especially when the eating problem is exacerbated by emotional, interpersonal or other psychological challenges.
Q: How do I know whether I could benefit from therapy
A: People of different weight and with different body shapes come to therapy for help with eating regulation problems and/or other personal challenges. Here are some points to consider:
- Do you recognize a pattern of emotional eating or eating when not hungry?
- Do you experience recurrent incidents of loss of control when eating despite your desire to eat in a regulated and planned manner (for example binge eating, excessive snacking/grazing, night eating, eating in hiding)?
- Are you overly preoccupied with food, eating, your weight and/or body shape?
- Do you have low self-esteem? Do you overemphasize your weight and shape as crucial aspects of your worthiness?
- Do you engage in compensatory behaviors (for example vomiting to rid yourself of the food you ate, excessive exercise, use of diuretics and/or laxatives without medical reason)?
- Do you suffer from emotional regulation problems such as frequent bad moods, irritability, anxiety, depression?
- Do you struggle with challenges in one or several interpersonal relationships, for example, frequent arguments, problems with intimacy, difficulties asserting yourself, ongoing anger that you express by overeating?
Q: How do I know that now is a good time to begin therapy
A: Sometimes people suffer greatly from their problems, but they are not yet ready to begin therapy. In order to maximize its effectiveness, it is important to begin therapy when one has the time, emotional availability and financial resources necessary to persist. Here are some points to consider:
- Readiness and motivation to change: In order to be willing to make changes, the perceived benefit of change must outweigh the perceived cost of the change.
- Willingness to get help: In order to benefit from therapy, we must be willing to share and open up to someone else.
- Belief in the potential benefit of therapy: Sometimes, even though we suffer greatly, it is difficult to believe that therapy or anyone can help us. Hence, some people enter therapy with negative beliefs about the process and excessive skepticism towards the treatment and/or the therapist. While at times understandable, skepticism is likely to impact negatively on therapy outcome.
- Keeping an open mind: In order to change chronic or long term patterns, we must be able to observe ourselves when it is difficult to do so and be open to learning new ways of coping. This requires a certain level of flexibility. Change takes us out of our comfort zone and we must be open and flexible enough to experience a reasonable level of discomfort in the process.
- Persistence: Any therapy or change process will include moments of crisis and frustration. Sometimes, it is difficult to see progress especially in comparison to fantasies with which we enter therapy. Hence, the ability to commit to an ongoing therapeutic process is contingent upon the ability to tolerate the frustration involved in process of long term change.