I often receive clients complaining of obesity who have already undergone various treatments or tried to lose weight alone without success. I have witnessed the suffering of those who invest a lot of time and energy in counting calories. The pain of those who eat in hiding to avoid others’ judgment. The emotional wear and tear when searching for clothes that disguise their rounded shapes. The desperate search to fulfill a promise that will often be broken. Not to mention the anguish of isolation, the hunger for love, and social contact. In our Western society that highly values physical appearance, the obese body evokes repulsion and distancing, mainly emotional.
To understand obesity, we must undoubtedly consider psychological and genetic factors, cultural and social patterns in a given time and place. However, this phenomenon often symbolically expresses an unmet need. That is, it points out subjective issues that are often the crux of the problem. No wonder many people regain weight after bariatric surgery or try unsuccessfully restrictive calorie diets for endless times that generate more frustration and despair. Or change from binge eating to games, shopping, cigarette, etc.
I understand that no significant changes happen when focusing on food control and spending all energy worrying about food, weight, and body. In other words, controlling and being inflexible, worrying about “I must lose weight.” Thus, the focus of psychotherapy is not specifically on obesity or on losing weight. I consider it essential to achieve the underlying, reaching what is behind this symptom.
When clinically treating obese people is particularly important to facilitate re-signification of the relationship of the person with food (often food is someone’s best or only source of satisfaction) and the person with oneself. In many cases that I followed, a person would see oneself with severity, denigration, seeking perfection, as if to be loved, one should have a specific shape. They often reproduced how they were treated in childhood by one or both reference figures. Or, on the other hand, a need for confrontation doing precisely the opposite of what was expected. Thus, the person gained weight to oppose who was significant to them, harming oneself in the process. All this on an unconscious level.
I consider it essential to realize the distresses and anxieties that covertly use fat as a protective but restrictive shield between the person and the world around them. While protecting and isolating, this wall generates more anxiety, vulnerability, sorrow, and sensations such as helplessness and failure. And the cycle repeats, perpetuating binge eating.
Finally, when the person’s relationship to oneself changes, what figuratively nourished the way of being, favoring an obese body, is no longer relevant. And energy once used for control is now available to invest in the way of being that promotes changes, favoring well-being.
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