Monday, April 25, 2011

Secondary Gains from Overeating

I often ask clients what they are getting out of their compulsive eating behavior. Most look at me as if I’m from another planet and insist that they get absolutely no benefits from eating compulsively or from being overweight. I can understand their surprised reactions, for how can an issue which feels so painful and all-consuming bring with it any advantages? Inevitably, when I suggest we talk about the possibility, people resist the idea. “How can this weight or this behavior bring me anything positive?” they ask. It seems too hard to think about, impossible to imagine. I often tell them the following story to illustrate my point:

Once I was working with a woman who had been steadily gaining weight since the birth of her first child. She was referred to me by her medical doctor when her weight began seriously taking its toll on her health. She was dangerously obese when we met and was becoming increasingly depressed and discouraged. We worked together for quite a while and, despite all of her best efforts and mine, she continued to put on more weight. Sporadically she would make attempts to take control of her eating but nothing was effective. One day, after several months of unsuccessful weight loss attempts, we began talking about her family situation and she disclosed to me that her husband and parents badly wanted another child/grandchild. Her first child, an extremely active little girl, kept her busy constantly and she strongly resisted the idea of adding to their family (and thus her workload). She feared her husband’s and parent’s anger and possible abandonment if she openly stated that she did not want another child to care for.

Soon she realized that her weight kept her from having to confront her family or deal with the issue at all. Her doctor had emphatically told her that having another child was far too dangerous an undertaking if she became pregnant at her current weight. Losing weight would mean confronting the issue and admitting the truth. Once she realized this she knew that she would never let go of her extra pounds until she figured out how to handle this matter directly.

Scenarios like this one happen frequently as part of the therapy process. People sometimes find out that their weight, their emotional eating and out-of-control behavior provides them with illusions of safety. If they are overweight, they can avoid the situations that they fear. They may think such thoughts as, “If I am heavy, no one will make advances towards me. If I am fat, I can’t possibly _______ (fill in the blank: go to school, ask for anything, be successful, take risks, compete with others, have a good relationship, etc.) If I am fat, I won’t be called upon to give my opinions or ideas. People won’t take me seriously and I won’t have to risk being wrong and feeling foolish. If I am overweight I may be excluded from good jobs where I will be expected to be responsible and competent (it is illegal, but it happens). If I am obese I can stay close to home – buses, planes, trains and subways have small seats so I can’t possibly travel.” This thinking provides an illusion of safety.

Being overweight is not simple and generally there are at least a few hidden, unconscious agendas behind the eating behavior. Close your eyes, take a few deep breaths and think for a few minutes about the advantages you get from being overweight. Then return to the present. Write those advantages down. Now note any other, more nurturing ways you can take care of yourself and your feelings and write these down. Next, choose one area where you would like to make a change. For example, if you have discovered that one advantage of overeating has been to numb feelings of grief, you might plan to talk with a friend about your loss. In this way, you allow your feelings to surface and find expression and you no longer need food to anesthetize yourself. You can do this exercise often as a way of checking in with yourself and changing your compulsive behavior.

You are making your unconscious conscious and only then can you make the changes you need to make. Send me a note and let me know what you find out! ( ) I would love to heare from you!

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