On starting a weight loss journey, it is important to have appropriate psychological support, and one of the first steps towards developing healthier habits is understanding the psychological elements that have contributed to the situation. Therapy can make a huge difference and, while there is no one-size-fits-all approach to therapy relating to weight and weight loss, it is very important to have a positive relationship with a professional whom you trust.
People who are severely overweight often have issues that impact on their overeating and body image. These can include emotional avoidance, self-critical internal dialogue, negative core beliefs, and addictive behaviours. Often, by tackling their underlying psychological problem or problems, people find that it becomes much easier to control their food consumption, and weight loss follows.
Unfortunately, many people who are overweight have experienced others attempting to shame them into losing weight by making them feel bad about their health status and their lifestyle. Possibly sometimes these attempts are well-meaning, but they never work, because making people who generally already have very fragile self-esteem feel even worse about themselves is likely to simply lead to further overeating, and an increasingly destructive cycle of behaviour that will cause both their weight and their psychological problems to escalate.
It can be useful to explore the dynamics in your family of origin, because in many cases, the roots of unhelpful behaviours relating to food and weight started there. For example, children are often offered comforting foods as rewards for good behaviour or to provide consolation at a challenging time. Food can become inextricably associated with reward and comfort for them, persisting into adulthood. For someone living with stress or depression, for example, food might seem to be the natural choice when they need to self-soothe, because they were always given a “little treat” when they were upset as a child. Similarly, someone who grew up with food insecurity, often not knowing if there would be enough to eat for the next meal, may grow up with the tendency to overeat, as they live with an unresolved mindset of deprivation. A deprivation mindset can also be the result of a childhood in which you never felt loved or cared for enough, which can lead to emotional eating and, over time, to unhealthy levels of weight gain. Working with your therapist, you will be able to figure out your own triggers and sources of comfort, and learn how to adopt healthier coping strategies when life is tough, and alternative ways to celebrate during the good times.
In some cases, it may be useful for family units to engage in family therapy, to explore the group dynamics around food and its symbolic values in this context, to figure out triggers to overeating, and to break an unhelpful behavioural cycle, making it easier for you and others to develop a healthy relationship with food, and helping everyone to learn how to avoid passing dysfunctional behaviours around eating on to the next generation.
Excess weight, including obesity, is often closely linked to low self-esteem and other psychological factors. Research indicates that values affirmation with clients can be a positive intervention in terms of helping them to lose weight and grow their self-esteem, and to maintain higher levels of self-control in general. Your therapist might encourage you to explore with them the values that are important to you, such as close relationships, community, or whatever the case may be. By focusing on important values in this way, it becomes easier to step away from the short-term fulfilment sought in eating, and to grow your self-esteem, which is negatively associated with excess weight.
Many therapists offer a gentle, person-centred approach with a therapeutic modality such as Cognitive Behavioural Therapy (CBT) to help people understand themselves better, identify the triggers to overeating and other unhealthy behaviours, and to develop new reactions to stressors in their environment. In tandem with strategies to reduce calorie intake and increase physical activity, CBT has been shown to result in more weight loss and improvements in overall health than dieting alone. By helping you to identify the factors in your life that contribute to unhealthy food choices, it becomes much easier to unlearn old, unhelpful habits and to learn new, more useful ones. CBT can work in parallel with a rigorous approach to both the physical and psychological aspects of excess weight and weight loss.
Many therapists will also integrate elements from positive psychology, as negative self-talk (for example, thinking of yourself that you are “lazy” or “bad” when you gain or fail to lose weight) can impact badly on efforts to maintain a healthier lifestyle: people may feel that if they don’t see dramatic weight loss quickly that they are inadequate and doomed to fail, and the negative emotions that accompany these thoughts can make it much more likely that they will turn to food for comfort, as they have so many times before. Psychodynamic Therapy (PT), which will help you to explore and tackle the root causes of damaging behaviour, which may spring from early childhood experiences and the dynamics within your family of origin, can be a crucial tool on your weight loss journey.
You can work with a therapist to help you to relearn new eating and exercise habits. Your therapist will use various interventions to replace unhealthy habits with new, healthier ones. Obviously, if you want to lose weight, you need to eat fewer unhealthy foods and exercise more – but implementing change can be more complex and challenging than you might expect. Your therapist may ask you to use tools such as a food diary to create an accurate record of everything you consume and help you to acquire better self-monitoring habits.
Integrative therapeutic approaches to weight loss that draw on the therapist’s background, knowledge, and tools, and on the relationship that they have formed with their client, can lead to treatment modalities specifically designed for those who struggle to maintain a healthy weight and personalised for each specific individual. By working with a therapist, you can gain a much deeper understanding of the behaviours that are contributing to your excess weight, and steadily acquire new ones.
