Understanding obesity

References to weight loss and obesity are everywhere – magazines, television shows, even e-mail spams and advertising mails are always talking about it. However even if the prescribed treatment in the form of reduction of food intake and an increase in exercise is evident, some people still do not manage to lose weight or maintain their weight loss.

The value attached to food within the milieu of the family field may be a fundamental agent in understanding the contextual factors of obesity.- Amanda Grech

While one appreciates the importance of exercise and nutritional information, some axioms of obesity are less obvious than others, particularly the psychological and emotional factors.

Prejudice towards obesity prevails even in our politically correct society. The suffering brought about by the stigma about obesity often impacts both the social and psychological spheres and many argue that discrimination against obese people continues to be apparent even at the workplace.

A common misconception is that obesity is a matter of self-control, and obese people, since they cannot lose weight, do not have self-control. However lack of self-discipline is not a typical key factor in the etiology of obesity.

A more relevant element is that the individual can lose the accurate sense of physical hunger and satiation. A baby is born with the faculty to be in touch with the body in order to recognise feelings of hunger and satisfaction and this can be observed in the early days of life. The baby seeks the breast when hungry and withdraws when satiated. From a contrasting point of view, obese people are not in touch with their body, pay no heed to what they eat and gobble down food indiscriminately without chewing it.

One of the factors that contribute to desensitisation from the body is trauma in childhood. Children who go through physical or psychological suffering such as chronic pain, grief or abuse are likely to become disengaged from their body. Psychotherapy supports children and adolescents to unblock and regain connection with their physical selves through creative media and play.

Similarly, adults benefit from an enhanced awareness of their body sensations in order to draw a distinction between the need for food and emotional needs such as love, attention, expression of anger and self-care.

The value attached to food within the milieu of the family field may be a fundamental agent in understanding the contextual factors of obesity. When food is given exaggerated importance, this could be indicative of a lack of emotional contact between the primary care giver and the child. When the caregiver has difficulties pertaining particularly to bonding with the child, this distress can be compensated by over protectiveness and excessive feeding.

Interestingly, there are significant parallelisms between the relationship with food and the relationship with the world. The inclination to swallow food down quickly without proper mastication often indicates the tendency to conform and assimilate expectations coming from other people, while disregarding one’s inner truth in the process. Sometimes individuals who become aware that they lost their sense of taste oscillate to the other polarity, which is that of being very particular about what they eat, and also overly critical of others. It is as if they become aware that they lost their sense of taste, and they want to ensure that they do not gobble down toxic elements. Psychotherapy supports the individual to become aware of introjected messages and challenge them. It is as if the psychotherapist supports the client to remember the function of taste, not only in relation to food but also in relation to the world.

Understanding obesity encompasses enhancing the person’s awareness to understand possible reasons with regards to the need to be big in order to survive in the world. Obesity may be serving the function of limiting the self from ensuing particular activities. In other words the person may be using obesity as an unconscious excuse to abstain from engaging in activities such as fighting for success, risking asking for love or sexual activity. In the case of the latter, the individual may be covering behind obesity as a protection from sexual advances due to a traumatic sexual history or dissatisfaction in the love relationships.

Obesity has a major impact on the self-concept and it is often accompanied by physical and mental exhaustion, shame of one’s body and of the desire for food. The psychotherapist needs to provide a safe and supportive environment where the client can work on body shame issues and have realistic expectations out of interventions such as diets and surgery.

Eating patterns are the symptom not the cause of obesity and the individual benefits from a shift in perspective. Rather than considering food as the enemy, the compulsion to eat is best utilised as indicator implying that something needs to be addressed. The primary goal in stepping out of obesity is to develop the skill of acting in response to one’s needs rather than in response to self-criticism, and predominantly to establish self-love.

Amanda Grech is a registered and European Certified Psychotherapist.