"Feed" your feelings or nurture your spirit?

Denial is an unconscious coping mechanism that gives you time to adjust to distressing situations. But when you remain in denial you deny yourself the ability to thrive.

In summer of 2008 Zoe, a then 74 year old woman came to my presentation, “What’s Eating You: Tools for Permanent Weight Loss”. She told me that her diabetologist had recently informed her “you’ll never get rid of your belly.” If that wasn’t enough to discourage her, the sleep disorders specialist said, “Since you can’t tolerate wearing the CPAP apparatus for your apnea, you’ll need to lose 65 pounds, but I know you’ll NEVER do that.” She walked away feeling angry, humiliated, and discouraged, then cancelled her follow up appointment. Zoe thought, “What’s the use. I’m fat and I can’t change it.” She felt hopeless about losing weight- she’d been on multiple diets throughout her adult life and each time she lost weight, she gained it back and more.

Unfortunately, the doctors’ words allowed her to rationalize her denial of the severity of her health problems (diabetes, coronary artery disease, stage 3 renal failure, diverticulosis and asthma). She continued making poor food choices until she reached 252 pounds. She wasn’t able to take a bath because she couldn’t lower or raise herself in or out of the tub. Her family was having discussions about installing a walk in tub for $ 14,000. When I heard her story I realized that Zoe may have been close to reaching her bottom, the place where positive change for a compulsive overeater becomes possible.

I handed Zoe the Beck Diet Solution Weight Loss workbook and told her that another client of mine had lost 131 lbs using this model. We discussed what she’d need to do to lose weight and keep it off for good. I asked about her feelings. Like many people, Zoe said, It’s not about feelings, “I just like to eat.” I asked her if she’d like to see her granddaughter get married. In tears, she said “I’ll try the program.” I told her what Jillian Michaels says about just trying–it’s planning to fail.

And so she began. She worked through the workbook, journaled her calorie counts at each meal and learned to plan ahead. It seemed her compulsive nature was working in her favor. She began exercising daily. As the pounds came off and the clothes got bigger, Zoe felt empowered.

We’d schedule phone sessions. When I noticed she’d sometimes avoid talking about her progress, I’d ask about her level of stress and how she was coping to soothe her anxiety. Zoe said most days she was able to notice her cravings and allow them to pass by keeping busy with work and other interesting activities. Finally, she admitted that she was having some very tough days. It was then that I learned she is the caregiver for a severely mentally ill son. She also has job stress as director of a school. Zoe was beginning to make the important connection between her anxiety and unhealthy reliance on food to comfort herself.

We discussed the following strategies for managing stress and calming emotions: taking a walk or other aerobic exercise, diaphragmatic breathing, progressive muscle relaxation, having a cup of tea, leafing through a magazine, reading and writing emails, calling a friend, completing a task, hugging a friend or family member, taking a shower (completely incompatible with eating)), relaxing in the bath, imagine being with a favorite friend, reading, or watching a funny movie and laughing.

Two years later Zoe has lost 53 pounds. Her insulin needs are less than 1/3 of what they were; her kidney function is stable. Her doctors are amazed and thrilled with the change in her attitude and behaviors. Instead of just trying, she is DOING one day at a time.

Zoe’s success story can be yours as well. Email Ellen at [email protected] and learn what to do about What’s Eating You.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com.