Chapter Summaries from
"Mind Over Fat:
Reading Therapy for Overweight Persons
& Other Dieters"
© 1999 Reginald B. Humphreys, Ph.D.
Duplication Prohibited. All Rights Reserved
Emotional and
Psychological Causes of Overeating
Being Fat
Being overweight or "fat" in our society is for many individuals
one of the most uncomfortable and painful experiences to live through. Aside from the
psychological and social problems associated with being overweight, the health risks and
medical consequences of overweight conditions constitute a serious burden in their own
right. In spite of all the emotional, social, and health penalties associated with being
overweight, such conditions continue to be our nation's most common health problem. The
national obsession with losing weight and slenderness continues to fuel a variety of
lucrative industries and businesses, including weight-loss and fasting clinics, athletic
clubs, and the never-ending parade of diet books and fad diets. While each method
proclaims superior success rates over the others, overweight conditions are still as
prevalent as ever. It has been clear to the health care community for a number of years
that this epidemic problem will never be solved by a new diet or exercise approach. What
is needed is for the general public to become knowledgeable about the most important
factors behind overweight conditions, which are the subject of this article. These factors
have to do with the emotional and psychological reasons for being overweight. No diet, no
matter how effective in promoting weight loss, can have lasting value if the individual
fails to address the emotional issues that have resulted in overeating and weight gain in
the first place. In fact, most weight loss methods, by failing to address these emotional
issues, actually constitute a form of exploitation of the individual's emotional
weaknesses and dependencies. The overweight person may shift their hope for a new and
slender lifestyle from one popular approach to the next, which only temporarily shifts the
emotional dependency away from food.
In referring to overweight conditions as fat or fatness, no
disrespect to the individual is intended. Instead, this terminology is deliberately chosen
to aid the person in desensitizing herself or himself to the word fat, in the belief that
eating problems can only be solved when we look at the problem directly and realistically.
The term "fat" in this article applies equally to conditions of obesity (50
pounds overweight or more), and to mildly overweight persons (10 to 15 pounds overweight).
Also, the reasons for overeating which will be discussed may apply equally well to
individuals who have no weight problem, but who need to understand episodes of overeating
for other reasons.
The Role of Fatness in Personality
Functioning
The most important idea contained in this article is the notion that
overeating or being fat actually serves some helpful function for the individual. While it
is a simple matter to recognize the physical and social liabilities or problems associated
with being overweight, focusing on these penalties rarely gets a person anywhere in terms
of permanently reversing the weight problem. Only after realizing the adaptive value or
benefits of being overweight can the individual begin to become less dependent on food for
achieving such benefits. As an extreme example, we can consider the case of a woman who
has experienced childhood sexual abuse. The emotional and psychological trauma associated
with this abuse becomes connected with any approach from men which may seem to carry
sexual overtones or potential. If such possibilities are experienced as frightening, and
therefore unwanted, then creating an overweight body image may have the adaptive benefit
of reducing the woman's sexual appeal and attractiveness. This serves as a form of
protection by reducing the frequency of approaches from men. Of course, all of these
factors may be operating at an unconscious level, even to the extent that the woman may
feel that she in fact desires to be slender, and desires to be approached by men. It
should be mentioned that while this example is extreme, the emotional factors in operation
are actually quite common, and are seen frequently in both men and women who have never
been the victims of sexual abuse.
Much more will be said about this particular pattern
shortly. What is crucial for the moment is for the reader to recognize that being
overweight does indeed carry many adaptive benefits. The key to successful long-term
weight reduction is recognition of the particular adaptive benefits which apply to each
individual. Usually, these benefits can be conceptualized in the form of certain emotions
or emotional issues which are expressed through being overweight. These emotional causes
of overeating are as individual as a fingerprint, just as no two life histories are ever
the same. And yet, it is possible to gain some insight into one's personal reasons for
being overweight. Following are brief discussions of some of the most common emotional
reasons for being overweight. For you as an individual, none of these may apply, or all
may apply. More likely, many will seem familiar to you as being related to excess food
intake, and several may seem very strongly related to your personal problem with
overeating.
Self-deceptions of Physiological and
Biological Causes
Before discussing the most common emotional causes of
overeating, I feel it is critical to recognize certain ideas which constitute major
barriers to developing an honest personal understanding of overeating. The chief barrier
to being open to understanding the emotional causes of overeating is the belief that one's
person weight problem has a biological or physical cause. A person may feel that she or he
is genetically predisposed to being overweight, or has a metabolic disturbance which
results in being overweight. Along with this belief is the idea that it is natural for
many persons to be overweight, and that the current emphasis on slenderness is a product
of our materialistically oriented society and its superficial values. The conclusion that
is often offered is that being overweight is actually the healthiest state for some
individuals.
I will admit that the issue of physical versus psychological
causes of overweight conditions is a very thorny and hotly disputed question. Further, it
is a never-ending question, because both sides are forever unprovable! For a given
individual, we can never prove to what extent an overweight condition is the result of
physical problems, nor can we prove to what extent emotional or psychological factors are
responsible. Which side you end up taking in this mind-body dispute is largely a matter of
unprovable belief or personal philosophy. For the individual, however, a certain approach
to this issue is advisable, so I will just recommend this directly as an immediate
practical solution. First, a person should never hold the belief that an overweight
condition has a physical cause unless this has been diagnosed by a physician. Second, even
when a physical cause or contributor has been identified, the individual should not
believe that she or he knows to what extent the physical problem is responsible
for the overweight condition \unless the physician suggests evidence of the
percentage contribution of the physical problem. Third, it is reasonable and helpful to
presume that the causes of overeating are emotional and psychological unless otherwise
demonstrated. These simple rules of thumb free up the individual to engage in a thorough
and honest self-analysis pertaining to the emotional causes, which is impossible if the
idea of physical causes reappears whenever the person begins to feel threatened or
defensive. The best approach is to put physical causes (which are often unprovable anyway)
out of your mind while you are considering emotional and psychological causes of
overeating. It is a startling and dramatic event when an individual who has believed
herself or himself to have a physically determined overweight condition, then has success
in permanent weight loss after dealing with the emotional factors for the first time.
Self-Esteem and Overweight Conditions
An individual's self-esteem is so closely linked with
the image or appearance that is presented to the world that the person's appearance can
actually be used like a barometer of increasing self-esteem. So often, as a person loses
weight, this has a visible impact on self-esteem. The person may begin to demonstrate
better self-regard in a variety of ways, including enhanced job performance, better
relationship functioning, and all-around improved self-care. It would be easy to say that
all these improvements come from the person's happiness with the lost weight, and that it
is a shame that the person will only demonstrate good self-care when they are happy with
their appearance. Such a perspective is foolishly oversimplified. Rather than believing
that self-esteem flows from having a good appearance, it is usually the reverse: that
one's physical appearance displays the underlying level of self-esteem.
The fat or overweight person is displaying to the world how
she or he really feels inside. A shabby or unhealthy exterior reflects a troubled and
pained self-esteem. Such an exterior states "See how much I dislike myself, and how
needy I am. See how I must rely on immature gratifications such as overeating to derive
any sense of pleasure". When a person is only slightly overweight, then the message
which is sent is more moderate, such as "things aren't quite right in my self-image,
and I have to rely on food too much to get through". Although not all overweight
persons will identify with such self-esteem issues, my experience is that most overweight
persons identify with these ideas very strongly. And while the connection of fatness with
self-esteem seems so obvious to most people once they hear it, I am routinely astonished
to meet individuals who have been through one weight control program after another before
seeking psychological help, and who say "No one has ever mentioned the issue of
self-esteem to me before in connection with my weight, and I never even thought of
it". Many such persons also report that they always assumed that they had good
self-esteem up until the point when they actually took a serious look at the issue.
Body Image and Obesity
Somewhat related to the issue of self-esteem is the
relationship of one's body image to one's actual weight. Being overweight and other eating
disorders as well often occur in combination with a distorted sense of one's body.
Person's who are \fx19not\fx11 overweight may frequently perceive and insist that they
are, while others who are in fact overweight may not perceive themselves as so. Truly
overweight individuals sometimes show surprise if the suggestion is made to them that
weight loss would be a desireable goal. The best documented body image distortion is the
misperception of anorexic individuals that they are overweight and must starve themselves
to lose weight. The actual (but often unconscious) goal of this behavior is to prevent
one's sexuality from being evident to others in the form of curvaceousness or shapeliness.
Food as Suppressant of Emotional Experience
It has often been said that food is the drug of the
poor. Although it contains truth, this cliche is too limited in scope, as individuals at
every point on the socio-economic scale may use food as a drug. In describing this aspect
of overeating, what we are actually referring to is that consuming excess amounts of food
has the effect of blunting, dulling, or suppressing our emotional experience. While it is
well known that alcohol and substances of abuse are utilized in this manner as a form of
self-medication, it is less well-known that food is often used as a tool for suppression
of one's emotions. We only need to invoke the Latin-American tradition of the siesta to
remember that excess intake of food will tend to have a sedating effect. Even more so, we
tend to displace any emotional experience that may be occurring when we begin to eat. The
emotions are replaced by the sensations of pleasurable flavors in the mouth and tongue,
and followed by feelings of satisfaction in the stomach. Food thereby becomes one of our
defense mechanisms, as a way of dealing with feelings which can become routine and
repetitive. The more we rely on the gratification of food as a coping mechanism, the more
likely this is to result in a chronic pattern of overeating, and in chronic overweight or
obesity.
The use of food in this manner is just one facet of an
emotional problem which is common to almost every type of psychiatric or addictive
disorder. I call this problem emotional dysregulation, using a term coined years ago by
Dr. Karl Menninger. Emotional dysregulation refers to an individual's difficulty in
experiencing emotions, and in needing one's coping mechanisms to be supplemented by some
powerful mind-altering or emotion-altering event, such as using alcohol, or a drug, or
excess eating. Almost all problems in living are based in part on an inability to tolerate
emotions, on an inability to feel intense feelings fully. If we face our inner lives
without the support of a chemical or food, then it may be difficult, but our natural
internal coping mechanisms are allowed to function and become more effective. When we no
longer fear that emotions will overwhelm us or destroy us, then we can face the experience
without undue fear, and maintain emotional equilibrium without the need for ego
supplements.
What are the feelings that people commonly suppress through
overeating? Anxiety and nervousness are common reasons, and it is almost a cliche in
today's society to say "I eat when I'm depressed". Many eat to suppress anger or
frustration, and food is often a dear friend to those who are alone and lonely. Unwanted
or unfulfilled sexual feelings may be the target of suppression by overeating, as well as
feelings of career or relationship unfulfillment. Suppression of any feeling or conflict
that has been chronically present, for a period of years or even over the course of one's
entire lifetime, may be the cause of chronic overweight or obesity.
Fatness and depression
The linkage between overweight conditions and
depression is so strong that special discussion is warranted. Research on depression in
recent years has documented that the prevalence of depression is far greater than was ever
expected in the past. Depression may masquerade as a sleep disorder, as performance
problems on the job or in school, as alcohol or substance abuse problems, and as eating
disorders and overweight conditions. Weight loss professionals in the mental health field
are all familiar with the pattern of an individual who begins to experience increasing
levels of depression as the excess weight comes off. It is strikingly clear that excess
eating has been used to suppress the experience of the depression, and that as the layers
of fat are removed, that the underlying layers of depression are revealed. Sometimes
antidepressant medication is needed, and almost always the weight loss efforts are
interrupted or slowed down, to allow the individual to gradually process in therapy the
painful emotions which are surfacing. This phenomena helps to illustrate what weight loss
professionals know - that there is no "trick" to weight loss, that weight loss
itself is a relatively easy phenomenon to accomplish. It's dealing with the emerging
emotions and other previously suppressed issues that constitute the true difficulty. The
treatment must be refocused on the depression or the other emerging issues, until
overeating is no longer needed to contain the emotional experience. Of course, if the
person supervising the weight loss is not trained in recognizing or treating depression,
or worse, if no one is supervising the weight loss efforts, then the unrecognized or
untreated depression can constitute a significant danger to the individual, and a much
greater risk than the excess weight could ever have been. In addition to the depression
concealing effect of overeating, it should be noted that food cravings are often caused by
depression, and then more craving can result from the process of overeating, especially if
sweets and high carbohydrate foods are involved. So, a vicious circle of food craving,
overeating, and depression is becoming increasingly understood in current research on
depression.
Fatness and Sexuality
Marriage Protection
Eating as Aggression and Rebellion
The Overweight Person and Fantasy
Eating as Self-Nurturance, Self-Reward, and Self-Punishment
Impulse Control and Self-Indulgence
Research on Obesity and Eating Patterns
Cultural and Symbolic Aspects of Fatness
Family and Generational Trends in Overweight Conditions.
Obesity and Mental Illness.
Holiday Overeating
The Role of Exercise
Alcoholic Obesity