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Ondina Nandine Hatvany, LMFT

Why Support Is Important for Dealing with Food, Weight + Body Image Issues

In her first session with me Rose exclaimed emphatically, “No offense to you, but I feel that I should be able to control my food and weight by myself without the help of a therapist!”

Over the years, Rose had tried various ways to cure her food and weight obsession. Although she had been able to achieve some temporary relief, nothing lasted for very long. She soon found herself back on the not-so-merry-go-round of failed diets and increasing self-hatred and desperation. Was there something Rose was not getting?

I did a thorough review of all her previous attempts to get better: the numerous diets, New Year’s resolutions, self-help books, a workshop here and there, also a couple of Overeaters Anonymous groups. A pattern started to emerge: It seemed that every time she started to feel better and more in control of her weight she would stop getting support, because she believed she should be able to control her food and weight by herself. She was able to keep the healthy momentum on her own for a while, but inevitably she would fall off the wagon and then feel terrible about herself again. She would beat herself up and resolve to do “better next time.” Years of this pattern had brought her self-esteem to an all-time low. She described herself as “a failure” and “out of control.” She had developed painful habits around constantly obsessing about her weight and hating her body.

I call this approach that Rose was using “band-aid treatment.” She was not really addressing the underlying wound or problem; she was simply trying to feel better. There is nothing wrong with trying to feel better—we all do this. But if a wound keeps reappearing, the underlying cause needs to be explored and addressed; otherwise, the wound will keep getting re-infected. Rose's problem was that as soon as she experienced some symptom relief she would drop whatever support she was receiving, because she honestly believed she should be able to continue on her own. Dropping the support was sending her back into the negative cycles around her body and weight. She needed to stop the negative cycles long enough to be able to see what was driving them emotionally. In other words, she needed to stabilize patterns on the physical plane before she could explore what was happening on the emotional plane.

I was honest with her. I told her I wasn't sure I could help. I predicted that after a few sessions with me she would start to feel better and then move on without addressing the real problem. I suggested that she decide on one method of treatment and stick to it until her recovery was rock solid strong. I encouraged her to stop beating herself up for not being able to sustain recovery by herself. Most importantly, I stressed the importance of getting ongoing support if she really wanted full and lasting recovery.

Rose decided to see if my suggestions might work. As I predicted, pretty early on she experienced immediate symptom relief as she stabilized her eating and exercise routines. This was the “band-aid stage” where she would usually quit whatever treatment or support she was getting because she felt better. She decided to give me the benefit of the doubt to see if keeping the support she got through our weekly sessions could help her sustain her recovery. From my end, this was when the real work began. Now that problems on the physical plane had stabilized somewhat, we were better able to address the emotional issues that kept her trapped in negative cycles around her body and weight.

Rose worked hard. She looked at the deeply internalized messages she got from family around how much her value depended on looking a certain way. She explored the many overt and covert messages she received that fed her fears that if she didn’t look skinny she would not be loved, accepted or belong. She looked at how she used food to attempt to replace some of the comfort and nurturing she didn’t expect from her relationships. She explored the isolation she maintained because of the fear of others’ judgment. How food had become her drug was also explored: Both overeating and undereating were ways she used to stuff her pain or disconnect from it. I had so much respect for Rose’s courage and willingness to explore herself at this level.

Although Rose was getting a lot out of individual therapy I encouraged her to also look for a group to join and maybe check out some workshops. I knew that if the outside world was not also factored in, her recovery would be hard to sustain. I explained to Rose the importance of hearing other women’s recovery stories so she could know she was not the only one going through this. She knew this intellectually but not on an emotional level. Emotionally she still struggled in isolation. She could reach out to me at her most vulnerable, but I knew her full recovery meant also getting this kind of emotional support outside my office

Luckily, in the Bay Area there is an abundance of groups and workshops that support women in relating to their bodies and food in more positive and empowered ways. Rose chose a group that also brought in creative and expressive art modalities. She had always loved drawing as a child and so it was a delight to bring this back into her life. She was surprised by what was revealed to her through her art. While this made her feel very vulnerable, she was relieved to see that the other women were also uncovering surprising revelations that were shaking them up. Seeing these other women share their experiences with the group gave her the courage to do the same. She was astounded at the amount of support she received, usually at the exact places where she would normally turn to food for comfort.

So why is support so important? As I have shown, in Rose’s case support helped her explore the deeper underlying emotional wheels that were turning these painful patterns with food, weight and her body. The next level of support was taking her very personal battle out into her community and feeling held there. This step was particularly important because the road to disordered eating is usually paved with social, cultural and familial messages that encouraged us to turn food into the enemy and our bodies into the battleground. Dysfunctional patterns with food and hatred of one’s body are learned behaviors; we were not born with them! To combat the strong, negative messages we constantly get about our bodies from media, society and even family requires conscious effort and lots of support! We need other messages continually coming in that encourage us to focus on self-care, self-love and health (of mind, body and spirit). Creating a strong community that feeds us these positive messages is the sure way to sustain a lasting recovery.

In closing, I would like to emphasize that the sooner you get support the better! The women I meet who have been muscling through on their own for the longest are usually the lowest on the recovery scale. This is because the disordered eating has also created disordered thinking. Sadly, I rarely see their solo recovery efforts work. Instead, these women dig that much deeper into the battle with their bodies and appetites. Many years later when they realize how much energy they have wasted on this painful battle, they often experience great remorse that they didn’t get support sooner. Don’t let this happen to you! Reaching out for help and support is not weak, it takes enormous strength and courage. The better you are able to build community and support around your recovery, the longer your recovery will last, and the more empowered you will feel!