When I first started working with Eating Disorders, I did not think I would be too involved with overweight clients. People also seem surprised when I tell them that at least half of our clients are overweight, the rest are anorexic or bulimic.
I have to confess, I am finding working with overweight clients extremely rewarding. Maybe because most of them are very motivated and extremely grateful for the help they are given. The results have also been very successful!
I think in the past, people suffering from binge eating did not realize they had an illness, they just thought they did not have enough will power. It is becoming more and more evident that this is not the case; there are many pathological factors that contribute to a person suffering from binge eating. I will mention a few that I have dealt with while working in Montrose Manor.
As with most psychiatric illnesses the problems usually start from early childhood in the client’s relationship with the primary care givers (usually the parents). Whether the experiences were real or imagined, this can result in the development of faulty belief systems.
Typical examples are:
“I am a bad person and people are disgusted by me.” By becoming fat, they believe that people will be disgusted by their size rather than by their inner core, or that they deserve to suffer by being overweight and undesirable. “This is my punishment for being a bad person”
“I need food to survive, without it I will be invisible or disappear”
“If I am feeling any distress, food is the only way I can comfort myself’. In families, food was often the way nurturing and comfort was given.
“I am weak and vulnerable and I need my fat to protect me.” Being overweight makes it difficult to get out, socialize and do things and can be an excuse to avoid situations.
“If I was thin, I would not cope with my sexuality and all men would try and rape me or I may not be able to control myself and will become promiscuous.” Overweight people can believe that people will not want to touch them, which keeps them safe from “sexual dangers”
“I am actually a small eater, but I put on weight more easily than others” and “I just have to look at food and I put on weight.” This is often because one or both parents are also overweight. Research has found that unless there is a medical reason, few people gain weight significantly faster than others. Often the overweight person will not eat much in front of others but will binge eat in secret (this can be so shameful, that they can even deny this to themselves and truly believe they do not eat too much)
“I do not get enough” and “people try and control me by withholding from me” This may be as a result of experiencing some form of deprivation from an early age and trying to make up for it for the rest of her/his life.
There are many other examples I could give, but these are the most common ones that I have experienced.
At Montrose Manor our focus is a psychodynamic approach rather than just on how and what they eat. If we helped them change their diets without addressing these core issues, our clients would relapse soon after discharge. When our overweight clients leave Montrose Manor, they have often not reached their ideal weight, but rather they develop a much more positive and healthier sense of self, they challenge their belief systems, they learn tools to manage their distress instead of using food and they are introduced to a healthy meal plan, exercise program and hobbies. This new attitude to eating and exercise is a starting point for clients to eventually reach a healthier BMI(weight).
I am aware that many professional’s feel binge eating should be treated as purely an addiction and although we do introduce the 12 steps to them, there is so much more than can be offered.
I believe Montrose offers them this help!!