This is the story of a young girl who, at 13 yrs of age, weighed over 17 stone, however, it could be the story of many youngsters. For the sake of confidentiality we will call her ‘Sally’.
Sally’s mother brought Sally to me in the desperate search for a ‘cure’ that would change Sally’s eating habits, money was no object, she just wanted a solution for Sally. According to Sally’s mother, the nutritionist, whom they saw regularly, did little more than weigh Sally and to blame her mother for buying sweets and chocolate. (Clue 1)
During the preliminary consultation, Sally’s mother was present as Sally was still a minor. An interesting observation throughout the consultation was that Sally’s mother spoke for her, and interrupted Sally, often correcting her responses to direct questions. (Clue 2) Her mother openly acknowledged that Sally would try to please everyone and would give the answers she thought people wanted. With permission from her mother and from Sally it was agreed that treatment would take place with Sally alone.
Over the first few sessions it emerged very clearly that Sally’s confidence and self-esteem were extremely low, she felt pressured from all sides to resolve her eating habits, and viewed herself as inadequate and a failure. The focus at home was on what Sally ate, how often, and on how much she weighed. (Clue 3) What was also significant was that Sally’s mother was also extremely overweight, and, although she denied that she had a problem with her weight she had put herself and Sally on slimming pills, and tested her own urine each morning for diabetes. (Clue 4)
During the first few sessions, I used hypnosis to boost Sally’s self esteem and also provided her with an ‘anchor’ to help resist the temptation of giving into the eating habit when she was anxious or bored. At the same time Sally and I worked together to improve her daily life-style – increasing the amount of daily water intake, installing a very small exercise regime eg 10 sit-ups and a dance routine to her favourite music. This may seem small but the strategies needed to be acceptable, do-able, and sufficiently unobtrusive to become habitual. (Multi disciplinary approach)
As time passed it became apparent that Sally was bored, her self-esteem was better and she was more confident, but her mother worked a lot and, during the summer holidays, Sally was alone for most of the time – their house was quite a way from town – and there was a special chocolate and sweets box in the kitchen, from which Sally was allowed to have one or two items. (Clue 5) Discussions with Sally’s mother revealed that the family viewed Sally’s obesity as her problem, and her mother was not prepared to deprive the other members of the family of their treats just because Sally had this problem. (Clue 6)
My response was direct and factual - I provided a written report to Sally’s mother for her to consider seriously with her husband. I outlined the route to success as being through team effort – I felt there was little possibility of Sally overcoming her difficulties single-handed, whilst the family continued to see them as separate. (It is difficult for a child such as Sally to take the lead – in an ideal situation her mother would set the example.) I asked that Sally’s parents should consider working with me as a team to shift the emphasis from food as rewards, and to move away from processed foods, sweets and chocolate to more healthy options. I went to great pains to provide nutritional information on the ‘treats’ which are, in fact, poisons – the effects of MSG, Aspartame, processed foods, fast foods, sugar-rush, and I also explained carefully where I believe the origins of comfort eating lie.
Comfort Eating:
As newly born infants, we, as a species, are completely dependent for everything – we have a built in mechanism to alert those around us to our needs – we cry – to be cleaned, to be fed, and to have any other basic needs attended to. The time when we are most comfortable is when we are being fed – we are held close, cuddled, our tummies our filled so the pain of hunger is assuaged and we are warm and satisfied. We also learn to recognise that we control our environment in this way. This association between food and comfort is reinforced throughout our very early development. It should be no surprise then that we easily fall into the behaviour of seeking out food later in life when we are in need of those feelings of comfort – whatever the reason. The ‘sugar-rush’ experienced with sweet foods makes these prime candidates for ‘comfort-eating’. (By the same token the association with food as a reward is learned – so that some foods are regarded as ‘treats’. Don’t we all know that one!!)
Once the family had had time to consider the content of the report I met with Sally’s mother to hear their views. She agreed that it would be in everyone’s interest to revise the family life-style, and the first step would be to substitute the sweets and chocolates for more wholesome, perhaps home-made foods.
Sally loved flowers and she expressed an interest in the nearby nursery where it was possible she might be able to help out – which, I hoped, would help overcome her boredom.
The most difficult aspect of this case, were the mixed messages both Sally and I were being given:
Sally adores her mother, her mother is very dominant and is the pivotal member of the family. Sally looks like her mother, same shape, colouring, mannerisms etc. Mother states that she has no problem with her own weight and is happy as she is, but she regards Sally as having a problem.
So here are the questions which arose in my head first:
* Sally wants to please, and therefore emulates her mother – her mother is critical of Sally and Sally’s weight, yet states she is happy with her own weight – what must Sally do to please? (result – inner conflict)
* Food is used as rewards in Sally’s household, but Sally is not allowed to have any rewards – how can Sally feel rewarded for her achievements? (result – inner conflict)
* Sally’s mother is often working, Sally gets bored and feels guilty – so then Sally seeks comfort by eating – and then feels more guilty – how can Sally break this cycle? (result – more inner conflict)
The way in which to resolve the inner conflict this young girl experienced needed total commitment, not just from Sally, but also from me, and, most of all, from her family.
The family helped Sally to get a part-time job in the nursery – she felt very good about this and her self-esteem improved. However, I began to notice discrepancies between Sally’s version of events and her mother’s. (Clue 7) Then it emerged that Sally’s mother was not able to keep her part of the bargain and continued to buy sweets and chocolate, and to use food as a reward for her other children.
When I challenged Sally’s mother on the agreement we made, she explained that she was doing as we agreed, and she had only bought a few Kit Kats, but she was working at lot and didn’t have time to do any more. (Clue 8)
After that, Sally did not come to me again.
My point is this, the issue of over-eating is wider than just the individual – it is a family responsibility and also a cultural one.
Let’s go through the 8 clues that I have identified within this text:
1. Other professionals had identified that there was a home influence in Sally’s eating habits.
2. Sally’s mother completely dominated Sally.
3. Everything revolved around Sally’s eating behaviour at home and she was constantly under observation, being weighed every day.
4. Sally’s mother was in denial about her own health issues.
5. Treats, in the form of sweets and chocolate, were available in the home, but rationed for Sally.
6. Sally was viewed as having a problem in isolation from the rest of the family.
7. There was a lack of honesty within themselves, between each other, and between them and me.
8. Sally was not a priority for her mother in practice.
Overall this is a complex case, involving not just Sally, but her whole family and their life style. The effects of the cultural influences that have gradually seduced us into believing that sweets, chocolate, cakes etc are treats and can be used as rewards, are clearly demonstrated in this case. Equally, the very mixed messages that this young girl was receiving exacerbated the inner conflict and confusion, serving to disempower her even further.
I have no way of knowing whether Sally has changed her life-style, or whether she is continuing to eat herself into ill health. Perhaps she will have to wait until she is an adult to take control of her life – I can only hope that she will do it sooner rather than later. Very few of Sally’s issues were about food, they were more to do with her low self-worth and low self-esteem – feeling of no value, unwanted, unattractive, and unable to achieve – and in response to these negative feelings, trying to find some way of feeling better and to have some control.
Does any of this sound familiar? If so, what can we do? My response is this:
* Let’s work on the underpinning psychological aspects rather than focusing solely on the eating and weight issues
* Let’s engage the whole family in taking a positive lead
* Let’s devise a multi-disciplinary six-month programme that is led by the person, that empowers the person, and his/her family, through increased self-esteem, behavioural strategies, and progress awareness
There is no doubt that, as a species, we are very adaptable creatures, and this has enhanced our survival in the long term, but our adaptability can also work against us when we are involved in a process that has gradual results, such as weight loss. We find it difficult to perceive the gradual differences in our bodies as we lose the weight – we forget how we were when we began.
When a drastic change occurs in a short space of time, then an expectation is created that this should be repeated, when this expectation is not met we feel disheartened, and, instead of recognising our overall progress, we feel negative and need to be comforted. It is, therefore, essential that perception and awareness are facilitated every step of the way, so that improvements in mood, energy levels, concentration, activities, social interactions, and every facet of daily life are taken into consideration. By switching focus, food and weight can be de-emphasised, so that general well-being can be enhanced, and, with a healthier life-style, the weight will naturally reduce.
Beauty is not about being thin – beauty is about being healthy and feeling valued.
Personal Empowerment Therapy: Dr Dawn Heather, Camborne Complementary Healing Centre:
Tel: 01209 711504 www.dawnheather.com
email:
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Posted by: Hoodia | October 05, 2007 at 09:39 AM
Thank you for your great story. I know the total reverse of this story. This time it's Sally gone skinny...so much that her entire life she is wrapped up in insecurity about her thinness. When people comment on her thinness(it's genetic), she smothers herself in defiance and rebellion. Why does the way you look dictate so much of who you are?
Posted by: healthybpm | February 01, 2007 at 08:51 PM