Chapter 133: Are You Happy With Your Weight?

 

Eating disorders are one of the most difficult disorders to treat. Obviously, we can live without drugs and alcohol but not food. One of my first questions at a screening interview with overweight prospective group members is: “Are you happy with your weight?” Most say that they aren’t but despite knowing what has to be done to trim down, they are either unwilling or unable to do so.  My next question is: “What are your favorite foods of choice?”   I believe that the type of comfort food a group member chooses is indicative of the kind of internal void they are trying to fill. In most cases, my view of eating disorders is much the same as my view of addictions and OCD behavior–  an attempt to control what can’t be controlled.

For example, during one group session,  Andy, a  50 year old, 6’3”, almost 300 pound  food addict, told us that before coming to group that night, he ate a whole pizza, washed it down with a liter of Pepsi and then ate a pound of chocolate.  The group was appalled and voiced concern for his health. Henry, half-jokingly said: ”I’m worried that one day you’ll just explode!”   I asked Andy: “What feeling were you stuffing down with food?” Andy was usually self-aware and so he didn’t miss a beat and said:  “I’m very anxious but I don’t know why. When I was a kid, my mother would soothe me with pizza and chocolate if I was (sic) scared…Which was just about all the time”.                                                                                                          Andy’s father was a raging alcoholic who would take his frustrations out on his wife kids, beating them when he came home from work in a drunken fury. Andy’s mother adored Andy but feared the father.  To compensate Andy for her guilt in not protecting him from her cowardly husband, she indulged him with food.  “Mother’s milk” Alice said.   “Pizza and chocolate are Andy’s Mother’s Milk”. I said: “That’s a very smart interpretation of Andy’s behavior. What’s your feeling toward him? “   Alice said:” I completely understand Andy. I use food to soothe anxiety too. I prefer pretzels and potato chips. I like the salty and crunchy taste”.  Angela agreed: “I know I’m a food junkie too but I’m helpless to change it” Andy replied. “True dat”.    Vinny said: “I been in 12 Step programs and respect your honesty. Acknowledging your helplessness to control the disease is the 1st Step”.

In another group, Fred, came to group and reported his binge-eating behavior since the last meeting. His psychiatrist had recommended a consultation with an eating disorder specialist who said the absolute worst thing to him. She directed him: “Don’t binge!”  Without much emotion, almost boasting, he sheepishly told us: “After I left her office, I went home and ate 13 bagels and cream cheese.  Then I threw it all up and had two quarts of ice cream.” Alarmed, the group wanted to fix him. Vicki said:” I’m so concerned about you. You’re hurting yourself”.   But Jason understood Fred’s behavior: “If I were Fred, I would have done the same thing if someone told me not to binge. It’s like that idiot Nancy Reagan whose response to drug use was: ”Just Say No!”  She might as well have said—“Go do it!”  Any self-respecting addict is going to defy an authority”.                                                                                                                   Fred laughed and said:” I feel so understood but what can I do?”  I said:” The next time you binge, don’t try to stop it. You can’t. That’s what makes you an addict”.    He said: “But I want to stop”.  I said: “You do and don’t.”   He said:” But I’ve developed acid reflux as a result of all the puking.  The doctor said that I’m wearing away the lining of my esophagus!”     Georgia anxiously said to me: “Can’t you help him to stop.  This is making me so anxious.”   I said:” Fred is not ready to stop. He has a high tolerance for pain. He’ll know when he’s had enough. As strange as it may sound, Fred hasn’t hit bottom yet. He’s not scared enough to change. Maybe he never will.  Fred said: “Funny, I feel understood and calmed but alarmed at the same time.”   I said: “You’re having all the right feelings.”     Mary asked me: “Isn’t there something he can do in the meantime?” I said: “While he’s bingeing, he can ask himself: ‘what am I feeling right now? Why is the feeling so intolerable?”  Liam asked: “Will that stop the bingeing?”  I replied: “Probably not. But it will put Fred on the road toward understanding the emotions that underlie his abuse of food. If he continues at it, there come a time when he can make a conscious choice as to what he wants to do with his body.”