Theresa, seventy, fifty pounds overweight, the subject of Friendly Fire,https://shirahvollmermd.wordpress.com/2010/01/23/friendly-fire/, seeing me consistently for ten years, says “I don’t know why I resisted weight watchers for all these years. I am doing it now and it is the best part of my life.” “No kidding,” I reply, thinking over the numerous discussions we had about how she can help herself with her weight problem. “I go there,” she continues enthusiastically, “and I feel like I have a loving family.” Fellowship, I think, is the strength of these meetings.
Blue, fifty-three, a patient of mine for three years, seventy pounds overweight, refuses to go to weight watchers, saying “I know what to do, I just don’t do it.” “Yes,” I respond, ” but Weight Watchers can help keep you focused.” “Well, I don’t think so,” she responds, as if we are in an argument. Persuasion, the art of it, is not often my job, but sometimes I think about how people can help themselves if they become more open to new experiences. Pre-conceived notions, resistances, get in the way, and sometimes these resistances are more rigid; other times there is an opening. I recognize with Blue that the feeling of being in a fight signals that the resistances are strong in this moment. I wonder if Blue will be like Theresa, wondering ten years from now, why she did not go sooner.
Like antidepressant medication does not help every depressed person, Weight Watchers is not helpful for everyone with a weight problem. Yet, everyone with a weight problem could go once to see how it feels; to see if they think it is worth their time and money. Having said that, I am mindful of the emotional risk of trying to lose weight; fearing that a failed attempt will just make things worse psychologically speaking. Like a child who does not study for a test so that he does not feel bad if he does not do well, many people with weight problems prefer to avoid their food issues, rather than chance feeling like a failure. Appetite suppressanst and/or liposuction can be attractive because with these interventions, it is the procedure that failed, not the person.
Weight is so interesting to me-the obvious mind/body connection. The meaning of food, the meaning of eating, is so rich with conscious and unconscious experiences. Food is an personal experience, a family experience and a social experience. The value we place on eating, the types of foods, the portions of food are all driven by biology, culture and emotional states. How these three factors are woven together define our relationship to our body and to our mind.
Theresa knew that she would feel better if she lost weight. She also felt lonely and food gave her comfort. Simplistically speaking, now that she has found comfort with her new “family” she has less of a need to comfort herself with large portions of food. I say simplistically speaking because on the one hand I know it might be more complicated than that, but on the other hand, I wonder if it is as simple as that. In other words, Theresa needed a “family” to motivate her to take better care of herself. For reasons that are not clear to me, she joined Weight Watchers at a time in her mental life where she was open to having a new “family”. By contrast, Blue is in a scared place, a closed mental space, such that she is not emotionally ready to try new ways to tackle her weight problem. How much I wait for her to open up in her own time, and how much I push her to reconsider her decisions is the art of my job. Seeing Theresa’s turn with her eating, along with a turn in her mental state, makes me want to push Blue a little harder. At the same time, maybe I should let Blue change the subject; maybe I should respect her resistance. Dilemma.