Do I Need Therapy to Lose Weight?

News and Advice, Weight Loss
on September 21, 2011

DEAR FFG: I am about to embark on losing 100 lbs. How easy will it be for me to pinpoint why I eat? Can I overcome this without going to see a therapist, for example? My doctor today laughed me out of his office. When I said I need help, his retort was "use small plates." Is it that simple? Please—some advice! — Ashley

DEAR ASHLEY: My first advice: Fire your doctor. He is may have made straight As in med school, but he obviously doesn't know much about the emotional issues that drive people like you and me to overeat.

To be fair, I used (still do) small plates. I exercise all varieties of portion control. But all of those typical dieting techniques are just Band-Aids if you don't work through what's going on in your head.

I did much of that work on my own. One of the keys for me was starting with exercise — not because it burns calories, but because it started me down the path of believing in myself. I began thinking, Hey, if I can do this Jazzercise thing, maybe I can get unstuck in other areas of my life. I started believing that I can, because I saw myself doing something I had never really done before. I built a positive foundation, a sturdy platform of self-esteem that allowed me to, a year-and-a-half or so later, tackle the diet part of the issue.


Many times before, I'd focused just on what I was eating, or tried to control my diet and start an exercise program at the same time. And that never worked. It was too hard — and completely negative. All I was doing was saying I can’t to all of those fabulous foods that had kept me such good company for so long.

So exercise gave me that mental push; it was therapy in motion for me. But I have to say that had I been able to afford a therapist at that time in my life, it would have been helpful. I did go to therapy after I had lost most of my weight, and then off and on for years. Mostly, therapy affirmed my instincts, told me it's OK to put myself first, showed me where I was losing my boundaries and needed to stand my ground — whether with food or people or work or whatever. The therapists I stuck with longest both had experience treating compulsive overeaters, and both were women who understand how hard it is for women to say no, to put their health and wellbeing at the top of their to-do list. Just having their affirmation was worth the $80/hour fee.

I do believe it's possible to overcome overeating over time (hey, that's "over" overkill). But the right kind of support at the right time is, as they say in the Mastercard commercials, priceless. If therapy is an option (ie, if you have the $$), I would keep it in your back pocket to pull out if/when you need it. Stay in touch with how you're feeling, whether you're making progress (not just on the scale — in your behaviors and motivation), and if you start having trouble, consider the couch. Er, the therapist's couch — not the one in front of the TV.