Binge Eating and First Psychotherapy Appointment
When a new patient who is a binge eater walks into my Los Angeles office for her first session, she often feels afraid, hopeful, desperate, determined and skeptical. She is energized by an inner courage to make her life better by means she doesn't understand. Nothing else has worked, so she has decided to try psychotherapy. Since I'm a specialist in eating disorder recovery, she chooses to see me.
I hope she'll stay to do the real and effective work I know is possible. I've seen so many people who lose massive amounts of weight through various diets and weight loss programs only to gain it back and more. They feel terrible about themselves for failing. They do not believe the words, "You didn't fail. The program or diet failed."
Psychotherapy is Effective Long Term
Over at Rutgers University, a long-term study now backs up those words.
Six months after treatment via psychotherapy, self-help guidance, or behavioral weight loss programs, binge eating recovery is about the same. But, in follow-up after two years, the findings show:
"Interpersonal therapy and cognitive behavior therapy/guided self-help were significantly more effective than behavioral weight loss therapy in terms of remission from binge eating."
And there we have it. The person who binge eats does not get long-lasting recovery. She stops binge eating. She loses weight. She feels a sense of freedom. Then she goes back to her binge eating and the inevitable weight gain, often gaining more than she carried before.
Why Psychotherapy for Binge Eating Works
Psychotherapy that addresses the underlying issues of her need to binge eat and which provides support, caring, understanding and gentle challenges to stimulate psychological growth and sturdiness gets to the heart of the matter. Her recovery from her binge eating rests not on her dependence of an outside system but on her support from her own inner strength and health that remains with her for a lifetime
So there we are in that first session. If she suffers from binge eating, she can't see how sitting with me and talking will stop her from eating so much and so often that it's hurting her life, her body, her relationships and her willingness even to be seen in the world.
Her immediate concern and goal is to stop binge eating. She believes that if she could stop binge eating, the rest of her life would fall into place nicely.
Her husband would stop criticizing her and be sexually attracted to her again. She could conceive a child. She could have friends and make headway in her career because she would be at ease with people and not ashamed of her appearance.
Immediate Wishes and Long Term Goals
We sit together in that first meeting with different perspectives and a different time frame. She wants to find a way to stop binge eating as quickly as possible. She wants immediate relief.
My goal is to find a way to help her have a long, fulfilling, healthy life full of joy and satisfaction. I want her to live to be a feisty, energetic, happy and loved old lady. To me, ending the binge eating is one aspect of making this goal a realistic possibility.
She shares my goal in a magical thinking way. She wants to focus on stopping her binge eating and believes that all her dreams will come true if she succeeds. I understand this. Her way of eating dominates her thinking and the way she lives each day. She wants freedom from that domination.
I know that if we work on healing her emotional wounds and developing her inner strengths so she can live her authentic life, her binge eating will fade, and her better life will begin. And now, at last, we have some research that supports what has been going on in deep eating disorder recovery psychotherapy all along.
Thank you, Rutgers!
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Written by Joanna Poppink, MFT. Joanna is a psychotherapist in private practice specializing in eating disorder recovery, stress, PTSD, and adult development.
She is licensed in CA, AZ, OR, FL, and UT. Author of the Book: Healing Your Hungry Heart: Recovering from Your Eating Disorder
Appointments are virtual.
For a free telephone consultation, e-mail her at
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