With great enthusiasm, we set out to write a book for therapists that would address the problem of compulsive eating. Our motivation stemmed from a variety of factors. As clinical social workers, we have both worked in the field of eating problems using a non-diet approach since the mid 1980s. On the one hand, we repeatedly observed that therapists were acutely aware that many of their clients struggled with eating and weight issues but lacked clear and effective clinical strategies to address these problems. In our experience, this scenario was compounded by the fact that many excellent therapists wrestled with their own relationships with food and their bodies that, in turn, had profound ramifications as to how they approached these issues with clients.

 

At the same time, therapists are in an extraordinary position to understand and implement a treatment of compulsive eating that offers lifelong, positive results for their clients. The psychological perspective that therapists have allows them to consider problems of overeating and body dissatisfaction on intrapsychic, interpersonal, and cultural levels. Their willingness to examine personal beliefs and experiences and their impact on the treatment situation offers therapists a basis for reconsidering their ideas. Throughout this book, our readers will be asked to do just that.

 

We are sisters who, typical of females in this society, struggled at varying points in our lives with food and weight. Bonding together in “sisterhood” has given us a wonderful opportunity to share with others what we have learned, both professionally and personally. Although the issues were different for each of us, we reached the same conclusion: Dietsdon’t work, and the obsession with thinness never leads to a positive body image. These principles, which we have incorporatedinto our work as therapists, have been substantiated over time by a growing body of research that exposes the harmful effects of dieting and offers new guidelines to help people achieve physical and psychological well-being. Despite the research and the experiences of most people that diets fail in the long run, Americans still turn to diets at a fervent pace, contributing to the $50 billion a year industry. Many of these consumers are our clients. The question arises, if diets don’t work, what can a person do instead? This book answers that question.

 

The majority of individuals seeking treatment for eating problems are women. Therefore, in order to simplify the text, we chose to use the female pronoun throughout the book. In no way do we mean to imply that men are immune from these issues and, in fact, their numbers are increasing. The information presented throughout this book can be used with male as well as female clients.

 

Another major tenet of our work with clients who eat compulsively is that people naturally come in different shapes and sizes. The word “fat” has become a four-letter word in our language, implying moral failure and creating shame. We view the word “fat” merely as a description of size, and therefore use it at times in the text as an appropriate adjective. In fact, we view the word “overweight” as more arbitrary and judgmental because of its implication that a correct weight exists, which someone is above; we therefore do not use this term unless it is part of a quote.

 

This book will teach you how to help your clients end their compulsive eating. However, this book is about more than just what people eat and weigh. As clients discover how to cure compulsive eating rather than control it, they pave the way for physical, emotional, and spiritual well-being. Energy freed up from the preoccupation with food and weight can be directed toward more productive endeavors, including relationships, work, hobbies, and general self-care. Learning to tune into needs related to physical hunger leads to an ability to recognize and respond to other kinds of psychological hungers. Taking pleasure in food and one’s body leads to a fuller, more satisfying life. These benefits will empower your clients. They may also empower you.

 

As therapists, we have a duty to promote practices that enhance the lives of our clients, rather than supporting mainstream viewpoints that may cause damage. Evidence of the harm caused by dieting is seen in the explosion of eating problems, body hatred, and weight cycling. As therapists, we can become knowledgeable about scientific research, the dynamics of compulsive eating, and the relationship between food and emotions, while questioning cultural messages about diet and weight that have become ingrained in our culture. The process of helping a client find freedom from the pain of compulsive eating is profound and rewarding.

 

We recognize that some of you will already be familiar with many of the concepts offered in this book, while others will be learning about this approach for the first time. Interspersed throughout the book we will ask you to examine your attitudes and their effects on clinical treatment. We hope that you will find information and case examples that will enrich your professional, and perhaps even personal, life.

 

If we come together as a therapeutic community to understand how a non-diet, size-accepting approach improves the lives of our clients and the public at large, our potential to create societal change will be immense. Full of research and theoretical and practical information, we hope that Beyond a Shadow of a Diet will become an invaluable resource for you.