When I was in graduate school a friend who had set up several successful  weight loss clinics invited me to observe the system she had worked out as part of her master's program in psychology. I didn't know what to expect. I had never thought much about the problem, which had been growing every year, and in all age groups The problem was hardly mentioned as part of grad-school curriculum, though a psychologicall component in one's weight and correspondending self-esteem and image is clearly a component of mental health.

Obesity is the last frontier for those who denigrate unprotected victims who eat because of a distorted image of themselves. Every minority group has been given a voice to register their pain and discomfort, as well as anger and rage towards those who cannot seem to understand that it is wrong to discriminate against any unfortunate group that is different, vulnerable, or unprotected.

Of course, like everyone else, I had heard the fat jokes, jokes about fat farms, and stupid jokes about fat camps for children. On its face, it is not funny but says a good deal about societal ignorance and denial that it hurts anyone. In fact, with the more recent emphasis on health and exercise, if anything the attacks have grown worse and more vile in their intensity.

Until more recently, diets, some extreme and even dangerous, were the only line of defense for the vast majority who suffered from obesity. Unless you could afford a stay at a spa in the mountains or at the beach, diets which seldom produced lasting results were the rule. If there was exercise, it wasn't considered important. In fact, most advertisements showed a model with a vibrating belt on the desired body part using power such as electricity to "vibrate the weight off.".

Later, plastic surgeons and others would set up surgery clinics to reduce fat with a knife. Many surgeons are particular about who gets the surgery and screen carefully, avoiding later complications whereever possible. Even surgery on a healthy person carries some risk of infection or other complication.

Then came lipo- suction and intestinal surgery. Lipo-suction literally pulls the fatty tissue out of the body using powerful suction generated through a plastic tube. Removing a portion of the intestines through surgery leaves very little space for food, is successful for some, but is dangerous and unsuccessful for others. I have seen mortality in both procedures and also success for some who have maintained the weight loss for many years. Remember, not every choice fits all.

I cannot possibly address the needs of those who are morbidly obese, bedridden, and who require serious intervention by a trained team equipped to work with such problems, or multiple problems revealed in the pathological need of the individual to harm oneself, actually suicide by food, long, painful, and drawn out for everyone involved..

I learned a great deal about obesity from a no nonsence practitioner who believed in the human potential of every human to be thier best. Very little time, in fact was spent on dietary systems in her group sessions, but on family dynamics that provided the rationaile for the destructive behavior..

Many of her clients did not seem overly heavy to my eyes, but they signed up because they believed they were incredibly fat, ugly, and unlovable, despite the spousal denial that her feelings of inadequacy resulted from a lack of love on his part. Most, if not all, the class she was working with were women, not because men are not obese. I would suppose they felt uncomfortable opening up their feelings to the group in the presence of women. Some men avoid their own need to do work in the group by taking care of others, women naturally, though they can be as strong as anyone else.

Twenty five years ago, most men and society in general, believed men could not deal with feelings as effectively as women, and while this is still true in many cases, At the time, it was written in stone. In fact, of the court ordered abusers in my first counselor assignment, I never once observed one cry in group., show overt interest in another's problems, or get past surface talk. some therapists will not work in mixed groups for this reason.

I believe these clinics were so successful because my friend never accepted a poor self image from clients nor did she berate anyone who had regressed. The focus and primaruy goal was to keep the self-image positive, not by the amount of weight lost during the week, but in the changes she recorded in attitude. " change the image and the weight will take care of itself." was her mantra.It makes sense and it did work in the groups i observed.

She used many techniques to reenforce a positve self-image, including creative visualization, self talk, music, the arts, and helping to establish the goals for each client. she found a coorelation between a positive self-image and the amount of weight loss, as well as success at maintaining the desired weight over a longer period than the end of the class. Students who maintained the weight loss were rewarded with positive recognition. Those struggling to maintan their commmitment, were invited to return at no cost for additional support.

The success I observed there helped me to launch my career on a good note in my first job as a drug and alcohol counsel for court ordered offenders. I saw the power in groups and the positive efffects of peers to elicit change.

Throughout my career, no matter the challenge, I was always keen on getting clients to use positive reenforcers for whatever they were trying to deal with. Those who insisted otherwise inevitably ended in jail, in a locked mental ward, or in the morgue. Active abusers of drugs or alcohol have similar traits those with eating disorders. Some present with dual disorders such as food addiction and alcoholism or drug abuse. There is loss of control in both groups and a total loss of spirituality,(not nercessarily church or religion, which is a popular scapegoat for bad behavior).

I have seen many controlling types, obsessive and with a need to look down as a punisher on those who are impaired or addicted in some way, enter the counseling field unsuccessfully. If confronted, they could not stand up under the light of objective scrutiny and easily transitioned into another less rigerous field of study.It is not the academic area that separated these individuals, however, it is the client confrontation they fear. Their fear of their own unresolved anger, fear they will be found out about their own weaknesses, and the ease with witch they can place their own unresolved issues on those they perceive as weaker or less perfect. Counselors are not directors. Their job is not to tell anyone what to do. All are subject to human frailities and weakness. A man with great wisdom and love for others once admonished a mob intent on stoning an adultress:  let he among you who is without sin cast the first stone.

If you as a patient or client of one of these types feels the heavy hand of their criticism or you feel controlled.by their anger, leave the session and seek out another who doesn't need to use clients to deal with his/her unmet needs, which have nothing to do with you. Many  counselors with unresolved issues of their own tend to seek the field of counseling, social work, psychology, nursing, and teaching. Any vocation in which they may control through anger, authority, or working with others who are seen to be in  dependent position attracts them, unconsciencely, of course. Some graduate- schools require candidates to seek therapy as a prerequesite before graduation or licensure as a counselor. 

This material is subject to the laws of copyright (c) March, 2009. MK