I work with people who are changing their relationship to food. Mostly they are obese and don’t want to be. Most have had surgery under my hand to give them a tool to help them relearn two sensations that their bodies have literally forgotten. The two sensations are full and hungry. Because of the disease process of obesity, the body literally experiences hungry/full in a faulty way, much like someone with diabetes experiences sugar in a faulty way. Making the stomach in to a small pouch changes the experience of hungry (reduces hunger dramatically) and full (increases satiety). The effects are dramatic most of the time.
What does not change is the emotional component of the relationship to food. If food has become the person’s experience of love or connection, that does not miraculously change. When I say something like this to a room full of physicians, some of them do what I imagine you are doing (only they literally do it right in front of me); they shake their heads. These physicians believe that the problem of obesity is eating, and they are wrong. The endgame is eating, like the endgame of alcoholism is drinking, but the problem is one of emptiness. My patients are not hungry. They are empty, like we all are empty. They fill up with food the same way an alcoholic slakes his thirst with a drink: not at all.
If a child is abused (over half of morbidly obese people were sexually abused as kids) and finds warmth when it’s cold from food, that message gets deeply imprinted. Relearning hunger then also means understanding that what the body needs and wants from food is not what the heart will ever get from food. Love is not there, in the end. The truth is that love happens within a person, and it is for that person and it is received and given between people (ok, and dogs). When the part of us that needs love and connection gets filled with the right stuff, even small amounts of food are enough. This is what my courageous patients are learning every day. As cool as it is to see a person lose a hundred pounds and watch the diabetes go into remission, the high blood pressure normalize, and to see them walk in a 5K for the first time, it is even better to watch them do this deeper work and find the real gold: themselves.