Dear Ruth:
How important is therapy really to the weight loss process? Isn’t it all about diet and exercise?

Therapy is quite important to the weight loss process, when one has struggled with weight loss for many years and has a relationship with food. Often, in these situations, the individual is using food as a means to cope with stress. The stress then arises out of the common feeling of helplessness. Therapy can help a person “sit with the stress” and tolerate it. Therapy is also useful in healing the wounds of shame and ridicule caused by the prejudice against overweight people.

Dear Ruth:
Is there really such a thing as “food addiction?”

Probably. This is a debate I have with myself. One dimension of any addiction is that the addict uses something to prevent the scary feelings of stress and helplessness. Over time, the addict then believes, or fears, that they cannot endure situations that produce stress without performing the addictive behavior. All addictions intensify with a person’s functioning and potentially can affect health, relationships, and job. All addicts have a “relationship” with their addictive behavior or substance. This means that activity and thought is put into procuring and using the substance of performing the behavior. The addiction takes precedence over responsibilities and there is a deep forging for the substance or behavior when it is absent. People often hate the fact that they are addicted, but feel powerless to stop. What may be different for food addictions is that unlike chemical addiction, there is no physical addiction, only psychological addiction.

However, new research seems to indicate a very complex process in the mind and body from too much of many foods. And there also seems to be a process that could be analogous to tolerance in chemical dependency. It may be that the more food that is eaten, the more it takes to feel good and to feel satiated.

Dear Ruth:
I’ve been on a diet for about 8 months and I’m doing really well – I’ve lost 25 pounds and 3 clothing sizes! The problem is, I’m totally miserable, and having a lot of trouble sleeping. Any ideas why this is happening?

It is possible that you are having trouble “sitting” with the feelings of stress and helplessness that may have led to overeating. Or you may have an underlying mood or anxiety disorder. A psychological evaluation would be a good idea.

Dear Ruth:
My 3-year-old won’t touch vegetables at mealtimes. He only eats macaroni & cheese, grilled cheese sandwiches, and french fries. Will he grow out of this?

There is a body of research that indicates that if children are given a selection of food at every meal that equals a balanced diet they will, over a three-to-four day period, consume a balanced diet. I would suggest that you give your 3 year old a balanced selection of foods at every meal (including macaroni & cheese and grilled cheese sandwiches) that your child can feed himself. Do not intervene with the food. If you stay out of his selection of food, but offer balanced choices on his feeding table or plate, he will nibble other things. Also, it is very common for children to go through phases of likes and dislikes of particular foods. Macaroni and cheese and grilled cheese sandwiches are not bad foods. Encouragement of lots of exercise is also very important.