A Substance Called Food: Long-Term Psychodynamic Group Treatment for Compulsive Overeating

Abstract

Obesity has proven difficult to treat. Many approaches neglect to address the deep-rooted underlying psychological issues. This paper describes a psychodynamically oriented approach to treating compulsive overeating as an addiction. Common to all addictions is a compulsion to consume a substance or engage in a behavior, a preoccupation with using behavior and rituals, and a lifestyle marked by an inability to manage the behavior and its harmful consequences. The approach represents a shift away from primarily medical models of intervention to integrated models focusing on the psychological underpinnings of obesity. Long-term psychodynamic group psychotherapy is recommended as a primary treatment.

The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study

“…In this regard, in case FA is confirmed as a comorbid clinical entity accompanying the ED (after using screening tools such as YFAS), the treatment of FA clinical dimensions and its overall impact on ED symptoms should be assessed in future studies. Accordingly, known suggested treatment protocols such as combining pharmacotherapies (opiate antagonists) and psychotherapies (such as cognitive behavioral therapy and psychodynamic group treatments) may be successful in targeting FA clinical dimensions and, subsequently, ED symptom severity [ 49 , 50 ].…”

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“…As well, program evaluations that employ biochemical measures, and examine the relevance of food craving to obesity as outlined by Potenza & Grilo [38] are strongly recommended. According to Schwarz et al [39] given the current support for some sort of a mediating or moderating relationship to obesity in selected cases, a psychodynamically oriented approach to treating compulsive overeating, as well as an integrated model, rather than a medical model of intervention alone may be helpful for reducing obesity in selected cases. In addition, given the similarities of food addiction to other addictive behaviors Dimitrijovic et al [1] have advocated for the application of traditional addictive treatment approaches in the context of treating obesity, while a staged or incremental food withdrawal approach may be helpful as outlined by Pretlow et al [31].…”

Is the Failure to Lose Weight among the Obese Partly Because Obesity is an Addictive Disease?

“…As well, program evaluations that employ biochemical measures, and examine the relevance of food craving to obesity as outlined by Potenza & Grilo 38 are strongly recommended. According to Schwarz et al, 39 given the current support for some sort of a mediating or moderating relationship to obesity in selected cases, a psychodynamically oriented approach to treating compulsive overeating, as well as an integrated model, rather than a medical model of intervention alone may be helpful for reducing obesity in selected cases. In addition, given the similarities of food addiction to other addictive behaviors Dimitrijovic et al, 1 have advocated for the application of traditional addictive treatment approaches in the context of treating obesity, while a staged or incremental food withdrawal approach may be helpful as outlined by Pretlow et al 31 For similar reasons Cattivelli et al, 40 propose that acceptance and commitment therapy may be helpful, while Shriner & Gold 4 stress integrating metabolic, addictive, and human relationship factors into obesity management efforts.…”