Alice was a bit overweight, had periodic eating binges. She’d sneak to the McDonald’s drive –through and order cheeseburgers and milkshakes. Afterward, she’d hate herself for it. She had tried for years to control her eating binges but with little success.
After an eating binge, I asked her to notice any thoughts that occurred to her, whether or not they seemed related to the eating binge. Her thoughts ran to her husband. She said he was self-centered and controlling and disregarded her needs. She said he treated her as a trophy to display, not as a human being with feelings of her own. Her additional associations were that her husband was happy when she was thin because she was a better trophy, that she felt deprived and unloved, and that she felt dependent on her husband and trapped. My patient’s eating binge was embedded in complex web of associations and meanings. As it turned out, her behaviour served simultaneously to punish her husband, to compensate for her emotional deprivation (because she associated food with love), to reassure herself that she was not under his control, to help suppress fantasies about leaving him (because being overweight would make her less desirable to other men), and to punish herself for her vengeful thoughts (because she hated being overweight).