Resultado de la audiencia de conciliación

The final master theme connects the experiences of emotional distress, interpersonal difficulties and self-identity with the lifelong battle with weight and the use of eating as an emotional coping strategy. The frustrations about weight expressed by the participants reflect the multifaceted impact of weight problems; the participants did also reflect on attempts at change and adaptation to their relationships with food.

3.7.1 Distress in life: Comfort in Food

Problematic eating behaviours were talked about in the context of difficult life experiences, interpersonal difficulties and the internalisation of distress. For many of the women there was an acknowledgement that patterns of overeating or binge eating as a strategy for managing distress had developed early in life. Pamela recognised that her pattern of overeating developed after having her children but she reflected on how in childhood she experienced her mother as “depriving”them of snacks and sweet treats. These early experiences appear to have influenced her attitude towards food and eating;

“It feels/I don’t know it feels like, I’m not depriving myself because if it’s there, I’m not depriving myself of it but if it’s not there I feel like, god, I’m missing something here, it’s deprive/depriving myself of having something I want in the house but if it’s not there you

know I feel like I’ve got to go out and get it you know and I’ll eat two or three packets but if it’s in the house I won’t eat/I won’t/I’d be lucky if I eat one but if it’s there in the house I won’t touch it.”

Eating had the capacity to bring great comfort offering a substitute for or a representation of, love and affection;

Paula:“it’s almost my way of getting a little bit of a hug, a hug in a second when you’re feeling a bit low you know when you want somebody to/to just come up and go you know it does it for me you know”

Gillian: “Now my nan used to buy five selection boxes every week cos there was the five children. And we’d eat them and she’d have to get them more the next week. So you just, I just, erm recognise food with love.”

Eating was also described as distracting from distress or providing a “high”. Comparisons were often made between eating and addictive substance use. This seemed an attempt to illustrate that the desire to eat in certain circumstances goes beyond the normal tendencies of eating for pleasure. The effectiveness of eating as an emotional coping strategy often seemed to relate to its capacity to numb or suppress feelings. Elsa uses an interesting analogy to describe a binge-eating episode: “You just wanna not feel it anymore and for the period where you’re like in that like zombie-like mood and eating all that, you don’t feel anything you just/you’re like physically numb”.

Ruth had initially made the decision to eat in order to gain weight and prevent sexual attention, however eating as a coping strategy had since become associated with a number of emotions; “Depression’s there, injustice, loneliness. Erm, loneliness is a big thing...cause I’m quite a social person.” Eating as a coping strategy had often developed in response to specific interpersonal difficulties, and then become generalised and relied upon in response to a variety of problematic situations and difficult feelings.

3.7.2 The frustrations of being overweight

When speaking about weight the women commented, in particular, on the development of weight problems, the struggle of weight loss and the psychological,

physiological and social impact of being overweight. This statement by Beverly, depicts not only the development of weight problems in childhood but the somewhat powerless position of childhood: “so I must have been about 10 or 11 and I knew I looked bigger…. than the other kids, so I said right I want to go on a diet and she said oh no you can’t go on a diet until you’ve started your periods”. For Ruth there is a sense that weight gain was experienced as a forced choice in adolescence to protect against further abuse: “…but then I think around fifteen sixteen when I got a Saturday job, even though I had to give my mum money I still had money for myself so that’s when I started buying you know, rubbish um A: I liked the taste of it, but my main goal was to put weight on you know”.

Following the frustration of initial weight gain came the added frustrations of being overweight. The impact appears multifaceted, affecting psychological well-being, social functioning and physical health. Beverly highlights how being overweight can feel all encompassing: “It makes me, well I’d say it makes me feel depressed, it makes me feel depressed the way it affects my life.” Many women reflected on the interrelatedness of psychological distress and interpersonal functioning and weight. For instance, Elsa spoke of the physiological implications of being overweight; she described the impact on her physical mobility as “aggravating”and explained how her holiday experiences with her husband were affected and how their relationship had to adapt: “Uhh, well it’s aggravating but then you just kind of get into that pattern after a while and you know [name of husband] just noticing that I’m getting too tired and I need a rest and I just you know, we’ve just... over the years it’s just the way our relationship works.”. Living with an overweight body seemed to be a daily reminder of ‘difference from the societal norm’ causing distress from what might otherwise be a pleasurable experience. Ruminating on such activities, in Gillian’s case shopping for

clothes“Well they could never get a blazer to fit me…”perhaps elicits thoughts of personal responsibility and self-blame, eliciting shame and embarrassment.

Following weight gain and the eventual realisation that weight has become a problem comes the struggle with weight loss and repeated attempts at weight loss strategies. Beverly talks honestly about her inability to maintain the motivation to apply strategies despite their usefulness; “at first I understood everything she’s saying to me, the mind perceiving, the grazing, the having no control, I used to write down everything I ate and for a while when I do that it’s fine but then you go back to your normal life and it’s not fine.” Weight regain was often experienced as a failure and entwined with psychological distress. The response was often to eat, illustrated by Ruth “erm and now because I tried so hard to get it off it didn’t feel fair that I couldn’t keep it off um and it was like a spiral then because um I was like sad because, depressed because I couldn’t keep it off which made me eat more and then,”.

However, comments such as ‘it’s not fine’ by Beverley and Elsa’s use of ‘just the way it is’ both perhaps indicate a recognition that their current weight is not what they had hoped for.

3.7.3 Adapting to cope with eating and emotions

There was reference to cognitive and behavioural changes and a determination to improve emotional coping and to reduce weight. There was some acknowledgement that the ability to apply practical changes was reliant on psychological changes, i.e. those associated with attitudes towards food and emotional coping:

Gillian:“Cos I think, I think I’ve always looked to food as comfort. And now it’s getting me, I’ve got to get out of that, looking at food as comfort. To look for other things.” The use of empowering cognitions was illustrated by both Ruth and Elsa:

Ruth:“…you know um I thought no I can do this and with enough time I’ll be ok.” Elsa:“…and try to learn to talk to myself like a friend would talk to me not like my mother would do to me or something you know just try to be more of a friend to myself.”.

Gillian reflects on how her determination for weight loss is more self-focused than before; “and I’m doing this, trying to lose this weight for me, not for anyone else. Just, this is my time and I’m putting myself first, which is something which I, is totally alien to me. I’ve always put other people before meself. But this time I’m putting myself first”. However, she also acknowledges the benefit of support from others and the need to participate in

behavioural changes “I feel more a part of this group than I’ve ever felt a part of any of them that I’ve gone to over the years and I actually, erm, got an award for, erm, losing 10% of me body weight which, after all the years of going to, erm, slimming clubs I’ve never ever got anything like that.” Orla also makes reference to behavioural changes and interpersonal relationships “I would sit at the computer at night and I’d pick at the biscuit tin, I’d pick at a bag of sweets, erm a bag of crisps but then I met my new husband and I don’t do that anymore because I’m not on the computer every night.”

Elsa highlights how, despite improvements in eating and weight she anticipates relapse; “so I feel like I’m on a good run now and I’m feeling positive about the future but I do have that niggling feeling that I might fail again.” This statement acknowledges the difficulty of change but also perhaps the challenge of escaping a lifelong problematic relationship with food.