Letters to the Editor
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food used as comfort
As with other types of substance abuse which also predictably lead to illness and early death, a very high fraction of dieters will relapse, and they will gain back much or all of the weight lost.
Relapse occurs because the underlying psychological distress and inability to self-regulate negative impulses are rarely successfully addressed. Part of successful substance abuse treatment can be identification of and coping with cues or “triggers”: the odor from a bong or buttered popcorn; the sight of a Big Mac or a syringe; and especially the social pressure to use exerted by other users, whether around a holiday table or a keg.
But even if all of the external cues, like those discussed in the interview, could be eliminated or managed (and with food this is practically impossible), what remain are the internal triggers – those feelings of worry, fear, emptiness, rejection, loneliness, inadequacy, etc. – that lead the user to reach for food (or other substance) for comfort, to manage the negative feelings. Until some level of insight and self-regulation of these feelings is gained, risk of relapse will remain high.