Trauma Informed Care Can Play An Important Role In Weight Management Counselling
It is so important to have a space, a place and a time where you can share your story. And, when you share it, you are given the care, respect and space you need to feel safe. Safe from harm, safe to be heard and safe to ask for help.
When I talk about obesity here I am not talking about being over weight or about someone who would like to lose a few kilos.
Obesity is a highly complex, chronic and relapsing disease with many interconnected causes.
Some interconnected causes can include, but are in no way limited to, a history of trauma, or intergenerational trauma.
It is the role of trauma that I would like to talk about.If you experienced trauma in your formative years you may have been left with many hidden and some not so hidden scars.
I am not saying any of the experiences below are a cause of obesity but sometimes they can add to the layers of complexity and distress when living with obesity. This is for many reasons. Chronic ongoing stress can sometimes cause cortisol levels to be chronically elevated. This in turn creates a cascade of changes to our bodies.It can cause increased inflammation, a stimulation of appetite in the centre of the brain, an increase in the hunger hormone ghrelin, it can alter gut bacteria, the type that can promote obesity, it can slow energy expenditure and can promote reward driven (hedonic) overeating, and it can promote visceral fat accumulation which is the metabolically dangerous fat around our belly and organs.
Food and eating can also be used as a way of self-soothing, and to regulate moods, which subsequently can lead to over eating, often of very highly processed sugary foods fatty foods. For some people food has a numbing effect so they eat to excess to avoid feeling sad or other distressing feelings, and for others it might serve to fill a void deep within.
Just like any chronic complex health condition, obesity needs careful and ongoing interdisciplinary care. This might be any combination of counselling, medication, or surgery along with dietary and exercise guidelines.
It is for some of the reasons below, why attending to a person's inner psyche, their pain, or their trauma might be important when discussing their weight struggles.
They might have been raised in a physically or emotionally abusive family
They may have suffered childhood sexual assault and abuse
They may have suffered massive grief and loss as a little one
They may be part of the stolen generation
They may have been displaced from their land
They may have escaped a war torn country
They may have suffered, or are suffering from domestic violence
They may be a survivor of sexual assault
They may have had an unwell parent and were their caregiver from a young age
They may have watched a loved one suffer from a debilitating physical or psychiatric condition, or are caring for someone now
They may have grown up in extreme poverty
They may have suffered childhood abuse
They may have suffered from childhood abuse that was not overt, like neglect
They may have had undiagnosed ADHD or autism and had sensory or food processing troubles that were dismissed as t being difficult or impulsive
They may have suffered from a serious childhood illness like cancer
They may have had troubles with rapid weight gain, hirsutism, acne, fertility problems, receding hair loss but nobody took them seriously and it wasn't till much later in life that they received a diagnosis of PCOS
They might suffer from anxiety and or depression so crippling that they need to be on medication, but this medication interferes with their weight
They may have grown up feeling like an outsider and didn't feel like they belonged at school and food was a form of solace
They may have been bullied at school
They have had a serious accident and are no longer able to be mobile
They may have an eating disorder or disordered eating
They may have insulin resistance, a metabolic syndrome, a thyroid problem but has not been diagnosed or recognised as causing significant weight challenges
They may have trouble sleeping, ie insomnia or sleep apnoea
They may have an autoimmune illness, which impacts their daily life
They may have fertility struggles
They may have ante or post natal depression
They may be or are peri or menopausal
They may have suffered or are suffering trauma due to the covid pandemic
The experiences mentioned above might not be a contributing factor for people living with obesity, nor might they be a reason why weight loss is hard, as many people suffer immense trauma and do not have weight concerns.
However, it is remiss to not factor in the possible history of trauma when speaking with people who are looking for some help to manage their obesity.
This is extremely important especially since the shame and stigma that people experience on a daily basis about their weight is deeply traumatic in itself.
This is why it is so important to have a space, a place and a time where you can share your story when you seek help for weight management. And, when you share it, you are given the care, respect and space you need to feel safe. Safe from harm, safe to be heard and safe to ask for help.
After what has been a very tumultuous few years with a lot of collective trauma and losses, I send you all my very best wishes and I look forward to sharing news, thoughts, updates and reflections in 2022.
Ginette Lenham © December 2021
If the content above raises any discomfort or worries and you need to speak with someone after hours here are some contact numbers to keep on hand.
Lifeline on 13 11 14
Kids Helpline on 1800 551 800
MensLine Australia on 1300 789 978
Suicide Call Back Service on 1300 659 467
Beyond Blue on 1300 22 46 36
Headspace on 1800 650 890
QLife on 1800 184 527