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Clinical Case Studies
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Implications of Emotional Eating Beliefs and Reactance to Dietary Advice for the Treatment of Emotional Eating and Outcome Following Roux-en-Y Gastric Bypass

A Case Report

Betty E. Chesler

Eating Disorders Private Practice, Pittsburgh, PA, bettyechesler{at}comcast.net

Bernadette G. Harris

University of Pittsburgh, PA

Pamela H. Oestreicher

ONSEdge, Oncology Nursing Society, Pittsburgh, PA

This case describes cognitive—behavioral treatment for emotional eating, preceding and following Roux-en-Y gastric bypass, which is associated with 84.52% excess BMI (body mass index) loss 53 months after surgery. It explores the relevance of emotional eating beliefs (EEB; that is, equating food with both alleviation of negative feelings and friendship) and reactance to dietary advice (RDA; that is, rebelling against prescribed nutrition) for the deliberate use of food to feel both better and befriended. EEB and RDA motivate and justify, respectively, the conscious consumption of rich or "forbidden" foods. Simultaneous treatment of EEB and RDA is associated with the utilization of rational thinking and problem solving to cope with emotional discomfort. Remediation of equations of food with friendship engenders amelioration of distress through spousal support. Unrecognized emotional distress fueling reflexive eating and accompanying external eating are found. External eating is decreased coincident with therapy for emotional eating. Implications are discussed.

Key Words: emotional eating beliefs • reactance to dietary advice • Roux-en-Y gastric bypass • emotional eating

Clinical Case Studies, Vol. 8, No. 4, 277-295 (2009)
DOI: 10.1177/1534650109341075
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