Changing your emotional responses, and the unwanted eating behavior that flows from them, requires slowing down, listening to your thinking, evaluating your reactions, and altering them. That's why you must learn to put your mind into slow motion like a videotape. I know this sounds like a tall order, but let me assure you that it will be one of the easiest and most effective ways to manage your emotional life. If you have open emotional wounds, then you will "feed the need." Food can be a great comforter and can create weight that is a great excuse to drop out of all or part of your life.

Sandra, a former patient of mine, was a clear example. At 5'2" and 195 pounds, she professed to be desperate to lose weight. Consciously, she hated her appearance and feared for her life, knowing she was at high risk for a heart attack or stroke. Yet despite repeated attempts at dieting, she would put the weight back on every time she got close to her goal. It was clear to me that Sandra was getting some kind of payoff for this self-sabotage. Somehow, someway, she unconsciously felt uncomfortable giving up her obesity. I began to dig deep, and it didn't take long to solve the mystery.

Starting at age 10, Sandra had begun to show signs of becoming a young woman—changes that did not go unnoticed by a sick and depraved uncle who molested her. The violation continued for years, and these were years marked by the shame and guilt of a confused little girl. Blaming herself and her body, Sandra discovered that as she inadvertently put on weight, the unwanted attention seemed to lessen. As she became more obese and her sexual characteristics were, in a sense, camouflaged, a feeling of safety came upon her.

From the October 2003 issue of O, The Oprah Magazine