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Obesity and Mental Health

What if the problem was not that a woman overate? What if a woman overate (and became obese) because she had another problem?

If you remember one thing about people, remember this: There is always a good reason for the things people do. In nearly every case the person believed they were making a good decision. This can be true with overeating as much as it can be about stealing, lying, cheating or anything else you might consider a “bad” thing to do.

I do not deny that overeating hurts your body. But I am all too familiar with the reality that eating can be a great way to mask emotional and mental problems. Eating has the power to temporarily remove negative feelings and hurt. And sometimes, when the hurt is so intense that you can barely function, anything you can do that takes away hurt becomes a good decision.

If you are working with an obese woman, consider the possibility that obesity itself is the way she is trying to solve her problem. Consider that the woman may be struggling with the after effects of abuse, and eating is a way to help her forget.  She may have experienced sexual abuse, and obesity is a way to keep her body safe from unwanted attention.  She may be struggling with depression, and being overweight is more of a side effect than the major problem.  Indeed, obesity and depression often go hand in hand (and yet our cultural images are of happy, jolly overweight people).

In these cases, the advice to just eat less and exercise more are simply not enough. The underlying problem needs to be addressed before the woman is ready to begin changing her eating and exercise habits. You must talk to your clients, you must ask questions that encourage them to share what their problems really are instead of assuming you know. Each client is a unique individual, and to help her have a healthy pregnancy you must be prepared to work on her individual issues.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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