The woman next to me at the birthday lunch paused before digging into a gigantic piece of chocolate cake. “I really shouldn’t be eating this,” she said. “I gained almost twenty pounds over the past three months.” Then she shrugged and said in exasperation, “But what’s another 20 pounds when I have to lose 200?” “I thought of going to your weight-loss clinic,” she added before resuming her eating, “but frankly, what I need is a marriage counselor, not a diet program.”

judithAbigail (not her name) then briefly outlined the stresses that caused her to reach for food continually. Her husband had not earned any money for years and was not interested in looking for a paying job. He wrote books that he self-published and claimed that he was too busy to participate in the logistics of running the house. In addition to holding a full-time job with unpaid overtime, Abigail had to pay bills, do the taxes, clean, cook, shop, and, of course, take care of the children. She sputtered when she told me that her husband even expected her to visit his father who was recovering from a heart attack because he, the son, didn’t have the time.

The husband, who was also considerably overweight, insisted on large, fattening meals along with snacks that he could munch on while he wrote.“So who also eats the snacks? Who eats all the leftovers? You can see them on me: They are all on my hips and stomach, “she said. “It is easier to eat than to fight with him about everything.”

In the interests of self disclosure, I heard only her side of the story. And who knows, maybe her husband’s obesity could also be generated by his own dissatisfaction with his marriage and his life. Nevertheless, I agreed with Abigail that simply going off to a Weight Watcher’s meeting or getting private diet counseling was not going to solve her weight problems. She knew why she was overeating, but felt equally helpless about solving her weight and her marital problems.

Overeating is often the symptom that something is wrong with some aspect of one’s life. Unfortunately, diet advice to bring the overeater back to a normal weight overlooks the causes of the excessive food intake or offers no help in preventing it other than suggesting the use of will power.

Losing weight should not be deferred until the stresses and triggers that caused overeating are identified and removed. Someone like Abigail, who is so overweight as to make her vulnerable to a variety of health problems, should not wait until the problems with her husband, along with her exhaustion, stress and anger are resolved. But, as she said, she needed a marriage counselor (or life coach or psychologist) as much as a diet plan to be successful in losing weight.

One of the benefits of a slow weight-loss program is to allow enough time, perhaps a year or more, to work on the problems that caused the overeating. Abigail’s problems were complex, and she needed to look at her restrictions and priorities anew, so that she felt entitled to eat food that allowed her to lose weight and take time to exercise. But how could Abigail shift her palate to better nutritional choices? Could she do this within the confines of her marriage? She needed professional guidance, and not a diet counselor, to help her answer that question. But I convinced her that as long as she stopped gaining weight and started to lose, albeit slowly, she would have the time to work out the answers. And perhaps as she lost weight, she would gain a happier life.