Some Complicated Angles of Weight

Although styles of therapy differ, it is widely accepted that the root of all psychological malfunction is pain. In the animal kingdom, the amoeba is about as simple a creature as can be. And yet, even the humble amoeba knows to avoid pain, and somehow recognizes the appropriate moment to flee from a molecule of poison.

In that respect, people are very much like amoebae, but have more freedom of choice in their reactions. Amoebae probably can’t even fight. Their choice of displacement activity is quite limited.

Now, what about the entities that facilitate the healing of pain? Psychologists, for instance — do they absolutely need to be human?

As we have discussed, one aspect of psychological therapy has developed quite rapidly and noticeably into an overwhelming issue. Can excellent results be achieved with less, or even zero, human interaction? Can human connection be adapted and reconceptualized into something equally curative, by perfecting the ability of Artificial Intellligence to imitate high-quality connection?

It’s not that surprising

One might ask, why shouldn’t this be the case? Look, for instance, at books. They are made from common materials, and from symbols that are very different from human speech or breath. Furthermore, vast numbers of humans have been and still are unable to read books — and yet the influence that books have exerted on many of us (for better or worse) throughout the ages is a true marvel.

An important aspect of convincing relatability is in the bag already. Thanks to technology, AI can be engineered to swindle people out of their life savings by speaking in a voice so relatable that a perfectly sane adult will think it’s their grandkid, in desperate need of bail money. Compared to such an accomplishment, the ability to sound like the world’s most empathic therapist is no big deal.

One thought leads inevitably to another

So, why shouldn’t an equally convincing fake entity succeed in helping a person feel worthy and capable of making enormous life changes and losing 100 pounds? Or, if the human in need of therapy is a child wouldn’t it be theoretically possible to dispose of breath and heartbeat entirely, and let AI help the kids adopt, painlessly, a lifestyle through which they would never become overweight in the first place?

How much actual personal contact between patient and therapist is actually optimal? Can a group of other people with similar problems serve the personal-connection need just as well?

Maybe so. Millions of group therapy participants will attest that to go through the self-discovery experience with a cohort of similarly affected others can be incredibly helpful. For many, it has been vital to associate with others who are on the same basic journey, but a little bit ahead.

As Alcoholics Anonymous and similar groups have demonstrated, we also benefit from hanging out with people who travel a little way behind us so we can take our well-deserved turn as experienced encouragers of others on the same path.

(To be continued…)

Image by dbutlerdidit/Pixabay

So, relax. Eat cake.

Not long ago, we mentioned the experience of Kris, who totally recognized how much her emotional health depended on feeling so massively immovable that she could not be knocked down and rendered helplessly vulnerable. (To state it more theatrically, and sadly, she could absolutely never be “swept off her feet,” either, which was all according to plan).

As we have seen, Richard C. Schwartz and (unrelated) Mark Schwartz spent a decade refining the philosophies and practices of Internal Family Systems, stressing “the importance of working with the eating disordered part of self that encapsulates the trauma of the past.” The materials written for the public explained that, in contrast to other existing treatment facilities, Castlewood helped clients to heal the pain beneath their eating disorders “rather than just manage the symptoms.” They got in touch with their “parts” — the various inner beings known as Exiles, Managers, Firefighters, and other types.

When worlds collide

It seems unfair that even people who grow enough to accept and follow advice will still mess up so badly in choosing which advice to adopt. When taking action, it is also important to do the least possible harm. Listening to the wrong person and/or the lousy advice can be a problem at home, in group therapy, and basically whenever someone sets out to claim agency.

We could say that Kris had an inner advisor who advocated staying massively overweight for the sake of safety. And to all intents and purposes, it worked. But here is the problem. A “part,” be it manager, exile, firefighter, or whatever, could be mistaken in its opinion, and might be a wrong-headed advisor, just like a regular human. Real people and “parts” can all be mistaken, and so might people with degrees and headlines. And so might AI.

Important note: When a counselor helps a patient to identify the decent protective impulses that drive the parts called “firefighter” or “manager,” this is for identification purposes only, and does not imply endorsement or recommendation. To provide meaningful service, the professional really needs to have a handle on what’s what.

Today’s illustration features a slogan that has been seen, with creative variations, many times over the years, but to track and credit the original author would probably be impossible. Our most recent post asked if it is possible to facilitate the healing process without the participation of any actual second human.

And why not?

Well, why shouldn’t this be the case? It has already happened. Look, for instance, at books. They are made from common materials and from symbols that are very different from human speech or breath. Furthermore, vast numbers of humans have been and still are unable to read books — and yet the influence that books have exerted on humanity (for better or worse) is a true marvel.

Now, the real world connection, in-the-flesh, in the same space-time — how much of that is the minimum amount needed; the “necessary but not sufficient condition” that would be required to cause an effect? Is it the same in every case, and if not, then how do we tell the difference and decide how to proceed?

Okay, how about not very much?

One aspect of that psychological challenge has developed quite rapidly and noticeably into an overwhelming issue. Can excellent results be achieved with minimal human interaction, or even none at all? If the ability of AI to imitate high-quality connections could be perfected, then what? Well, first of all, forget all that, because it doesn’t meet the criterion of being human.

But what if AI works anyway? What if it learns to function incredibly well? Then, could human connectivity catch up and be similarly effective? Could human connection be adapted and re-conceptualized into something equally therapeutic?

Some people will always insist that AI is not human: end of story. Likely, there will always be others who insist that, of course, AI is drenched in humanity because people conceived and created it, and trained it on the works of thousands of unpaid creators, and so forth. Most likely, it is too soon to know.

Your responses and feedback are welcome!

Source: “The Therapy That Can Break You,” TheCut.com, 10/30/25
Image by Iffany/Pixabay

How Much Connection?

How often does it happen that a perfectly valid therapeutic approach fails, although there may be nothing wrong with that approach whatsoever? Maybe, for example, an outside force exerts a negative influence on the relationship between a therapist and the person being counseled. Among adults, an insecure partner, especially one who lives with the patient, can sabotage weight-loss efforts with ease.

In a far different setting, on the conceptual level, there may be difficulties, like those that can occur in the implementation of Internal Family Systems (IFS) theory. This modality is said to be designed for patients 18 and older, and may seem to have only a slight connection with childhood obesity — at the moment.

But if our current offspring emerge from their teens still carrying extra weight, the popularity of IFS guarantees that they will run into it sooner or later. It claims to be very successful in dealing with weight-control issues centering around either substance addiction (to food itself), or behavioral addiction (to the process of eating). IFS raises questions that may seem to stray far afield, but which provide glimpses into areas of human psychology that are quite different from jogging for miles, juggling calories, or judging portion sizes.

Human frailty never ends

In the Sixties, group therapy became popular and helped scads of people with various problems. There was a lot less obesity in those days, but for some folks, it was their main difficulty. For them, and many other types of help-seekers, there were side effects.

What if, during every group therapy session, a patient was fantasizing… “I’ll lose so much weight, and at our anniversary parties, I’ll tell the story of how we met because I couldn’t fit into my jeans, but my doctor fell in love with me. And he/she will playfully pinch my bottom, and all our friends will laugh and laugh…”

This is a tempting road to explore, because in the hearts and minds of most psychological counseling participants, to win the approbation of the therapist is golden. It is a powerful drive, and the possibility exists for a patient of any age or sexual orientation to develop very strong, situationally inappropriate feelings toward their therapist.

Another question

How heavy an effect does this need for approval, validation, and love exert in already-established obesity prevention programs? Everyone who enters therapy might not visualize an engagement ring, but plenty of us like to believe that we are the favorite patient, the one whose astonishing improvement makes it all worthwhile, not like those ordinary schlubs our therapist merely tolerates.

How does it tend to work out, for instance, in IFS, where the therapist has a chance to become acquainted with not just one aspect of the help-seeker, but with an entire cast of interior characters, each one of them whispering into the patient’s ear whenever they feel like it?

The future is now

All of this brings up a much bigger and potentially more dreadful problem that gains ground daily. Never mind being the favorite patient. Do we really, really need our psychological maladies to be addressed by a human intelligence or consciousness, at all? Or, for therapy to succeed, can a mere simulacrum do the trick? If we truly require a certain amount of human attachment in this context, how can the most useful amount of it, along with the correct amount of intellectual and emotional content, be achieved and maintained?

A human connection, whether through office visits or online counseling sessions, can affect a patient at any age, though with varying manifestations. In the case of weight-related problems, the relationship involves ideas and emotions about the body, and this additional dimension can be tricky.

What happens when human practitioners are replaced by chat robots and artificial intelligence? How has that method succeeded so far? In light of recent news reports about teenagers persuaded to commit suicide by human-imitating AI programs, the very existence of such an abomination is terrifying. (On the other hand, the issue becomes more complicated when, for instance, we learn that AI counseling may be of great help in preventing suicide among military veterans.)

Two views

Getting back to Internal Family Systems, here are two pertinent quotations from an article by Rachel Corbett, who conveys some of Richard Schwartz’s ideas about how the method that he originated (and developed at Castlewood Treatment Center) “is really the opposite of fragmenting people.” Corbett writes,

Clients come into treatment with their parts already intact — like a bulb of garlic, rather than the layers of an onion, he has said — “It’s not like I’m creating them.” Instead, IFS therapists work on “rounding up all those outlying parts and bringing them back home.”

Corbett views it all from another angle (and more about that is coming up next time). She cautions:

Most of Castlewood’s methods, starting with its use of IFS and the focus on trauma, contradict the prevailing playbook for treating eating disorders. Dredging up harrowing memories can overwhelm already fragile psyches and may lead to self-harm, substance abuse, or other unhealthy coping behaviors.

Your responses and feedback are welcome!

Source: “The Therapy That Can Break You,” The Cut, 10/30/25
Image by ThomasWolter/Pixabay

Listening to Internal Advice

It is worth mentioning here that many people, even in the healing professions, tend to discount emotional pain, as if it were a mere inconvenience or even a whim that someone can simply choose to shrug off. There seems to be a “Just say no to emotional pain” school of thought that tends not to work out well in everyday life. Really, the only people who “get” how crippling emotional pain can be are those whose lives are impoverished by it.

This might be why some practitioners obviously see great value in a basic Internal Family Systems concept, which is:

[D]isordered eating behaviors are not the problem themselves but rather attempts by protective parts to manage deeper emotional pain.

The internal beings called “parts” are also sometimes known as sub-personalities, thoughts, ideas, internal dialogue, feelings, sensations, symptoms, behaviors, defense mechanisms, maladaptive coping strategies, or even spirits.

The crowd

Among the inner multitude, one category of respondent, known as a “manager,” wants to protect the host and might be interested in setting up some rules. Also, those might be counterproductive rules that will wind up creating even more pain in the end. A manager sees a problem and proposes a solution, and strives to make something happen, even if it isn’t the optimal thing. Still, the managerial parts probably tend to have more common sense than those even more proactive parts that leap into the fray — known as “firefighters.”

Firefighters operate under a different set of criteria. They suit up, grab high-pressure hoses, mount ladders, and rush in to try and save the day. Their mission is to stop the immediate threat of psychic violence and destruction, even if it entails physical violence and destruction. Their priority is to end the inner pain, right now. The impulsive firefighters can be like enthusiastic amateurs who mean well, but do a sloppy job. If the only way forward is to tear down the museum-quality ancestral drapes to smother the fire with, a reactive guardian will do it.

Or that over-amped protector might pull some stunt like a spending spree, an unwise date, self-harm, violence, or even suicide. More likely, to terminate the current discomfort, this misguided volunteer might send the person on an eating binge. Sure, that is a variety of self-harm, but it smothers the present, in-your-face pain.

Thanks a lot

A binge is harmful enough, but there are, in fact, other shades and nuances of damage that must be written off as the inevitable consequence of avoiding immediate pain. Conversely, but for the same purpose of escaping today’s pain, tomorrow’s opportunity to heal might be put at risk by purging. If things continue badly, the firefighter’s next suggestion might be to exercise compulsively, or to try some nice numbing opiate.

Of course, all of this activity, however misguided or futile, takes place to protect the Exiles, the “parts” who are like ossified copies of the person at crucial stages when shattering life events took place. They broke off and live like hungry ghosts, unable to reconcile the horrible experiences they went through with a desire to keep on living, and yet unable to give up life as long as the tough old meat body is still hanging in there.

So, why not punish that animated corpse in some way, like the way that is so easily available in almost every society on Earth these days — by piling on the bulk until life becomes undesirable, and is sustainable only at a very high cost in daily pain?

Your responses and feedback are welcome!

Source: “Internal Family Systems and Eating Disorders: A Compassionate Approach to Recovery,” BalancedAwakening.com, undated
Source: “The IFS Model With Eating Disorders: ED is Just a Part of You,” EatingDisorderHope.com, undated
Image by cottonbro studio/Pexels

Parts and More Parts and IFS

Many professionals have explained and elaborated on the theories, called Internal Family Systems (IFS), of Dr. Richard Schwartz. It’s all about the “parts” — or inner beings — that inhabit psychologically troubled people. In what is perhaps a vain attempt to understand why these childhood-obesity-related teachings have caught on in such a big way, we consult yet another explainer, this time, writer Tess Brieva.

Overall, there seems to be a consensus that the various parts all aim to do the same job in different ways. That main task is to help the patient figure out, “Why am I doing this to myself?” Or perhaps, “Why are we doing this to ourselves?” Bottom line is, they all, in their unique ways, struggle to ultimately blend together into a single, healthy being.

One problem is, some of the parts are misguided, and every effort they make to avoid causing pain to the “exile” parts will only cause new problems. A “firefighter,” for instance, being an emergency first responder, might recommend an obvious cure that will distract and comfort the human host quickly, but alas, only temporarily. Brieva writes,

A binge-eating part might believe it’s helping by offering temporary comfort from emotional pain, while a restrictive eating part may believe it’s creating safety through control.

Then — just like small children when Mommy and Daddy fight — the “exile” parts experience even more fear, loneliness, shame, separation, and other negative emotions. Their problems are compounded, and another cycle of attempted compensation begins.

“It’s above my pay grade”

This author characterizes the “manager” parts as proactive, and anxious to avoid such obstacles as, for instance, painful emotions. Sadly, those efforts to dodge suffering only generate more problems, like, for instance, unreasonable rules and unachievable standards. It all gets to be just one big dysfunctional merry-go-round, with every part clueless about how to make the darn thing grind to a halt so everybody can get a grip.

Apparently, the basic goal of Internal Family Systems is to rope all those confused yet earnestly striving inner beings onto the “same page.” Or at least, singing from the same hymnal. Brieva explains what stands in the way of that peaceful resolution:

In eating disorders, managers and firefighters are usually polarized, creating inner conflict and a sense of confusion, turmoil, or stagnation. Protector parts in these extreme roles often lead to yo-yo dieting, restrict-binge cycles, and other unstable patterns.

Nobody wants to live with a bunch of different voices yammering away inside their head, and IFS makes a valiant effort to carve a new path to a better way. As the author explains,

IFS encourages individuals to explore the underlying intentions of their parts and uncover the deeper wounds driving those behaviors. Healing becomes possible when all parts are welcomed, listened to, and guided by the Self toward new ways of being.

Then, she clarifies that listening to and understanding the different internal parts, and their various plans for correcting the situation, does not imply approval. The therapist “does not necessarily condone or support this behavior,” because obviously some of the protective plans made by firefighters and managers are anti-social, self-harming, or otherwise counterproductive.

While the intentions are good, the methods may just cause more trouble, and this is what all the inner parts, it is hoped, will understand, and then figure out more effective methods for their healing process. It’s like a club where some members misbehave, but nobody gets kicked out, because the goal is to convert them into team members, who will then help to bring those other slackers into line.

Your responses and feedback are welcome!

Source: “Internal Family Systems and Eating Disorders: A Compassionate Approach to Recovery,” BalancedAwakening.com, undated
Image by kirill_makes_pics/Pixabay

WHO Releases First Global Guidelines on Weight-Loss Medicines

The World Health Organization (WHO) has issued its first-ever guideline on a new generation of weight-loss medications — a major move that could reshape global obesity treatment as rates continue to climb.

The recommendations center on GLP-1 therapies, a fast-growing class of drugs that includes liraglutide, semaglutide, and tirzepatide. WHO’s new guidance offers conditional recommendations on how these medicines can be used safely and effectively as part of long-term obesity care.

A growing global crisis

Obesity now affects more than one billion people worldwide, contributing to an estimated 3.7 million deaths in 2024. Without stronger action, the WHO warns the number of people living with obesity could double by 2030. This surge poses enormous challenges for healthcare systems and could result in $3 trillion in annual economic losses.

Given WHO’s role as the world’s leading public health authority, the new guideline is expected to influence national policies, insurance decisions, and clinical practices at a time when demand for effective weight-loss treatments is exploding.

WHO Director-General Tedros Adhanom Ghebreyesus commented:

Obesity is a major global health challenge. Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care. While medication alone won’t solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms.

Obesity recognized as a complex and chronic condition

The WHO stresses that obesity is not simply due to poor lifestyle choices. Instead, it is a complex chronic disease shaped by genetics, biological factors, environment, and social conditions.

A recent mindbodygreen article stresses that:

What makes this announcement meaningful isn’t only the endorsement of medication; it’s the explicit recognition embedded within it.

The WHO is formally acknowledging obesity as a chronic, relapsing disease requiring comprehensive, lifelong medical management. Not a character flaw. Not a willpower deficit. A complex metabolic condition deserving the same comprehensive, lifelong care we afford any other chronic illness.

Obesity increases the risk of heart disease, type 2 diabetes, and several cancers, and it can also worsen outcomes for infectious diseases. For many individuals, long-term weight loss is extremely difficult without medical assistance.

GLP-1 therapies help by mimicking a natural hormone that regulates appetite, blood sugar, and digestion. These medications can trigger meaningful weight loss and significant health improvements.

WHO added GLP-1 therapies to its Essential Medicines List in 2025 for high-risk diabetes patients, and the new guideline now recommends long-term use for adults with obesity, except during pregnancy.

However, the guidance remains conditional because of limited long-term safety data, questions around maintaining weight loss after stopping treatment, high cost, and concerns about unequal access across regions.

Medication isn’t enough

A major theme throughout the guideline is that GLP-1 drugs cannot serve as a standalone solution. mindbody green chimes in:

The WHO’s new guidelines recommend these medications for long-term obesity management in adults (excluding pregnant women), but with a critical caveat: they must be combined with what the document calls “intensive behavioural interventions,” structured, ongoing programs involving nutrition counseling, physical activity support, and behavioral health services…

This integrated approach (pharmaceutical intervention plus foundational lifestyle medicine) represents the future of metabolic health. GLP-1 therapies can be powerful catalysts for change, but they work best when layered into a broader foundation of movement, nutrition, sleep, stress management, and community support.

WHO also highlights the broader need for systems-level action. Creating healthier food environments and early intervention programs requires cooperation between governments, healthcare providers, and industry, not just individual effort.

Ensuring access, affordability, and safety

Demand for GLP-1 medicines already far outpaces supply. Even with expanded manufacturing, the WHO estimates fewer than 10% of eligible people will have access by 2030. Without careful planning, this scarcity risks widening existing health inequities. To counter this, the WHO urges governments to consider pooled procurement, fair pricing strategies, and voluntary licensing agreements.

Another emerging issue is the rise of fake or substandard GLP-1 products, driven by global shortages. WHO stresses the importance of regulated supply chains, proper prescribing, and strong oversight to ensure patient safety.

WHO plans to update the recommendations as new research becomes available, and in 2026, the organization will work with global partners to prioritize access for people most at risk.

Your responses and feedback are welcome!

Source: “GLP-1 Medications Just Got WHO’s Backing — Here’s The Part You Can’t Ignore,” mindbodygreen.com, 12/1/25
Source: “WHO backs wider use of weight-loss medicines, calling obesity a chronic disease,” UN.org, 12/1/25
Source: “WHO issues global guideline on the use of GLP-1 medicines in treating obesity,” WHO.int, 12/1/25
Image by Karola G/Pexels

The Problematic Core of Internal Family Systems

Obviously, aspects of Internal Family Systems (IFS) might prove elusive or difficult to grasp. Why are patients with eating disorders said to be exceptionally difficult to treat? Why do so many sources mention the particular suitability of IFS to treat eating disorders? And yet, why do some experts consider it an unsafe form of psychotherapy?

If the popular Internal Family Systems philosophy is quite possibly dangerous, or even simply misguided, inconsequential, or otherwise unworthy of attention, why devote so many words to it? Because it cannot be ignored. The number of adherents and practitioners is startling. This may be because, despite sounding perhaps unlikely, some of the basic notions are either familiar enough to be comfortable with, or unfamiliar enough to be intriguing.

Although the tenets are controversial, they are by no means original. For example, we noted how, several decades ago, the popularity of a particular book was able to dramatically increase public awareness of multiple personality disorder. Once the existence of a new malady is confirmed, the day inevitably comes when the public will “take that ball and run with it,” as the saying goes.

Age of Aquarius

Along came the Sixties, when huge numbers of young (and not-young) Americans tuned in to ancient ideas, and turned on to new ones. Our society has entertained some interesting notions and practices. Although Richard C. Schwartz did not suggest this, a case could even be made that the additional inner beings he posited might originate from previous existences.

Each “part” is like you, because they all are you, and yet each brings to the table its own concerns, talents, and traumas. Over thousands of years, millions of humans have accepted the concept of reincarnation. It would not be difficult to interpret those voices as echoes from one’s own successive physical presences on Earth.

We see how people might be persuaded that each human contains a whole crowd of entities, all with different and important roles. Even if we are unable to prove it with science, most of us have experienced the feeling of not being ourselves, as if another driver had metaphorically taken the wheel and steered us to a bad place. Still, it is a matter for concern that large numbers of professionals have climbed on board with the multiple personality premise, a theory that is, after all, not amenable to proof.

Not uncomfortable yet?

Strong objections have been voiced regarding a corollary of IFS dogma that many experts do not accept, or at least have limited enthusiasm for. This is the idea that most early-life trauma has to do with sex. For decades, that carnal connection was mostly associated with Freud. It is not difficult to see why, even within the professional realm, it might draw negative attention.

As journalist Rachel Corbett discovered, some therapists, reviewers, and patients have embraced (maybe too enthusiastically) the apparently extensive connection between eating/food issues and early sexual trauma. Patients tend to want to please their therapists, and when multiple interior beings are proposed, are perhaps too eager to find those “parts” within themselves.

Especially when the patients or clients are minors, emphasizing this view of things can attract unfavorable attention. Regardless of how severe the problem is, or even how logically obvious it might appear that some type of sexually-oriented trauma could be the root of it, no practicing therapist wants a lawsuit involving an underage individual.

Your responses and feedback are welcome!

Source: “Internal Family Systems and Eating Disorders: A Compassionate Approach to Recovery,” BalancedAwakening.com, 12/01/25
Image by SHVETS production/Pexels