In the UK and the USA, obesity has been labeled as an epidemic. (FAI 2014). Obesity is defined as carrying too much body fat for your height and gender, to the extent that it poses a risk to health. (Chrysalis 2010). People who have tried different ways to lose weight and find none “work”, will seek that “ultimate” solution. With many addictions, the resolving factor is to eliminate them from a person’s day to day living, those being alcohol, drugs etc. (FAI 2014). Food isn’t something that can be eliminated. It would be more effective that a change would need to be considered and an assessment of what the underlying issues are in order for the eating habit to be changed. (Hadley and Straudacher 1996). While the subconscious isn’t a simple power, it is only through permanent changes in this part of your mind that you will experience permanent changes in your life – changes that come automatically and are not painful (Hadley and Straudacher 1996). This would in turn lead to a better life or weight loss in order to maintain a healthy weight and lifestyle. In view of this, this essay will assess Miss E’s issues as presented in the case study. I will describe a treatment plan with an attached initial screed and any ethical issues that may arise.

Hypnotherapy is a popular therapy for weight loss. (Chrysalis 2010). Clients may have tried techniques and diets. As an ethical therapist, you wouldn’t jump to any conclusions about the clients weight but obtain information, to build rapport. The client may initially be looking to lose weight but may be masking deeper issues. I would offer a free initial consultation with decisions from both parties being made about suitability. As an ethical and responsible therapist, I would ask questions about background asking to complete an initial consultation form including medical history, medication and personal details. I would ask about their understanding of hypnosis and any previous experience ascertaining any ethical reasons why I may not treat Miss E, including any form of psychosis or contraindicated medications. If this were the case, I would refer Miss E to a qualified professional. Confidentiality will be held at all times. I would find out reasons for wanting to lose weight. It wouldn’t be in my remit to act as a nutritionist if I was not qualified to do so. (Chrysalis 2010). I would need to refer the client on if, after questioning, I felt the client needed more appropriate guidance.

Weight loss hypnosis is used in aiding to alter lifestyle to a healthier one instead of their previous more detrimental ways (Chrysalis 2010). I would ask what the client's goals are. Miss E wishes to lose 2 ½ stone and hopes to have lost this in three months. I would need to identify whether the time-frame is realistic and achievable. According to the UK NHS website, it is realistic to lose at a safe and sustainable rate of 0.5kg to 1kg (1lb to 2lbs) a week.(NHS 2014) For most men, consuming no more than 1,900kcal a day, and for most women, 1,400kcal. In terms of Miss E’s goal weight loss, this would mean longer than what she had set as her target. This would be addressed to eliminate false expectations towards the effects of hypnotherapy. We would readjust the goals, setting realistic and achievable goals that will not leave her feeling unsuccessful. I would find out a detailed history about her relationship with food and dieting using different questioning techniques – paraphrasing, reflecting, clarifying and summarising. It has been pointed out that Miss E has struggled with her weight, dieting and putting the weight back on.

The next step would be to discuss her motivation for losing weight. I would ask on a scale of 0 to 10 to lose the weight, where 10 is very motivated and 0 isn’t at all motivated. 8 and 10 will generally be more successful in their weight loss through hypnotherapy. A score lower than 8 will need to be investigated further to find out why they are attending the sessions and whether or not you can heighten their motivation, otherwise the hypnotherapy is likely to unsuccessful. (Chrysalis 2010) If a client is attending hypnotherapy because of someone else's desires, then there is a likelihood it will be unsuccessful. The techniques used require personal motivation. Miss E may be lacking in motivation from the many previous failures in weight loss from dieting that she has mentioned. “She has tried many diets” (Chrysalis 2010). I would say that her motivation is more for herself this time – “she is now ready” (Chrysalis2010). It would be important to discuss that diets vary, but most are based on the same themes (NHS 2014). I would reinforce that diets often use techniques relying on willpower or food supplements which generally work short term as they are hard to sustain, often leading to returning to old eating habits. If they go back, they will be putting the same emphasis onto eating as they did before and it will cause them to behave in the same way as they did before (Stewart and Joines 1987). Hypnosis isn’t based on deprivation, it focuses on changing the programmes currently used by the subconscious. As a therapist, you would also need to enquire into whether or not the client has previously used hypnotherapy to aid in weight loss as this may hinder them going forward because the client will have already built up the idea that it may not work again, which automatically puts a barrier between themselves and the therapist (Heap and Dryden 1991).

I would give Miss E a booklet/leaflet about weight loss obtained from a reliable nutritionist/NHS encouraging healthy eating. It would be important to reiterate that dieting is always considered temporary in our minds (NHS 2014) whereas a healthy eating habit should become part of our lives, making informed choices and recognising when we are hungry. Being mindful of what we are eating taps into our subconscious mind creating new habits (Greenberger and Padesky 1995), describing the health risks of being overweight and the benefit of loosing weight.

I would discuss different reasons why people overeat asking which one(s) she identifies with and why? Eating to lessen unpleasant experiences. This is something we learn from an early age, such as getting something sweet from a parent when we are in pain. In later life we may be taken for meals out to cheer us up or be brought 'comfort' food such as chocolate and ice-cream after a break up (Chrysalis, 2010). Eating to get attention and gain authority. Larger people may feel more important and command attention, though not always positively. They may be making a point of telling people how much they are eating at a party, gaining negative attention in replacement of the harder to achieve positive attention. People may also overeat for reward and entertainment, receiving a treat food for completing chores as a child, or giving and receiving chocolates and wine on special occasions later in life. In today’s society treats are more common in households and not necessarily for special occasions and creating habits. People can also use food for fear, overeating on unhealthy foods to help deal with their fear. Lastly, replacing love with food, seeing food as a secure friend. As a baby, we receive closeness from the person feeding us as they hold us. (Chrysalis 2010) The need to recreate this feeling may cause overeating. (Hadley and Staudacher 1996).

I would ask leading questions linking discussions around body image and how this is linked to self esteem. Ascertaining whether Miss E has any self esteem issues – after being in a controlling relationship. This would help when putting together screeds. Hypnosis is about identifying and accepting the programmes that the client’s subconscious is accepting and deciding to change them. (Chrysalis 2010) Hypnotherapy for weight loss involves looking at where the programmes came from, for the client to understand their situation and stop blaming themselves. There are a number of main causes for overeating. They are eating to lessen unpleasant experiences, eating to get attention and gain authority, eating for reward and entertainment, food for fear or food replacing love. (Chrysalis 2010)

I believe Miss E would identify with using food to replace love as the case study states around the ages of 12 and 13, her parents “badgered her about being unattractive and eating too much” implying that they didn't show much affection towards her using food to make her feel better about herself. She may also identify with food for fear, fearing losing weight because of all of the attention it may bring. As she isn’t used to the positive attention, fearing how she will react to it or how it may lead to continued rejection from previous experiences being “very controlling” “badgered about being unattractive” fearing new relationships. At this point she is saying that she is “ready to look for another partner but is scared”. The missmatch of comments may be due to a fear (Mind over Matter (Greenberger and Padesky 1995) Therefore she might be overeating so that she doesn't feel attractive to people, not attracting another controlling partner reinforcing her parents telling her perhaps not to overeat because she would be unattractive and instead of her hearing “would become”, she has taken it as being unattractive leading her to the line of the self-fulfilling prophecy laid out by her parents, which was only their opinion. By having a controlling partner, Miss E has developed an unrealistic thought process about herself. More about her perception of what they think which has developed the lack of self esteem that she is “unattractive”. (Hadley and Staudacher 1996). I believe that she may have some unresolved issues from this time in her childhood which hypnogtherapy can help her.

We would look into the times and situations where she overeats. At this point the therapist may find that they begin to identifying any hidden agendas that the client may have for overeating. This may begin to uncover a more serious problem that didn’t arise during the initial consultation meaning ethically it is important that these are addressed before continuing and referring Miss E on if necessary. From this case study, I believe that Miss E has a form of hidden agenda that she is sustaining by over-eating - low self-esteem, caused in part by her parents words when she was younger along with her controlling ex-partner. Part of this low self-esteem is over-eating so that she isn't attractive to potential new partners protecting her from being hurt - avoiding going through break-ups.

Moving forward with hypnotherapy, I would need to look at her personality, looking at her modalities. It is important to build up a good rapport for designing induction screeds and determining what therapeutic approach could be used, direct/indirect, authoritative/permissive. Understanding her belief system, history of relationships with previous partners. By recalling memories of childhood, could be used to recreate and reinterpret rational and positive meanings to reprogram underlying issues. It is important not to emphasise or reinforce any negative feelings about being overweight, but engaging in normalising them and reframing her mind to be confident, to imagine herself with a slimmer figure, to replace the habit of comfort food to healthier options when she felt lonely or stressed. It may be beneficial to use metaphors, analogies, imageries about the benefit of eating less. With the use of positive affirmations it would reinforce her taking back her power. Anchoring positive resources and rehearsing them to future situations. Focus on changing habits, creating a healthier lifestyle, leading to continued weight loss, on holiday and continuing afterwards. It will be beneficial to incorporate new behaviour e.g. taking up exercise, an appropriate eating plan etc. I will raise her awareness in a positive light and help her at her most vulnerable times. Looking at times where, when and why she overeats and what feelings or places trigger her to eat more, because she might be doing so as driven by subconscious that is unaware to self. (Chrysalis 2010) I would then encourage her to change these danger points by replacing them with healthy new behaviours using therapeutic suggestions. I would encourage the use of a food diary, helping her to take control, recognising that her success is due to her efforts, reinforcing change (Greenberger and Padesky 1995), a healthy relationship with food.

I will create an induction and deepener. I will place her in a special place to building self-esteem and to indirectly ingrain the suggestion of the transition and transformation into the subconscious by carefully wording the script. Suggest new ways of thinking through visualisations, reprogramming the subconscious suggesting that healthy foods become more desirable. It will be the process of replacing the satisfaction food gives to her with something that gives as much emotional satisfaction in return. I will encourage change through direct and indirect suggestions, visualising the body she wants, imagining feelings towards her new look and health, imagining how confident she will feel. These visualisations are designed to empower her, taking control of her choices. I will include strengthening of self esteem and reinforce with affirmations. Getting feedback after each session will enable me to adjust specific aspects to achieve the best result going forward. The treatment plan will be 4 to 6 sessions.

It can be concluded that Miss E was seeking help to loose weight but was also suffering from deeper issue which included low self esteem and confidence which were resultant from her parents and ex-partner’s behaviour towards her. By redefining a realistic goal and by using suggestions I am confident that I could help Miss E to achieve her goals. I believe that hypnotherapy would be appropriate to her, it would be perfectly acceptable as an ethical therapist, to advise Miss E to consult a nutritionist and eventually a personal trainer, as well as a counsellor alongside her hypnotherapy treatment.