By the time people come to see me, a weight-loss doc, they have already tried everything. Keto, intermittent fasting, paleo, low-cal, low-carb, the Blood Type Diet, South Beach, and many, many more. They have tried commercial weight-loss programs like Weight Watchers, Lindora, Nutrisystem, and Jenny Craig to name a few. They have downloaded apps and counted calories, weighed their food on miniature scales, and measured them in serving cups and spoons or just with the palm of their hand. They have consumed pink-flavored protein shakes and portion-controlled bags of high-protein peanut butter and cheddar snacks. They have hired trainers and signed up at gyms, and some even recall bouncing up and down in pink leotards and leg warmers to the voice of Richard Simmons from their very own living room. I just barely missed that boat myself. Many have skeptically yet expectantly tried over-the-counter fat blockers and metabolism boosters, with the hopes that maybe these tablets might be the long-sought-after answer to their weight-loss woes. Some have tried shots, others have been prescribed pills, and still others have had bands and balloons placed around or inside their stomachs or have had their stomachs partially removed for weight loss. 

Regardless, those who make it into my office, usually, are not newbies, and they come asking one question: “What is finally going to work?” 

We are hungry, in fact we are starving, for belonging, connection, self-love, self-acceptance, patience, approval, presence, equanimity, and autonomy.

Dr. Adrienne Youdim

For years I felt pressure to answer that question in an eloquent soundbite. I was the doctor after all. I felt the pressure to satisfy timelines, to make assurances and guarantees even though my intuition told me otherwise. I felt responsible to rectify the years of diets, pills, and supplements that had failed them by prescribing other diets and pills and supplements as well. I am all for tools that can help my patients in this journey, and despite a deluge of weight-loss gimmicks, there are evidence-based tools and strategies that are effective in helping people achieve weight loss, many of which I prescribe. 

But as my patients often lament, these tools, on their own, do not work. 

Nothing works.

Because tools cannot take the place of process. Tools cannot replace the painstaking work, time, practice, patience, perseverance, resilience, deliberation, intention, understanding, self-compassion, and self-awareness necessary to engage and persist in this effort. Tools cannot restore our sense of self, nor can they restore balance to our lives. Tools cannot replace the deep reckoning that uncovers our true hunger

We are hungry, in fact we are starving, for belonging, connection, self-love, self-acceptance, patience, approval, presence, equanimity, and autonomy, among so many other hungers, as the following stories will describe. While the flavor may be different, the sentiment is not. We are all hungry to live fulfilled, contented, wholehearted lives. We experience our emotional hunger viscerally, like a gnawing sensation in our gut. Something akin to physiologic hunger. But it is not food we hunger for. Perhaps this is most keenly described by Dr. Edith Eger, author, psychotherapist, and Auschwitz survivor: 

We are hungry. We are hungry for approval. We are hungry for attention, for affection, we are hungry for the freedom to embrace life and really know and be our true self. 

Disconnection from that which we yearn for leaves a hunger that longs to be filled. That gnawing hungerwhen left unattended, is filled by busyness, work, alcohol, drugs, and mindless engagement with technology, and, not surprisingly, it is filled with food. When used in this way, food deceives us into temporary comfort, even elation. Food triggers the hedonistic or pleasure center of our brain. In fact, food triggers the same receptors in the frontal lobe of the brain that are triggered by narcotics, alcohol, and nicotine. The result is a feeling of euphoria, pleasure, and comfort. Momentarily. But as it is transient, food leaves us wanting, urging us to engage again and again against our best judgement, against our bodies’ knowing, to eat above and beyond what is necessary, resulting in self-harm and disease. Food is a simple comfort. It is easy, it is accessible, and it does not carry the negative stigma of drugs or excessive alcohol use. Food provides relief, albeit temporary, from difficult feelings, emotions, and emptiness. And, therefore, food is a common go-to to self-soothe. 

We are primed from birth to have positive associations with food, and the co-mingling of food and love is literally hardwired in our physiology as oxytocin, the hormone responsible for the release of milk from the mother’s breast, also fosters feelings of love and connection between mother and child. The dual role of oxytocin to provide nourishment and secure attachment solidifies the connection between food and love, food and comfort. Our social constructs also solidify this interconnection. Consider Grandma’s warm chicken soup, a neighbor’s fresh chocolate chip cookie, or Mom’s special mac and cheese casserole. In these ways, food signifies love and family. Our rituals and traditions also revolve around food, and the communal meals at these occasions are an important way in which we experience our togetherness. Some of my fondest memories growing up are of experiencing togetherness around the table whether we were gathering for our nightly dinner or to a special meal, like Shabbat, Sunday brunches, or Thanksgiving. In all these occasions, food, family, and community were deeply interconnected. The sanctity of sharing a meal is deeply ingrained in so many of our traditions; it is no wonder that food comforts and soothes us. 

But of course, food has a very practical function. Food is essential to life. It is substantive. And when abused, it is destructive. The right foods will support our bodies and our health while the wrong foods or too much food will make us feel sick, foggy, and bloated and will cause disease over the long run. Thus, food has a unique positioning. Food is sustenance and comfort. Food has the potential to improve our health and the potential for harm. As such, food forces us to reckon with duality and encourages us to achieve balance in how we eat and perhaps, too, in how we live. Considering this, food can be viewed as a paradigm for how we nourish ourselves more broadly. 

We are hungry. We are hungry for approval. We are hungry for attention, for affection, we are hungry for the freedom to embrace life and really know and be our true self. 

Dr. Edith Eger, author, psychotherapist, and Auschwitz survivor

In the many years of doing this work, I have come to understand that the desire to lose weight is a plea for something deeper, a yearning for a different way of living, a different way of being. Hunger, then, is the perfect word to describe this yearning, and food the perfect microcosm of our struggle. Our relationship with food is symbolic of deeper contemplations and of our relationship with ourselves. How do we care for ourselves? Are we worthy of the time and attention required for that care? What boundaries are necessary to support those healthy relationships? What true longing is our desire for food signaling? What do we seek to control, and what might we need to relinquish in order to achieve peace? Where have we abdicated our power, and how can we reclaim it? Is there a path for healing rather than numbing? And if not for food, then what are we really hungry for? Our reckoning with food can be a way of opening to these significant questions. And change in our relationship with food can be a spark for broader change, creating a rippling effect to other areas of our lives. This, for me, is the greatest beauty in this work. 

Learn more about Dr. Youdim’s book, Stories and Science to Inspire Weight Loss from the Inside Out.

Avatar of Dr. Adrienne Youdim

Adrienne Youdim, MD, FAC is an internist who specializes in medical weight loss and nutrition, and is author of Hungry for More: Stories and Science to Inspire Weight Loss from the Inside Out. Dr. Youdim served as the Medical Director of the Cedars-Sinai Weight Loss Center, then brought her passion and expertise to her own private practice in Beverly Hills, California. She currently holds positions as Associate Professor of medicine at UCLA David Geffen School of Medicine and Clinical Associate Professor of Medicine at Cedars-Sinai Medical Center.

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