Implications of Attachment Theory and Neuroscience for the Psychotherapeutic Treatment of Obesity and Overeating

This article examines psychological sequelae underlying dysregulated eating in the overweight and obese patient and proposes a psychotherapy approach informed by classical and modern attachment theory, developmental trauma, and neuroscience to address these structural deficits.

This article offers a new approach to the psychotherapeutic treatment of patients who are chronically overweight, show signs and symptoms of dysregulated eating, and are refractory to usual weight-loss interventions. Clinical observations garnered from psychotherapy and supported by research in the interrelated domains of infant development, attachment theory, and neuroscience suggest that these patients experience the sequelae of early attachment insecurity, which results in a compromised self-regulatory system, including dysregulated eating. This article examines difficulties in self-regulation, with a particular focus on overweight or obese patients with dysregulated eating behaviors and their associated underlying psychological sequelae and proposes how a psychotherapy approach informed by classical and modern attachment theory and neuroscience can effectively address these structural deficits.