This thesis presents understandings of binge-eating disorder (BED) and weight in the context of a
multimethod study of a two-phased treatment for patients with BED at Stolpegaard Psychotherapy Center
(SCP) from 2013 to 2018. My ambition was to generate new understandings of BED and engage critically
with the question of what constitutes problems and solutions in the BED field. I did this by taking a social
constructionist perspective.
The BED treatment at SPC was group psychotherapy targeting BED followed by either a Weight
Loss group or a Wellbeing group which conveniently represented a weight-centered health paradigm
and a health-centered paradigm. While obesity is not part of the BED diagnosis, a large majority of
people with BED develop obesity, and weight loss is regarded a necessary focus in treatment for health
reasons. Weight is also a huge focus in society at large and is a great concern in the Danish health care
system. And so, weight also came to play a central role in this thesis.
Responding to what I found was an individualization of BED and a compartmentalization of
knowledge productions into ‘psychiatric’ and ‘medical’, I chose to take a dialogical and systemic
perspective. The findings presented in this thesis come from qualitative data generated through semistructured interviews and participant observations and quantitative data collected though questionnaires
and diagnostic interviews.
The issue of weight is infused with norms and values that move it beyond mere physicality.
Looking into obesity research, I was surprised to find that researchers had long established that 1) weight
loss is achievable short-term but close to impossible to uphold long-term, and 2) weight is not a clear
measure of health. I had not come across this knowledge as a psychologist or citizen, and it was not
something the media or public health officials communicated. Looking at BED studies, I was equally
surprised to find that these limitations had not influenced how weight was approached in BED;
researchers and clinicians continued to try to develop interventions that could reduce weight.
In this thesis, I explore BED and weight as interrelated phenomena that are deeply rooted in social
and relational contexts. I present the analytical concept of a relational weight problem and demonstrate
processes of change in treatment that involve acceptance, a critical awareness of discourses and a feeling
of connectedness. The thesis invites discussions about how problems and solutions in the BED field can
be described and measured in a way that involves contexts and interactions between people. The findings
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raise critical questions about a weight focus in society and in the treatment of BED. The analysis of BED
and weight as relational phenomena is an original contribution to the BED literature.