Dialectical Behavior Therapy Skills and Behavioral Weight Loss for Emotional Eating and Obesity: A Case Study

Live FREE is a 16-week group intervention for adults with emotional eating and obesity that combines Dialectical Behavior Therapy skills (sessions 1–9) with standard behavioral weight loss strategies (sessions 10–16). Traditionally, behavioral weight management programs yield inconsistent outcomes, particularly for emotional eaters. Live FREE is predicated on the premise that improved emotion regulation will facilitate greater success in adopting weight management techniques among emotional eaters. Outcomes are presented with a case study of Amy, a woman who completed Live FREE. Amy reported a history of unsuccessful weight loss attempts, and she initially presented as timid, with limited awareness of her emotions. During the Dialectical Behavior Therapy portion of treatment, Amy learned to identify emotional eating triggers (e.g., feeling inadequate and anxious) and useful strategies for effectively responding to emotions (e.g., nonjudgmental awareness and checking the facts). Subsequently, during the weight loss sessions, Amy’s use of emotion regulation skills expanded as she encountered and overcame barriers to implementing conventional weight loss techniques. Post-treatment assessment results indicated that Amy’s emotional eating decreased from baseline to post-treatment, and was maintained at follow-up. Furthermore, her weight slightly decreased toward the end of the treatment (during the behavioral weight loss sessions), and she continued to lose additional weight over the 6-month follow-up. Adults seeking weight loss who also struggle with emotional eating may benefit from initially decreasing emotional eating behavior prior to focusing on weight loss.