John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442

Treatment of Overeating

RRP Overeating Trial Study by Dr. Tkach

RRP is a new form of psychotherapy that is gentle, non-threatening, and effective. RRP offers you hope for relief from overeating.

RRP is symptom oriented. It runs on feelings. Buried within the symptom itself is the path to its own resolution. What I do is to guide you gently to uncover and resolve troublesome conflicts that arose at past critical events. It was at that point that a part of you lost your smile. You will know RRP worked when you get your smile back.

Your experience with RRP is likely to be wonderful, profound and very beneficial. I videotape the sessions for Dr. Barnett to give me supervision. These videotapes are confidential.

1. Overeating Causes Overweight

How can I condense hundred of pages of scientific information down to a few paragraphs? I can't. Let's consider these highlights.

For thousands of years, people have struggled to get enough food to stay alive. Overeating (overweight/obesity) is a major health problem in the USA and in many other countries. Now 1/3 of Americans are overweight and another 1/3 are frankly obese. This leads to many health problems such as type 2 diabetes, cardiovascular diseases, asthma, some cancers and on and on including depression, a shorter lifespan, and decreased quality of life. The average obese person costs society $7,000 a year. Obesity contributes to 160,000 excess deaths a year in the USA.

The cause of overweight and obesity is simple. We eat more calories than we burn. We overeat. The doctor says, "You need to lose weight." Well, he/she is right. But how do you do that? Ask your doctor. Usually, you are told to eat the right foods in the right amount in a balanced diet, to exercise, and to get more sleep. To help you, there are thousands of food choices, diet plans, and exercise routines. But there is no alternative to eating.

Simple? Consider this. Extensive studies and meta-analyses of studies have shown that the failure rate of diets is about 95-97%. That's for idealized weight loss maintained for 3 years. If we lower expectations to 1 year of 5% weight loss, the success rate is 20%.

In other words, diets do work, but just for a short time. Then people crave food and put the weight back on plus more. That leads to Yo-Yo dieting: put on, take it off, over and over.

2. Why do diets fail?

The basic cause of overeating is emotional. There are some technical twists related to thyroid function, genetics, and illnesses in certain parts of the brain. But for the most part, overeating is emotional.

People may use food for comfort. To say a person obtains comfort from food implies there is something that person is uncomfortable about. Diets and exercise and pills ignore the emotional component. That's why they fail. What are we uncomfortable about?

Watch out for the "balanced diet." There is no such thing. The idea of a balanced diet goes back to Aristotle based on the four elements earth, fire, water, and air. Some may tell you that you need to balance and control the relative amounts you eat of carbohydrates, proteins, and fats; that is, eat them in certain ratios. Consider this.

A study of 800 overweight and obese patients looked at the results of eating foods in those categories in various ratios (FM Sacks et al, NEJM 2009; 360:859). Which ratio was followed had no effect on weight loss or satisfaction. However, sticking to some reduced-calorie-intake diet and exercising 90 minutes a week generally helped people to lose weight.

3. Patterns and Trends: The hunger that food does not satisfy.

In our work, Dr. Barnett and I have observed that many overeaters exhibit these patterns:

  1. They do not know why they overeat, but they do.
  2. They cannot control the urge to overeat.
  3. They hate the way that they overeat, and they hate being overweight/obese.
  4. Overeating comforts them. (Comment: this is the origin of the term "comfort foods.")
  5. They may eat several times more than is needed for nutrition. And yet, eating these tremendous quantities does not satisfy their hunger. What kind of hunger is not satisfied by food? I think it is emotional.
  6. There is a past history of emotional trauma.

4. Bariatric surgery is becoming the most common surgery done in the USA

Bariatric surgery is a variety of operations done to control obesity. Oversimplifying a moment, there are three basic kinds of bariatric surgery that will force you to eat less. Some surgery may restrict the amount of food you can eat. Some may decrease your ability to absorb the food you eat. Some combine both. Some bariatric surgeries are extreme and irreversible. All have risks.

Unlike dieting with a 3-5% success rate, bariatric surgery may have 50%-70% success rates. Some people figure out ways to go back to overeating in spite of surgery. They eat around the surgery, and that causes the surgery to fail. In my opinion, that is due to emotional reasons. RRP is nicely compatible with bariatric surgery. However, consider RRP before having surgery.

5. Body Mass Index: are you overweight/obese?

The chart below lists your weight on the top line and your height on the left side. Find the intersection of those two lines on the chart. This gives you a number. If your number is over 30, you are obese. 26-29 is overweight. 18-24 is normal.

Body Mass Index Chart

Body Mass Index Chart: Except for very muscular athletes, this chart gives you an approximation of obesity. Anything over 30 is considered obese. Ironically, this chart was developed in the 18th century. Larger view of the BMI chart.

6. History of RRP

Canadian medical doctor Edgar Barnett invented RRP in 2003. Dr. Barnett was born and raised in England. He went to Medical School in England. Initially a family doctor, he observed that many problems were not helped by medicines alone because they were also psychological. He has been doing psychotherapy for over 40 years. He has written two books on psychotherapy: 1. ANALYTICAL HYPNOTHERAPY 2. UNLOCK YOUR MIND. His RRP evolved after 40 years of his experiences treating patients with psychological problems. Dr. Barnett started training me in RRP in April 2004. We have written a book about RRP, titled RAPID REINTEGRATION PROCEDURE.

7. What is RRP?

At first we thought it was a type of hypnosis or "waking hypnosis," and it may very well be. Dr. Barnett thinks it is a special form of hypnosis. For me, the problem with that is that hypnosis traditionally requires a procedure called induction, induction of a hypnotic trance. We do RRP without doing a hypnotic induction. To you, RRP will seem like daydreaming.

The reason traditional psychotherapies sometimes fail is that they require people to reveal their innermost, private, personal, embarrassing, threatening, or frightening secrets and the details of those secrets. There is none of that with RRP. It is okay to tell me personal things, but I won't require it of you.

The procedure is between you and yourself. I, as therapist, guide you, and I am there with you so you do not need to go through it alone. Where you are about to go in the RRP state, I have been many times. I know the way in. I know the way out. I will be there with you every step of the way.

8. The Goal of the RRP Therapy Session

The goal of your Rapid Reintegration Procedure (RRP) session with me is to free you up from your urge to overeat, and to normalize your eating behavior.

The first step is for you to decide that you want my help. There is a feeling that goes with that urge to overeat. Try to identify what the feeling is that you experience when you have that urge to overeat.

9. What Will You Experience In RRP?

You sit in a chair with your eyes closed, and I guide you through recalling feelings and finding old memories. It is very simple, it occurs very easily. It is like daydreaming. If you can daydream, you can do RRP.

You do not need to suffer in RRP. You do not need to relive traumatic events. You can recall them without reliving them. During RRP you will still be in control at all times. If something about RRP puzzles you, just ask me. If you want to stop, you will be able to do so easily. Your being in control makes RRP easy and non-threatening.

10. Getting Results

RRP is results oriented. You and I want to get results for you. We want to free you up from overeating. We will keep working until you get results. That may take 26 minutes or it may take four sessions of two hours each. But it does not go for years.

If RRP does not get results for you within 4-6 sessions, then you need a different form of treatment, such as a psychiatrist, clinical psychologist, counselor or dietician.

Your RRP work with me complements your work with your primary doctor or therapist. I am not taking over your case from your doctor. I am helping out. With your permission, I shall send a report to your doctor.

I can help you with RRP. But I am not going to tell you what to eat or how much. That's for you and your dietician to work on. I am not a dietician.

11. After Your RRP Session

  1. Memories will come back to you, perhaps of things you have not thought about for a long time. This will go on for months and even years. It gives you a comfortable way to resolve old stresses.
  2. Once you have experienced RRP, you can do a lot of this RRP work yourself. When you experience the symptom, instead of bemoaning it, say to yourself, "Hot dog. This is the symptom I want to get rid of. Here's my chance, and I know how to do it now."

It used to be that you were imprisoned by your overeating. Now, RRP can set you free.

12. An Example of RRP: My Personal Experience with Overeating and RRP

Overeating is one of the most common problems Dr. Barnett treats. Here's my personal experience with my own overeating. Since about 1965, I have had an ongoing struggle with overeating and the subsequent overweight of usually about 50 lbs. You know the scenario. I would lose 50 lbs. and gain it back. I worked with traditional psychotherapy, a little with meds but not much, an ADA diet administered by a Ph.D. registered dietician, and lots of other diets like Atkins, high protein, and low carbohydrate.

I was always preoccupied with food. When would the next meal be? What would it be? I was eating two to four times more than was needed. When done eating massive amounts of food, I was still hungry. In fact, eating made me hungrier. It was a hunger not satisfied by food.

Why don't the standard diets work? They ignore or are unable to cope with the fact that overeating is psychological and has a basis in some past event, a traumatic memory/memories. With RRP you identify the feeling associated with the urge to overeat, follow the feeling back to the memory of the first time you felt that feeling, let go of the bad feelings, and, in so doing, unlock your mind from a prison that has controlled you for years. There are uncomfortable feelings that have been kept bottled up all these years, and now it is time to let go of them.

Such uncomfortable feelings were necessary back then when they started, but they are not helping now.

When I did RRP on myself, there was a sudden and profound end to my constant craving for food. It was dramatic. I woke up about 2 AM and did the RRP for about two minutes. It was that easy. It changed my life. Sometimes my weight fluctuates now, but I am not craving food incessantly.

So, why not just take diet pills and antidepressants? In my humble opinion, while they help for about 4 months, they only mask the underlying emotional distress and suffering. They do not get rid of it. The solution is to rescue and heal a distressed (dissociated) Child ego state from early childhood trauma. In this sense, with RRP, we repair damaged souls.

13. Other Things to Consider about RRP

What will your life be like once you have achieved freedom from your overeating and you lose weight? If you have been suffering from your overeating for years, you have built up a life style, and those around you have adjusted to it.

When you have achieved results in RRP therapy, there will be no question in your mind about it. Your whole attitude about overeating will change and surprise you and others. You will be delighted. As I have said before, it is like being released from jail and given all the respect, rights, and privileges of a normal citizen, a first class citizen.

If overeating has made you shy about going out of the house and being around other people, that will change. You will find yourself more outgoing. You will likely create new friendships. How will that affect your current friends? How will that affect your spouse? The two of you should talk about it before you start RRP.

I am not saying these things to discourage you from RRP. I just want you to let those close to you know that you are working on a way to free yourself from overeating to protect your health. And they should know that when RRP does work for you, they might notice some nice changes in you.

On a day to day basis, after your have had your RRP session, your goal is to watch your own behavior. If you are eating way too much, recognize it when it occurs and apply what I taught you.

14. How To Get Started With RRP

Dr. Barnett and I are doing clinical trials of RRP in the treatment of a wide variety of symptoms, especially when standard treatments have failed. Because these are trial studies, there will be no fee. If RRP sounds interesting to you do this:

  1. Determine if you want me to help you.
  2. Make a commitment to work with me. That will be very easy. I won't ask you to do anything difficult. You will find it easy to work with me.
  3. Obtain a letter of referral from your doctor at your expense. We want to make sure the problem is not hormonal (thyroid, hypothalamic, etc.) or due to an unusual disease such as Willie-Prader syndrome. You probably have already had this done.
  4. You must have already tried several forms of supervised dieting or supervised programs for weight loss that failed to give you long lasting results. We are seeking those people for whom standard treatments have failed. If you are considering bariatric surgery, consider a brief trial of RRP first. Perhaps it can help you to avoid surgical risks.
  5. Be willing to have the sessions with me videotaped for Dr. Barnett to review, and possibly for use in teaching RRP to therapists.
  6. Discuss with your family and friends how your life is about to change. Ask them to support you in this effort. Think it over for about a week before you go on to the next step.
  7. Call my secretary to schedule your RRP. 587-5442.
  8. Come to my home on a Saturday morning or several Saturdays. If you are not going to come, you must call my office two days in advance and cancel. I am doing this in my spare time, and I don't have much spare time. If you fail to show up for your session, you will be dropped from the study. I'd like you to bring a spouse, relative, or friend for a chaperone. If you can't, let my secretary know. We will send you a map showing how to get to my house.
    Sometimes it helps to bring old photos from your childhood.
  9. Send me a letter at 6 months, one year, two years, and three years letting me know how you are doing. Specifically, what is your weight at those times?
  10. Sign the release of liability form and the false memories release.

Potential Risks of RRP

Dr. Barnett has treated over a thousand patients with RRP and has found no negative consequences. RRP is new, and there is no history of adverse outcomes. The main risk of RRP is failure to get results. But, Dr. Tkach and Dr. Barnett feel that RRP is highly likely to get results. When results are slow to achieve, it may require several sessions.

Uncovering forgotten old traumas can be distressing, but finding and working through such critical events is the whole point of therapy. You will not go through it alone. I will be with you every step of the way. If you become too uncomfortable, just open your eyes and stop the session. Then talk about it with me before resuming RRP. You will not be required to do anything you do not want to do.

If you are feeling suicidal, tell me, and your primary doctor or therapist and get help with that.

See the separate information sheet on the recovery of false memories.

You will have to read and sign a copy of this with the release form before being seen by Dr. Tkach for RRP.

Learn more about the Rapid Reintegration Procedure or buy a copy of Dr. Barnett and Dr Tkach's book.