As this is my 1000th blog, it seems appropriate to write about my experience being an eating disorders’ therapist for three decades. I don’t pretend to speak for all therapists, but I know enough of them as friends and colleagues to assume we all share much of the same experience treating troubled eaters. Let me begin by saying that it’s really painful to see clients of whom we’re truly fond, who have so much going for them, pin their happiness on losing weight or being thin. I’m not talking about clients who wish to lose weight to be more comfortable in their bodies, but about those who minimize or discount all the wondrous things about themselves and can’t stand to look in the mirror.

Want to know what saddens me? Meeting with a caring dad who attends therapy regularly to improve his marriage and parenting skills, and is willing to answer any question I lob at him (even the tough, make-you-squirm ones), who thinks less of himself because of his weight. I wish I could take a snapshot of how I see him and paste it over whatever he visualizes in his mind as a better version of himself.

And having a client who’s a grandmother working part-time and raising her grandchild while putting up with an abusive husband, who thinks poorly of herself because she eats when she’s upset and hates her body. It breaks my heart, quite frankly, to hear her talk negatively about herself because of her weight. She is so much more than the sum of her parts. Because of her trauma history, she may never really value herself as she should and that possibility haunts me.

I feel sad when a client who’s lived and worked all over the world, has a terrific sense of humor, adores animals and nature, and has great interpersonal skills gets down on herself because she hasn’t been able to lose weight. My heart grows heavy when a client who’s trying hard to love herself exactly as she is feels crushed by the rude comments a blind date makes about her weight, when an amazing/kind/giving/loving client I’ve treated for years via phone refuses to have me see her via video therapy because she’s ashamed of her body, or when a client with a wonderful life—a great job, loving spouse, and terrific kids—ruins it by feeling like a failure and obsessing about weight loss.

I bet that eating disorders therapists all over the world feel as sad as I do when their clients ignore all their positive attributes and think they’ll only be happy when they’re thin or thinner. We wish these clients could see themselves through our eyes. We ask ourselves daily: What will it take for them to recognize how beautiful they are inside and out at any weight and How can I help them give up their obsessions with the scale and just enjoy and value being themselves? They are lovable and loved. You are lovable and loved. So, tell me: What Will It Take?