More Than Medicine: The Bariatric Counseling Center of San Antonio
Meet Dr. Sara Hamilton
The Bariatric Counseling Center (BCC) is a one-ofakind resource for behavioral healthcare for obesity and weight loss. It takes a truly revolutionary approach to helping clients achieve their goals through group and individual therapy, dietary guidance, cooking classes, chef-prepared meals, mindful eating and movement education – all in one place!
Dr. Sara Hamilton is a Licensed Clinical Psychologist and the Clinical Director at the BCC.
Thank you for taking the time Dr. Hamilton! Can you tell me about your background and training?
Thanks for asking me to contribute! I went to college at Occidental College in Los Angeles and majored in psychology. As part of my education I worked with kids and teens with autism, ADHD and reactive attachment disorder. I also participated in the Semester at Sea program my junior year and spent 3 months on a ship, sailing around the world. I took my clinical psychology class on board and had amazing opportunities to learn about mental health and mental illness in many countries. Before I decided to go to grad school to be a psychologist, I took a year off just to make sure I was ready to do another five years of school! During that time I worked at a group home for teenage girls and completed a program through the National Alliance on Mental Illness (NAMI). That solidified that I was passionate about working in mental health and I moved to Chicago to attend The Chicago School of Professional Psychology.
While I was there, I trained in private practice, university counseling, and psychiatric hospital settings and completed my dissertation “Teaching Mindful Eating to Children: A Program to Prevent and Treat Childhood Obesity”. I also discovered my passion for psychoanalytic and psychodynamic theories and completed a fellowship with the Chicago Center for Psychoanalysis. I accepted an offer to train at San Antonio State Hospital for my final year and I have been in Texas ever since.
Since graduating I have worked in private practice and intensive outpatient settings, spending most of my career at the Bariatric Counseling Center, where
I am the Clinical Director and primarily do individual and group therapy.
Okay, I thought I knew a lot about you but I had no idea you were such a world traveler! Those experiences sound transformational and BCC is so lucky that you settled here. What drove your passion to become a psychologist?
Clinical psychology appealed to me because I see good psychotherapy as the artful application of a science. I love information, science, and research, and I also love to think creatively and abstractly; clinical psychology allows me to engage with others in both concrete and expansive ways. My own good therapy experiences motivated me to join the field to help others learn the tools they could use to help themselves. Seeing people more fully become themselves through therapy is a privilege I get to experience every day.
And then what led you into the world of behavioral healthcare for obesity and weight loss?
I became more interested in working with eating behaviors during my first training placement when I ran a small group that discussed the book “Women, Food and God” by Geneen Roth. One of the women in the group said that she didn’t know what hungry or full felt like and it struck me that many of us can no longer hear what our bodies tell us because of how we are so inundated with food messaging and “food products” that can distort our bodies’ signals. This was the seed for my dissertation, which has served as the basis of my work for most of my career.
I care very strongly for people experiencing obesity. This is one of the most stigmatized groups worldwide, likely because it is one that people often unabashedly criticize. That discrimination is built into the very systems that are purporting to help people treat obesity, in ways that often exacerbate the disease process. I think clinical psychology and other sociological and behavioral health disciplines bring important perspectives to how the world thinks about people experiencing obesity and unique tools to help support people who want to change their behaviors. I am passionate about helping people to address internalized fat phobia and to learn to care for themselves in ways that are not rooted in calorie reduction.
It’s really inspiring to see how protective you are of people experiencing obesity and how broadly you think about the systems that impact people with obesity and how proactively you are helping them to respond to these systems.
Can you share a little about the Bariatric Counseling Center?
The Bariatric Counseling Center (BCC) was created in 2016 to serve people experiencing obesity in a new way, working from a behavioral health lens with a particular focus on eating disorders. At BCC, we work with clients who have tried everything in the weight loss world but have not seen the results they want. Our clients include folks who have had bariatric surgery, are planning to have it, people seeking behavioral obesity treatment without medical or surgical intervention, people on weight loss medications, and people who just want to change their habits. We work with people who struggle with binge eating, chronic overeating, and chronic emotional eating. We also work with people who have lost weight and are seeking to maintain their weight loss and those whose mental health conditions are contributing to difficulty with changing eating behaviors.
Our Intensive Outpatient Program (IOP), covered by insurance, offers a unique, behavioral approach led by mental health professionals and dietitians. Rather than prescribing diets we help clients change thoughts, feelings, and behaviors to create sustainable lifestyle change. Over roughly three months, clients attend three weekly three-hour sessions that include group therapy, individualized counseling, culinary lessons, movement classes, and dietary and nursing support.
We take a whole-person view—looking at home, work, relationships, mental health, and daily routines—to help identify where meaningful change can happen. While the time commitment is different from traditional weight-loss programs, the structure builds community, reduces stigma, and offers a supportive environment where clients can grow, connect, and have fun while working toward long-term well-being.
The BCC program is truly unique and there is no other program like it in Texas. I commend BCC for addressing overall health and long-term change.
Do you have anything coming up in 2026 that you’d like to highlight?
I’m so excited to be hosting a 5 day mindfulness retreat with Ranchlands at the Paint Rock Canyon in Wyoming in August of 2026 (https://ranchlands.com/pages/how-to-pay-attention-with-dr-sara-hamilton). I was a guest there this fall at a retreat and am thrilled to be invited to host my own retreat next year. My time there brought me back to my true self and I hope to create an opportunity for others to do the same. The retreat is called “How to Pay Attention” and will use mindfulness and art activities to help support all of us in renewing our capacity to be present in our lives and be less connected to our phones. No better place to do that than while horseback riding and glamping out in such a beautiful setting!