Sounds a bit crazy, doesn't it? I mean, surely those who "don't really eat that much" should be the thin ones? Yes they should – but then again, perhaps they are kidding themselves.
You as the counselor need to help them to change food from being an obsession, to making it merely an essential (though enjoyable) part of everyday life. This can be a long process. Perhaps, though, one should really start at the beginning.
Before even thinking about helping a client to embark on a serious weight loss program, it is important that you both discuss the pro's and con's of weight loss. What!? – how can there be any con's, you ask. Well, take the story of one of the most beautiful girls in my high school class. She was beautiful, but painfully shy. In the end, she began to put on weight, and, unstudied as I was, it was pretty obvious to me at that stage that she was just not able to cope with the attention her beauty gave her. However, with a bit of weight, most of the boys started leaving her alone.
Another person I knew said she is sure she gained weight (subconsciously) to spite her husband. She had fallen pregnant, and in those days, the thing to do was marry. I think she blamed him (deep down) for stealing her childhood, and got her own back by not being the trophy wife he had thought she'd turn out to be.
Your job as counselor is to examine whether or not there is some deeper reason for weight gain, and to work with that before jumping ahead with weight loss programs. Some of the issues one might consider working on include the following:
Is there some sort of frustration which food helps to relieve? Is there something that is unattainable in your client's life, because of weight gain? - and could it actually be that the person feels they do not deserve this thing (like love, being selected for a play...?)
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