Five Year Psychoanalytic Study of Obesity

The obese state is a much maligned one. Those with a religious bent see it as the outcome of the sin of gluttony. Our culture associates obesity with ugliness, laziness and poor self-control. The medical profession defines it as a disease — the criteria for diagnosis being if one is 20% or more above his desirable weight, and that extra weight is in the form of stored fat.

Most medical investigation has focused on the metabolic, genetic, constitutional and social factors in obesity. Mayer quotes studies which show that 2/3 of obese patients have one obese parent, as well as studies of fraternal and identical twins raised in the same environment which show that only 2% of the identical twins had a difference in weight of more than 12 pounds compared with the fraternal twins, 50% of whom showed a difference of more than 12 pounds. Now these statistics might be successfully argued to point to environmental influences; however the geneticists feel there is a recessive gene responsible for obesity — the obese carry genes for both fatness and leanness, while the lean rarely carry the gene for obesity. Also using Sheldon's classification of endomorph, mesomorph and ectomorph to study constitution and body build, one notes that the ectomorphs never become fat, and that obese people, in addition to having excess fat also have bigger muscle and bone mass which also contributes to their excess weight. Also, recent investigators ² feel that obesity is caused by the excessive number of fat cells laid down in infancy in response to over-feeding the infant.

After a medical investigation a patient is usually told there is no hormonal or metabolic factors to explain his obesity, so it must be that the patient just eats too much, which puts the full responsibility for the disease on the patient. It would be more accurate and also kinder to the patient if one said that our current medical instruments cannot identify any such abnormality. This is not to say that emotional factors don't p