Discussion

I want to thank Dr. Buchanan for an excellent paper and a fine summary of the five year program and also for his interesting observations, theoretical speculations and proposals for future possibilities.

We are at the beginning stage of a psychoanalytic understanding of the problem of obesity. There are some interesting correlations and theoretical possibilities, but we are still at step one, that is, the area of observing, gathering information and impressions, and generating ideas. With Dr. Buchanan I still find myself at a considerable distance from a solid position or conclusions regarding the etiology, dynamics or treatment of obesity; but I have arrived at a number of observations and ideas, described in detail elsewhere.¹ One idea deals with a practical approach to control and another one is devoted to my concepts of the psychodynamics involved. These are largely derived from and linked to Horney Theory.

The problem of obesity is worthy of serious attention whatever criteria we apply. More than half the population of the country is overweight. Many persons are grossly overweight. Most workers feel that overweight is due to compulsive overeating. I believe that most, if not nearly all, compulsive overeating has its roots in emotional factors and difficulties.

The accumulation of excess weight is clearly destructive because it kills physiologically, and in our culture it is also a killer of self esteem, of social possibilities, and even of economic opportunities. In so many ways then, it is a destroyer of happiness.

For years this illness — when it has been recognized as an illness — has been treated by charletans, quacks, business men (Weight Watchers, Tops, etc.) and also by physicians with little or no knowledge or interest in human behavior or psychological dynamics. Many doctors run huge pill factories and often specialize in treating with stimulants, diuretics, and hormones. Occasional exhortations and scoldings come closest to some sort of psychological trea