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Obesity is one of the most difficult problems to handle and successfully treat psychotherapeutically. The psychodynamics are extremely involved due to the oral fixation and the multiplicity of ctiological factors. The dynamics involved are characterized often by an insatiable need for love and at the same time defiant and spiteful behavior. Bruch (1973) points out that although modifications in psychotherapeutic approaches were changed significantly in respect to schizophrenia, borderline states and narcissistic personalities, the concepts in treating obesity, seen as “expressions of oral dependency, incorporative cannibalism, rejection of pregnancy … still follow the classical psychoanalytic model.”
This article will discuss the dynamics of a narcissistic character disturbance, the form of which has shown itself most conspicuously in severe overweight, dating from early childhood. The focus will be on the relationship between the resolution of specific narcissistic factors and weight loss.
Theoretically, obesity represents fixation or regression to the oral phase of development, where overeating seems to relate to the repressed oral aggressive drives of the patient. This aggression is internalized, since the child cannot direct its anger toward the frustrating mother without feeling that the mother is going to be