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This is a description of a case of obesity and an attempt at a general formulation of the genetic principles of obesity. The patient, aged nineteen, lived the first six years of his life under the exclusive dominance of his overprotective, seductive mother; he slept in his mother's bed 'and she maintained a frankly seductive attitude toward him, caressing and exciting him, biting him and rubbing him against her, while she repressed any genital attitude on his own part'. The father entered the child's life at six. He was sarcastic, ironical and rather cruel. The boy was always obese; one year before starting treatment he underwent a tonsillectomy, following which his weight increased forty pounds in a few months. During this year he also developed obsessive ideas of having intercourse with his mother, then of killing her. Finally he fled to his father, who worked at that time in a distant city, and confessed his thoughts. His masturbation fantasies consisted of 'the vision of a monster opening its jaw or … fellatio of his own penis in church with simultaneous flagellations; sexual organs would appear as sugar and cakes and an urge to destroy would make his hands twitch'. Prior to this, conscious fantasies of feminine identification predominated.
The authors' explanation is as follows: mother's behavior was 'like a prolonged tolerance of the boy's primitive oral relation. The restrictions imposed by his superego on his weak ego in the plane of his dependence on his father forced him to keep up a rigid obsessive attitude, which, with the first traumatic situation, the tonsillectomy, became unbalanced and dragged him into regression. He abandoned the last stand internalized in his superego—the father—and returned to his original position, turning on his mother all the aggressive content of his primitive cannibalistic situation… He flew in search of his externalized father, in order that he might help him to limit his overflowing id…' This psychic structure s