As a result of many years of research into the psychological problems of the obese, Bruch is convinced that 'different types of obesity are associated with different psychiatric illnesses'. In this paper she presents cases to support the hypothesis that a certain type of obesity marks a potential schizophrenic development. 'In such cases the excess weight may function as an equivalent for a protection against schizophrenic illness.' The obesity 'may have a positive value in the maintenance of a precarious adjustment'. It is particularly dangerous in these cases for the physician to attack the weight problem directly, for example, with the use of anorexogenic drugs.