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An extremely obese young woman showed disturbed physiology suggestive of Cushing's syndrome. She had a long history of sadomasochistic relationships. She had eaten excessively since the age of sixteen; food appeared to be a substitute for love, serving to pacify anxiety arising from numerous separations. 'Food … became a polyfactored symbol [affording] immediate relief of tension and [feeding] love needs, her aggressive drives, low self-esteem, and depression.'
Discussants of the paper stressed the wide variety of psychic structure present