Psychosomatic Aspects of Obesity

A common thought association with obesity is food. In a sense, all forms of adiposity are alimentary. When ingested food, unused by the organism, is transformed into fat, it deposits itself in predilected places of storage and so helps to shape the human form and figure. In the process of becoming stout, food and eating play the leading roles, aside from any etiological or pathological background.

While an increased appetite may be an obvious clinical symptom in obesity, less obvious are the pathological changes which may be found in some endocrine glands. In such instances one speaks of a hypothyroid, hypogonadal, adrenal, or pituitary type of adiposity (25). Occasionally in these cases positive laboratory data can be obtained. A lowered basal metabolism, or a diminished specific action of protein seem to confirm the diagnosis and to further the understanding of the underlying pathology. Sometimes, cerebral lesions are the cause of abnormal accumulation of fat such as are found in the diencephalon after an attack of lethargic encephalitis. Thus the amassing adipose tissue is but one phase of a larger process involved in the endocrine or cerebral disorder.

The endocrine findings lead to the belief that obesity is the direct consequence of primary glandular changes. Some authors are more inclined to regard adiposity as concommitant to the glandular pathology (9). McLester (18) prefers to think of obesity “in endocrine disease as any other form of obesity brought about by a breakdown of the regulatory mechanism in the relation of energy intake to energy output, resulting in a plus energy balance.”

If part of the food, however, in such cases is not available for metabolism, the energy requirements remain unfulfilled and must be satisfied. In order to accomplish this, the body asks for more food which it can obtain solely by a demanding hunger. Therefore, the abnormal appetite is not the cause of obesity but rather the expression of a physiological need.

Most authorities cl