Studies of Superobesity: I. Psychological Characteristics of Superobese Patients

Abstract

Close study of twelve superobese women revealed the following principal characteristics. None had a serious psychiatric illness, but most showed moderate personality disturbances with predominant passive-aggressive traits. Depressive features, though common, were not severe. Food typically had been used to allay feelings of emotional deprivation present since early childhood and historically associated with the unstable marriages of these patients' parents. The label “oral character” is not sufficient to provide even a capsule description; stubbornness, defiance, needs for autonomy and wariness of entangling relationships as well as conflicts over exhibitionism also were prominent. These characteristics contribute to the traditional reputation of the obese as “difficult” patients and deserve greater attention to help improve the effectiveness both of standard medical management and of psychotherapy.

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References

Bruch

, Eating Disorders, Basic Books, New York, 1973.

Friedman

, Weight Problems and Psychological Factors, J. Consult. Psychol., 23, pp. 524–527, 1959.

Weinberg

Mendelson

and Stunkard

, A Failure to Find Distinctive Personality Features in a Group of Obese Men, Am. J. Psychiatry, 117, pp. 1035–1037, 1961.

Stunkard

A. J.

, Eating Patterns and Obesity, Psychiat. Q., 33, pp. 284–295, 1959.

Mendelson

Weinberg

and Stunkard

A. J.

, Obesity in Men: A Clinical Study of Twenty-five Cases, Ann. Intern. Med., 54, pp. 660–671, 1961.

Bruch

, Psychological Aspects of Reducing, Psychosom. Med., 14, pp. 337–346, 1952.

Bruch

, The Importance of Overweight, Norton, New York, 1957.

Stunkard

A. J.

Grace

W. J.

and Wolff

H. G.

, The Night-eating Syndrome: A Pattern of Food Intake Among Certain Obese Patients, Am. J. Med., 19, pp. 78–86, 1955.

Fink

Gottesfeld

and Glickman

, The “Superobese” Patient, J. Hillside Hosp., 11, pp. 97–119, 1962.

10.

Freed

S. C.

, Psychic Factors in the Development and Treatment of Obesity, JAMA, 113, pp. 369–373, 1947.

11.

Stunkard

, Obesity and the Denial of Hunger, Psychosom. Med., 21, pp. 281–289, July-August 1959.

12.

Hamburger

W. H.

, Emotional Aspects of Obesity, Med. Clin. North America, 35, pp. 483–499, 1951.

13.

Swanson

D. W.

and Dinello

F. A.

, Severe Obesity as a Habituation Syndrome, Arch. Gen. Psychiat., 22, pp. 120–127, February 1970.

14.

Stunkard

A. J.

, The “Dieting Depression,” Am. J. Med., 23, pp. 77–86, 1957.

15.

Bychowski

, On Neurotic Obesity, Psychoanalyt. Rev., 37, pp. 301–319, 1950.

16.

Rascovsky

de Rascovsky

M. W.

and Schlossberg

, Basic Psychic Structure of the Obese, Int. J. Psycho-Anal, 31, pp. 144–149, 1950.

17.

Hecht

M. B.

, Obesity in Women: A Psychiatric Study, Psychiat. Q., 29, pp. 203–231, 1955.

18.

Leckie

E. V.

and Withers

R. F. J.

, Obesity and Depression, J. Psychosom. Res., 11, pp. 107–115, 1967.

19.

Atkinson

R. M.

and Ringuette

E. L.

, A Survey of Biographical and Psychological Features in Extraordinary Fatness, Psychosom. Med., 29, pp. 121–133, March-April 1967.

20.

Kollar

E. J.

and Atkinson

R. M.

, Responses of Extremely Obese Patients to Starvation, Psychosom. Med., 28, pp. 227–246, May-June, 1966.

21.

Swanson

D. W.

and Dinello

F. A.

, Follow-Up of Patients Starved for Obesity, Psychosom. Med., 32, pp. 209–214, March-April 1970.

22.

Reivich

R. S.

Ruiz

R. A.

and Lapi

R. M.

, Extreme Obesity—Psychiatric, Psychometric, Psychotherapeutic Aspects, J. Kansas Med. Soc., 67, pp. 134–140, 1966.

23.

Castelnuovo-Tedesco

and Schiebel

, Studies of Superobesity II, Psychiatric Appraisal of Surgery for Superobesity, Am. J. Psychiat., 133, pp. 26–31, 1976.

24.

Engel

G. L.

, Studies of Ulcerative Colitis III, The Nature of the Psychologic Processes, Am. J. Med., 19: 2, pp. 231–256, August 1955.

25.

Solow

Silberfarb

P. M.

and Swift

, Psychosocial Effects of Intestinal Bypass Surgery for Severe Obesity, New England J. Med., 290: 6, pp. 300–304, 1974.

26.

Bruch

, Obesity in Childhood; Physiologic and Psychological Aspects of Food Intake in Obese Children, Am. J. Dis. Child, 59, pp. 739–781, 1940.

27.

Werkman

S. L.

and Greenberg

E. S.

, Personality and Interest Patterns in Obese Adolescent Girls, Psychosom. Med., 29, pp. 72–80, January-February 1967.

28.

Stunkard

and McLaren-Hume

, The Results of Treatment for Obesity, Arch. Int. Med., 103, pp. 79–85, 1959.

29.

Conrad

S. W.

, Resistance of the Obese to Reducing, J. Am. Dietet. Ass., 30, pp. 581–588, 1954.