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Does obesity
begin in the mind?
William Shakespeare’s Julius Ceasar says :
"Let me have such men about me as are fat and sleek,
and sleep well o’nights. You Cassius have a lean and
hungry look - such men are dangerous."
Obesity has not always received such a favourable press,
but Shakespeare’s observation reflects popular
psychology - that the fat person is more contented than
the slim one - or simply different mentally. Let us see
that what the psychologists really say.
An early observation of Nicolson, suggested that obesity
represented a form of neurosis. An unconscious idea that
can play a role in obesity is the thought, I’m
unimportant, I’m a nobody.’ One of the father
of clinical psychology, Alfred Adler, coined the term
‘inferiority complex’ to the accumulation of
body fat as a sort of protective armour. The case of Mr.
R.M. is a perfect illustration of the role that feelings
of failure can play in overeating behaviour and obesity
as a defence against inferiority.
Mr. R.M. had a very mediocre job in a departmental store.
His wife constantly criticised him about their poor
standard of living. He wanted to quit his job, take his
small savings and open a road-side Chinese eatery or
take-away outlets. He was sure he would prove a success
at this business. His wife constantly resisted this
"silly dream" and R.M. never did try out his
business ideas. At parties R.M. was the life of the
party. He came prepared with jokes to do the
entertaining. The fact that many obese people adopt
humour as a defence against their condition has given
rise to the stereotype of the fat, jolly contented soul,
the apparent humour concealing the inner turmoil. ON an
unconscious level there was the nagging thought,
"I’m unimportant, I’m nobody, I’m a
small man." Mr. R.M. resorted to overeating
substituting food to compensate for his sense of
unimportance. Mr. R.M. became a ‘foodaholic and
actually believed he had become addicted to food and
began steadily to gain weight.
When he was examined by me he weighted 105 kilos with
serious effects of obesity having raised blood pressure
and severe knee joint pains. Once the underlying cause of
his obesity was diagnosed, he was placed on medical
guidance for obesity and a nutritionally balanced diet to
suit his individual needs. He was counselled as to why he
was overeating. Within sixteen months he had lost the
twenty-four excess kilos at the rate of two kilos a month
and he has maintained his desired weight since six years.My daughter is
obese but not the contended soul type. She hates company,
she is a loner, she is of a marriageable age. I am
worried. Could obesity be in her mind?
Yes. Just as obesity can be a way of seeking
attention of people, obesity can be a way of avoiding
people. People who lack confidence in their basic appeal
as human beings may use obesity as a defence against this
self-knowledge.
Take the case of J.V. a twenty-five-year-old school
teacher. J.V. had a dark complexion, with a broad face,
thick glasses over her eyes, prominent upper teeth and
few coarse hair over her chin. A victim of a broken home,
her parents were divorced. She was brought up by a
confused and inadequate mother who projected her
guilt-ridden mind on to J.V. and led her to believe that
sex was sinful and something to be hated. Men had no
interest in her, and she said to me she had no interest
in men. She thought men "were silly". Of
course, this was not an expression of true feeling. She
was only kidding herself. She wanted men to be interested
in her , but she was deeply unsure of herself. The
obesity also proved a defence against any sexual advances
made by men as she at an unconscious level had learnt to
hate sex. "The reason men don’t propose
marriage is because I’m fat." But if she lost
weight, and if men still didn’t propose, then she
would have to face the unpleasant fact that she
wasn’t very attractive even when slim. Her fear of
rejection and guilt of physical relations with men both
worked to keep her fat.
J.V.’s treatment involved a number of approaches.
Orthodontic work corrected the problem of her teeth. She
did away with her thick glasses with the aid of contact
lenses. A trained beautician and electrologist removed
her unwanted facial hair and groomed her with beauty
therapy to give her poise and confidence. She was
alongside treated for obesity and helped to shed excess
15 kilos in five months. By the time she was twenty-seven
she married an army Captain who found her to be very
acceptable.
J.V. was not and never will be a great beauty. She is
however, not an unattractive person. In a number of
girls, gaining ideal weight, a proper make-up, hair-do
and personality easily compensate for any deficiency they
may have.
Could I
be a stress eater?
Eating is known to alleviate stress and worries about
self-worth. Obese people have been known to gain large
amounts of weight at the loss of a loved one by death or
divorce. The ‘right’ eating syndrome
characterized by over-eating, mainly in the late evenings
or in the middle of the night seems to be a response to
stress.
Overeating due to emotional tension is common to both men
and women. According to Dr. Frank J. Bruno author of
‘Think yourself Thin’, obesity can be a form of
passive aggression underlying repressed hostility to
someone or to some situation. For example, a fat teenager
may resent and be angered by her mother and deliberately
eat two helpings of dessert in order to get even or
another teenager may overeat when under a stress of
college examinations. A man may feel resentment towards
his boss for promoting someone else instead of him and
may relieve his anger and frustration by overeating.
Food can be and frequently is used as a kind of a
tranquilizer, pacifier, and substitute for love and
affection.
Mrs. A.B. was a thirty-three-year-old housewife. When she
sought my help she was eighteen kilos over- weight. In
order to overcome marital problems with a husband who she
believed did not love her, she sought solace in eating
food indiscriminately. After every domestic argument she
would eat to pacify her hurt feelings. Her husband worked
night-shifts - a fact she resented for she felt that
although she was married, she did not really have a
husband. She was often alone and bored. To compensate for
her loneliness she ate from the refrigerator once too
often and sitting in front of the television almost
unconsciously ate her way through programme after
programme.
The result of this somewhat irrational behaviour was that
she received more and more attention ; her weight was a
constant topic of her husband’s conversation. She
also received more and more attention from her children,
who wanted to stop their mother from gaining additional
weight and showed their concern by repeatedly telling her
not to eat fattening foods. The result of this new and
welcome attention had a snowballing effect resulting in
her eating more and more and becoming fatter. She avoided
social functions and blamed it on her fatness. Lack of
physical activities and decreased energy expenditure
further contributed to the weight gain.
Within six months of being placed on the proper medical
treatment for obesity and a well-balanced food programme,
she lost the excess weight. With proper counselling she
was able to resume her relationship with her husband. In
the past five years, she has maintained her ideal weight.
Mrs. A.B. fortunately turned out to be a very
co-operative patient. A proper understanding of the
patient’s deep emotional problem with the help of a
doctor and ‘motivation’ of the patient are key
factors towards successful weight loss. No doctor can
help the person who cannot face his own problem, or who
does not sincerely wish to be helped.
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