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.