Borgman, D. (1986). Obesity. S. Hamilton, MA: Center for Youth Studies.

OVERVIEW

According to the Merck Manual (11th ed., pp. 322, 324),

Ordinary obesity is quite common, especially in middle life; extreme obesity or localized accumulation of body fat is less common and suggests unusual etiologic factors. Although heredity may play a contributory role, there is only one immediate cause of obesity: a caloric intake persistently exceeding caloric output.

If present for many months or years, overweight is associated with an increased mortality rate and decreased life expectancy. At age 45 to 50, in persons 10 lb. overweight, there is an elevation of 8% above the death rate; 20 lb., 18%; 30 lb., 28%; 50 lb., 56%.

CAUSES

For some, there may be a physical cause or attending factor such as hormonal or metabolic imbalance.

The majority of those overweight eat to fulfill the need for love and affection.

Studies show that a large percentage of obese children:

• Are unwanted.
• Have openly hostile mothers who push their children to compensate for unmet needs.
• Have mothers who repress hostility with overindulgence and encourage their children to attempt to gain parental approval.
• Hostile children may eat to ‘punish’ their parents.
• Children with a low self-image may eat to prove their own unworthiness.
• Hostility and fear encourage some to eat and gain weight in order to protect against intimacy—particularly with the members of the opposing gender.

Overeating as an addiction is a problem of all ages and is rarely found without accompanying symptoms. Contrary to the happy-go-lucky stereotype, most overweight persons can be insecure, moody (with some depression), or lacking in self-concern. An overweight teenage girl often feels socially out of place and athletically restricted. An obese teenage boy may also be socially and athletically limited.

TREATMENT

The following steps are essential for helping an overeater:

• A complete physical examination and medical counseling.
• Behavioral counseling. A program dealing with breaking habits, with schedules, exercise, and incentives (i.e., Weight Watchers).
• Therapy attending to inner conflicts and the need for self-nurturance.