Psychology Of The Fat And The Lean – Overweight Cause And Cure
“HOW DID I ever let myself get this way?” a patient once asked. “And how can I get out of it?” In this chapter we shall go into the psychological “how” of both cause and cure of overweight.
Most dieting books and manuals and some doctors sound a single theme on an accusatory note: “You became fat through overeating. So you must cut down on food to reduce.” This mechanical view of the problem has led to calorie counting and “crash” dieting.
Avoiding the redundant obvious, let us say rather: “The fat you acquired by overeating, and the overeating itself, served a psychological purpose—they fulfill for you some emotional need. Therefore, your success in reducing (on a balanced high-protein diet) will depend upon an understanding of your impulses, of what prompted you. Only when you can hurdle the obstructive emotion, will you be able to build healthier eating habits.
Breaking any habit pattern is difficult enough. How much harder is it when it involves food, our deepest need, shared by man with all animals and perhaps with higher species. Its satisfaction is even more fundamental and durable than the sex urge, even if no “Romeo and Juliet” has ever been written about a passion for waffles. Extending from before birth throughout our lifetime, it is virtually synonymous with life itself.
“I just love to eat,” a grossly overweight patient confessed, as if that were the sin. We should all love food (in moderation), though its primary function is to provide energy and cellular replacement.
Too much of American abundance is snatched down in haphazard undernourishment at the “greasy-spoon” cafeterias and lunch wagons and the kitchenless soda counters which constitute much of our eating out. While perched on the opposite gastronomic pole is the gourmet, intent only on gratifying his taste buds, with no regard for the blossoming fat. He lays on with lavish butter spreads and cream sauces at home and scours the continents in quest of Cordon Bleu cookery. But surely there is a middle path. Cannot the science of nutrition be blended with the culinary arts to provide an American cuisine, nourishing and delightful yet unfattening?
The patient mentioned above, whom we shall call Mary, could “chew a brick wall” when hungry, though she and her family managed nicely on fatty steaks and fried potatoes, along with pastries and puddings and vast amounts of cereals and bread. She was raised, she recalls, on potatoes and bread, in an impoverished home where they were trained to “clean the plate.” She grew up into plump womanhood and has been growing out since.
Married to a well-paid truck driver, she and her husband go off on weekly shopping forays to the supermarket and indulge in eating sprees at home. Their children, conditioned by them, already display a “family tendency” to overweight. Fat has long been considered a mark of social status in many parts of the world where only the wealthy can afford it. In our affluent society there has been a democratization of obesity. The worker husband could now blow himself up to look like the communist caricature of a banker—but should he?
For Mary, food has become a symbolic substitute, as the wafer and wine are in church ritual. It represents not only health and well-being but the security she missed in childhood. She is making up for her early deprivation by overeating now. Compensatory eating, to fill a real or imaginary need, is perhaps the most common cause of overfeeding and obesity.
Another patient, Jane, had weighed a hundred and twenty pounds before marriage. Six years later she weighed in on the office scale at a hundred and sixty. What had happened?
“When I was pregnant with my first, I had such a craving for sweets … I must have felt I had it coming to me.”
As solace, she regularly got down mountains of ice cream topped by pyramids of whipped cream, plus peanut butter and jelly sandwiches with heavily sweetened coffee. Her faulty eating habits, in disregard of a doctor’s diet, luckily did not endanger the child. After its birth there followed a half-hearted attempt to reduce that failed. The same process of consolation eating and of permanent weight gain occurred with the second and then the third child. (Psychologists have suggested that an inability to lose weight after giving birth may indicate an unconscious wish to hold on to the baby.)
Yet Jane did not need any psychiatric probing. She came to understand that her obesity was due to self-indulgence growing out of a destructive self-pity. She was free now to undertake a dieting regime that would rid her of her incubus of fat.
Compensatory eating, as with Jane and Mary, is often combined with “tension eating.” John, a successful lawyer working under great pressure, could not deny himself that second dessert or third cocktail. His work built up powerful tensions which he dissipated by wolfing down huge quantities of food and drink. Eating, spiced with alcohol, soothed and sedated him. John apparently needed this safety valve. He could not unwind at his work, though totally engrossed by it, nor did he find adequate release in an unsatisfactory home life or in social relationships. At fifty-two, of medium height and frame, he weighed close to two hundred pounds.
Always healthy and functioning at high gear, he was jolted from his complacency when he was rejected for additional life insurance. At the doctor’s office he later learned of a heart “irregularity.” He knew then he had to reduce weight by a drastic overhaul of his eating and drinking habits.
Anne, who worked in an office at a tedious job under a difficult boss, similarly combined compensatory with tension eating. She nibbled chocolate bars and cookies to “get through the day” (to ward off the tension) and had a daily malted ice cream with some meatless sandwich for lunch. Inadequately nourished, she undoubtedly needed the extra sugar ration for short spurts of energy, but the surplus was being changed by her body chemistry and was accumulating as fat.
Becoming less attractive to men and approaching thirty, she mostly sat home evenings “eating her heart out” plus whatever the icebox held for snacks during television watching or reading. “I felt so sorry for myself,” she said, “thinking of the fun I used to have and what I was missing.” The more sedentary, the more tense, the more she nibbled and fattened.
Then, threatened with the loss of her job because she looked so “sloppy,” she several times crash-dieted for momentary weight losses she could never maintain. What was needed was a profound transformation of her eating patterns. But before she could diet successfully, she too had to learn to accommodate her tensions.
Both John and Anne considered themselves victimized by the pressures of their work. In other cases, tension leading to overeating and obesity can be brought on by some emotional crisis such as the death of a loved one, failure in sexual relations, or by apprehension over some impending event. In addition, there is the fearful daily battering most of us take, and the downright disagreeable chores attached to much of living— A perfect rationale for overeating, if you are looking for one.
Yet tension in itself is a part of our life equipment, as natural and protective as our reaction to heat and cold. It mounts when we are confronted by some looming threat to our safety, happiness or self-esteem. And we are certainly living in a dangerous and difficult time, properly called the “age of anxiety.” But when, if ever, from its earliest beginnings has mankind lived without anxiety for sheer survival?
Few persons are blessed with an environment free of stress or with an inner serenity immune to it. The less sorry we feel for ourselves the closer we come into harmony with the relentless universe. And the less -need we have to explode our tensions through food and drink.
The fat we gather in overeating or inactivity may also serve its own subconscious purpose. Henry was a plump and pampered boy who was called Fatty-grub by the other kids. Exiled from their play by his flabby muscles and their scorn, he did grow into a fatso. He protests he did not eat more than other boys, at least not until later; he simply became increasingly inactive. That this holds generally true for obese children was borne out in a recent study of their eating and exercise habits.
“Nobody (except my mother) likes me,” he decided. The world appeared as an enemy to be kept at bay. He ate to fill a psychic void and his fat was transformed into an insulation, a bulwark against people, also an alibi for ‘lazy” behavior at school and slow movement outside. “Don’t hurry me,” it said. “You see I can’t go any faster.”
He had disqualified himself from boy-girl contacts (girls laughed at him), and later from vying for economic betterment. At thirty-three, of more than average intelligence, he held a menial job and was unmarried. His fat had thus cushioned him against marriage, the economic struggle, the very give-and-take of life itself. Henry had always felt that his condition lay basically in his make-up, probably glandular or “something wrong inside.” Yet medical tests failed to reveal any glandular or metabolic disturbance. He came to the doctor because he had reached a point in his adult development where the normal urge had risen to win a mate, to make a better place for himself in society. That is, he was excellently motivated to diet and exercise himself back into the mainstream of life. He will succeed in the degree that he feels he can dispense with his protective buffer of fat.
Florence, who is receiving psychological help, was able to analyze the meaning of her obesity. As a girl she was normally slim but, “I felt like such an ugly duckling, so unsure of myself. Whenever I had a date, my face would break out.” Her anxiety made her so self-conscious she dreaded the ordeal and wasn’t very good fun—one way of keeping her from competing for male companionship.
After a wretched childhood, she got on badly with her quarreling parents and was desperately afraid of marriage, of sexual aggression. Then came the solace overeating and obesity. Her fat was a refuge from an unhappy home life, a shield against all feeling but primarily directed against the opposite sex. Like Henry, she had taken herself out of competition. Unlike him, however, she would periodically attempt drastic reducing measures.
In one of her slimmed-down periods she met a man and persuaded herself into accepting a marriage proposal, mostly to take her “out of the house.” But soon a violent rejection of sexual life was expressed in omniverous eating. The fat returned in bulk and it succeeded in its unconscious purpose of erecting a barrier against the husband, who turned to other women.
Left to herself, “I went to pot. I lost interest in everything except food: friends, the workings of my brain, the world outside.”
At the doctor’s office she described alarming symptoms, mostly of anemia, felt “sluggish, numb,” and was starting to lose her hair which she treasured.
Since her divorce, Florence has undertaken a vigorous campaign of rehabilitation. With a newly developed self-awareness she is determined to slough off the sheath of fat. Setting a minimum goal of one to two pounds a week, she keeps a bathroom chart for a constant check-up on her progress.
At first she would break down and cheat and each ` time felt ashamed enough to give up. Then she placed a mirror inside the refrigerator and her bathroom scale next to it. No more icebox raids. As a final gimmick, whenever shopping for clothes, she buys a frilly dress one size too small which she cannot wear till she reduces down to it. Her ingenuity has paid off. On a minimal high-protein diet, which sustains her for a demanding secretarial job, she has in several months lost over ten pounds and is well on her way.
Where fat serves as a shield against love, companionship, or economic striving, we are caught up in a vicious circle. The fatter Henry and Florence became, the less chance of winning a mate, advancement or good social relationships. They would then eat all the more to make up for what they lacked. Food thus came to replace these adult achievements. The patient has now regressed to early childhood, but without the natural safeguard of the normal child who does not eat beyond satisfying hunger pangs.
Such compulsive eating may at times turn obsessive, resulting in a gross deformation of the human shape. Margaret, a patient in the psychiatric ward of a local hospital, was a victim of obsessive eating. The psychic roots of the malaise lay in the death of a beloved parent early in childhood. She was at twenty-seven so grotesquely obese she could barely be maneuvered through the door. She appeared otherwise quite rational and had lately expressed an interest in dieting.
“We don’t encourage these people to diet,” a psychiatric worker explained. “What will replace for her this all-absorbing need? . . . Love? Loving and being loved are so uncertain. Food is always at hand.”
Though obsessive eating is fortunately rare, with the superabundance of food and the scarcity of love there may be a germ of it in much of obesity.
In all the cases presented here except Margaret’s what prognosis would you make for each patient? What do you think are your chances for success in dieting? According to the findings of a Cornell University study, there is a direct correlation between successful reducing and the emotional stability of the dieter. That is, an emotional unbalance tends to maintain a food imbalance.
A group of over a hundred dieters was subdivided into three categories of “high,” “average” and “low” emotional stability. The top stability group met with fair to excellent results. They had permitted themselves through middle-age inactivity and over-exercise at the table to become obese. They mostly enjoyed eating and had little knowledge of their bodily requirements. Learning about the causes of overweight, they made excellent subjects for any dietary regime.
In the middle stability group, representing the American average of overweights, the results ranged from moderate to fair with few failures. These people required not only food facts but an insight into their emotional problem. The obesity could be controlled to the extent that they faced up to the cause of their overeating in their inner tensions and anxieties.
The low stability group was only moderately successful in about a third of the cases, with outright failure of more than half. Many of these persons apparently needed psychiatric help to implement a dieting program.
Mayo Clinic psychiatrists have indeed advised against any dieting at all for persons with a deep-seated emotional disturbance. Before the safety valve of food is removed, a second line of defense must be established. Failure, adding feelings of guilt and ineffectuality, only exacerbates the emotional unbalance. These individuals will sometimes develop fresh symptoms called “the dieting depression.” At least they should not make the attempt without the supervision of a doctor. Even for the more stable, it has been suggested that dieting should be postponed during a period of great stress, as in sickness or the menopause.
A small minority of persons, therefore, may not be able to undertake a dieting program unaided. The overwhelming majority, however, the average American overweight, can learn on his own to control, modify or redirect his impulse to overeat—once he understands its “defensive” origin.
Eating, like all life activity, must be a compromise. Adults measure an impulse against its consequences. We do not race a car to the maximum shown on the dial nor do we often kill those we dislike. We likewise can muster self-discipline to overcome habits of self-indulgence. There are surely better ways of expressing inner conflicts than by punishing our stomachs and deforming or enfeebling our bodies.
An awareness of the urgency (see the following chapter) and a readiness, a total commitment to retraining your attitudes and habits must come first. If you are strongly enough motivated, you will reduce your weight.
Can you now apply what you have read here to your personal psychological problem? (If you have one—and you may not). Ask yourself: “Why do I overeat? What is my special weakness—all day nibbling, “coffee and” breaks, between-meals and bedtime snacking? Do I know my actual food needs? What substitute gratifications can I find? Do I exercise enough? And how can I dissipate my daily tensions through means other than food?”
A pamphlet of the National Association for Mental Health suggests ways of handling one’s tensions that we can apply to dieting. Here are some suggestions:
1. Channel your frustrations into productive activity or else seek some satisfactory displacement in daily recreation. There are ample diversions to choose from other than food to help dispel your “blues.” A normal sex life, when it is possible, is of utmost importance.
Find a physical outlet for your emotions. Schedule regular and pleasurable exercise, as violent as your age and bodily condition allow. It will serve the double pur pose of exploding tensions and consuming calories. If you have a garden, dig like mad; if a home owner, you can putter, but molto furioso. At the very least, take long and vigorous walks.
Make yourself accessible to others. Don’t withdraw. Social relationships will take the edge off the personal anxieties you have been sedating with food.
Involve yourself in some community service organization. Working for others will distract you from yourself; feeling sorry for somebody else will keep you from consolation eating.
If you need guidance or psychological aid, there are various community and welfare agencies where you can apply. To find out about counseling, get in touch with the local or state Mental Health Association.
And if you suspect there is a medical problem at-tached to your tensions and overweight, go see a doctor. He will guide you in your dietary regime and, where it is indicated, will recommend psychological help.
(Of course, if the doctor is himself overweight, through carelessness, neglect or the same pressures to which you are subject, he may be somewhat perfunctory or defeatist in his attitude. Then proselytize him. It has been said: “Doctor, cure thyself!”)
You may be reading this book with a jaundiced eye. You have tried so many Get-Thin-Quick schemes and failed. This holds true more often for women, since men have been proven, statistically, to be better dieters. Perhaps they were convinced by the recent splurge of publicity on heart disease that it is a matter of life and death for them. While a woman may still feel that all that is at stake is vanity, which is really her pride that goeth before the fat. A doctor sees calorie-counting women patients with little energy, taut skin and frazzled nerves. One is almost tempted to say they might be better off slightly overweight, rather than having to wage their ceaseless battle “against nature,” lured on by the glamour of slenderness exemplified by the latest French Look and the undernourished, breastless and hipless American mannequin. Compulsive dieting can be as neurotic as compulsive eating. Inevitably, many of these women in their middle years sink with a sigh of relief into the protective folds of fat, accepting it along with gray hair as part of the aging process. But it isn’t; and they need not.
The grossly overweight reducer who has never stuck to a diet may require (even after all the exhortation in this chapter) the added incentive and stimulus of doing-it-together. Alcoholics Anonymous has shown the way to effective group therapy, and overeating obviously has much in common with overdrinking.
The F.A. (Fat Anonymous) movement was initiated in 1954 by Dr. John Pate, Health Director in Washington D.C. It has since spread country-wide. If you should be interested in joining or forming such a group, here is how they usually function.
A number of overweights come together in a club under the direction of a doctor, health officer, or public health nurse. They pledge to follow a dietary schedule and to appear at consecutive weekly meetings over a period of four to six months. Members must lose at least a pound a week or they are dropped.
At the weekly meeting there is a public weighing-in ritual accompanied by much chaffing and applause, and also by laughter and tears. These people are sold on what they are accomplishing and there are few dropouts and little backsliding. The atmosphere of sympathetic pulling-together and of the censure or approval of fellow sufferers has worked small miracles for thousands who could not succeed by their solitary effort.
Whether you diet singly, as a family, or with a group, here are some final do’s and don’ts:
1. Be firm in your resolution to make significant adjustments in your living patterns but don’t become fanatical. Too great rigidity tends to snap back in a counter-reaction.
Set yourself a modest and attainable goal. Reach it in small stages of one to two pounds a week. Each cumulative victory will fortify you for the next advance.
Don’t forget that exercise, recreation and a limiting of alcohol are as important to weight maintenance as proper eating. The only calorie counting you need do henceforth is of the second drink and of rich desserts.
Follow the high-protein diet which will be ex plained in subsequent chapters. It will bring your weight down and keep it at a metabolic balance.
The cook in your home should use the offered menu suggestions creatively, so you will relish the smaller portions you must eat at the start. Take time for eating and have congenial surroundings that make it pleasurable. If you must eat out, be discriminating in your food choices.
When entertaining or being entertained, let your friends understand your problem, again without being too rigid, and they will cheerfully cooperate in your ven-ture.
Lastly, if you follow through, your reward will be not only pride of accomplishment but the joyous feeling of being youthfully attractive and healthy. Written By: Max Konigsberg, M.D. and Louis Golomb, Continue Reading: The Ills Fleshiness Is Heir To
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