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Psychotherapy of Six Hyperobese Adults During Total Starvation

Christopher V. Rowland, Jr., MD
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Submitted for publication Oct 16, 1967.

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Arch Gen Psychiatry. 1968;18(5):541-548. doi:10.1001/archpsyc.1968.01740050029005
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PSYCHOTHERAPY was carried out on hyperobese adults during total starvation of 10 to 50 days on a metabolic research ward. Observations on six patients (one woman and five men) included the vicissitudes of aggressive and sexual impulses, the impact of fasting and weight loss on the patient's body image, and the psychological effects of the study on the patients. None of them had major physiological factors producing their obesity, and all six would be considered hyperobese by the criteria of Atkinson and Ringuette.1 All but one of the patients were seen for at least 20 hours.

Previous Studies  The difficulties involved in successfully treating "simple obesity"—that form of obesity which is primarily related to overeating and underactivity and which has no observable relationship to known physiological disorders—are well known.In 1959, Stunkard and McLaren-Hume2 reviewed the results during the previous 30 years from outpatient treatment

REFERENCES

Atkinson, R., and Ringuette, E.:  A Survey of Biographical and Psychological Features in Extraordinary Fatness , Psychosom Med 29:121-133, 1967;.
Stunkard, A., and McLaren-Hume, M.:  The Results of Treatment for Obesity: A Review of the Literature and Report of a Series , Arch Intern Med 103:79-85 ( (Jan) ) 1959;.
Bruch, H.: The Importance of Overweight , New York: W. W. Norton & Co., Inc., Publishers, 1957;.
Bruch, H.:  Perceptual and Conceptual Disturbances in Anorexia Nervosa , Psychosom Med 24:187-194, 1962;.
Bliss, E., and Branch, C.: Anorexia Nervosa: Its History, Psychology and Biology , New York: Paul B. Hoeber, Inc., 1960;.
Stunkard, A.J.:  The Dieting Depression , Amer J Med 23:77-84, 1957;.
Keys, A., and Brozek, J.: The Biology of Human Starvation , Minneapolis: The University of Minnesota Press, 1950;.
Kollar, E., and Atkinson, R.:  Responses of Extremely Obese Patients to Starvation , Psychosom Med 28:227-246, 1966;.
Shipman, W., and Plesset, M.:  Anxiety and Depression in Obese Dieters , Arch Gen Psychiat 8:530-535 ( (June) ) 1963;.
Biggers, W.H.:  Obesity: Affective Changes in the Fasting State , Arch Gen Psychiat 14:218-221 ( (Feb) ) 1966;.
Fischer, N.:  Obesity, Affect, and Therapeutic Starvation , Arch Gen Psychiat 17:227-233 ( (Aug) ) 1967;.
Mendelson, M.:  Psychological Aspects of Obesity , Int J Psychiat 2:599-607, 1966;.

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Atkinson, R., and Ringuette, E.:  A Survey of Biographical and Psychological Features in Extraordinary Fatness , Psychosom Med 29:121-133, 1967;.
Stunkard, A., and McLaren-Hume, M.:  The Results of Treatment for Obesity: A Review of the Literature and Report of a Series , Arch Intern Med 103:79-85 ( (Jan) ) 1959;.
Bruch, H.: The Importance of Overweight , New York: W. W. Norton & Co., Inc., Publishers, 1957;.
Bruch, H.:  Perceptual and Conceptual Disturbances in Anorexia Nervosa , Psychosom Med 24:187-194, 1962;.
Bliss, E., and Branch, C.: Anorexia Nervosa: Its History, Psychology and Biology , New York: Paul B. Hoeber, Inc., 1960;.
Stunkard, A.J.:  The Dieting Depression , Amer J Med 23:77-84, 1957;.
Keys, A., and Brozek, J.: The Biology of Human Starvation , Minneapolis: The University of Minnesota Press, 1950;.
Kollar, E., and Atkinson, R.:  Responses of Extremely Obese Patients to Starvation , Psychosom Med 28:227-246, 1966;.
Shipman, W., and Plesset, M.:  Anxiety and Depression in Obese Dieters , Arch Gen Psychiat 8:530-535 ( (June) ) 1963;.
Biggers, W.H.:  Obesity: Affective Changes in the Fasting State , Arch Gen Psychiat 14:218-221 ( (Feb) ) 1966;.
Fischer, N.:  Obesity, Affect, and Therapeutic Starvation , Arch Gen Psychiat 17:227-233 ( (Aug) ) 1967;.
Mendelson, M.:  Psychological Aspects of Obesity , Int J Psychiat 2:599-607, 1966;.

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