Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within

By Hilde Bruch | Go to book overview
or he felt that she had stopped, he would cheat on his diet and his weight would increase; he would blame his wife for not having watched his weight, and a violent fight would ensue. Whenever the impulse struck him he would go to a restaurant for a meal, sometimes to two or three in a row. He explained that he needed to do this to relieve the tension about his marital problems. He described his wife as very fussy, compulsive, and rigid, and he reacted to her reproaches by becoming angry and eating more. He was still quite resentful about having a child, though he got along fairly well with his 4-year-old son, but only when he was alone with the boy. He would become acutely disturbed when his wife was present and the child showed his preference for the mother. There was also tension because they were continuously in debt. The amounts he spent on food and at times on alcohol were quite out of proportion for the family's budget.I have emphasized the great diversity of clinical pictures that are covered by such global terms as "overweight" or "obesity." For a long time the mechanistic statistical approach has obscured the picture. It has labeled as abnormal many people whose individual body build falls outside the statistical average, or overlooked in others serious underlying problems that are not exposed by dry statistics. The preoccupation with so. called norms has led to a neglect of the variability of individual human beings. As long as we insist that being fat is ugly and undesirable and should not be permitted, we force a great many people to fight or to disregard the individual endowment of their own physique and to act as if this were not real. Gulliver in the land of the Lilliputians was suddenly very much outside the range of "average" size, but he himself had not become "abnormal." From the point of view of his size one might say that his environment had deteriorated, just as it has deteriorated in our culture for people of large body build. If he had tried to conform to the average and if it had been possible to shrink him to the size of a Lilliputian, he would not have been healthier. On the contrary, he would have been highly uncomfortable and quite "abnormal" in terms of his own biology. The differences in size and weight with which we are concerned are not as extreme as in Swift's satire; but they are just as real and often just as unalterable.
BIBLIOGRAPHY
1. Bjurulf, P., and Lindgren, G., A preliminary study on overweight in the south of Sweden, pp. 9-15, in Occurrences, Causes, and Prevention of Overnutrition, G. Blix, ed., Almqvist & Wiksells, Uppsala, Sweden, 1964.

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Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within
Table of contents

Table of contents

  • Title Page iii
  • Acknowledgments vii
  • Contents ix
  • Part I - General Aspects 1
  • 1 - Orientation and Point of View 8
  • 2 - Historical and Sociocultural Perspectives 23
  • 3 - Biological Basis of Eating Disorders 42
  • 4 - Hunger Awareness and Individuation 64
  • 5 - Family Frame and Transactions 86
  • 6 - Body Image and Self-Awareness 104
  • Part II - Obesity 107
  • 7 - Diversity of Clinical Pictures 132
  • 8 - Obesity in Childhood 150
  • 9 - Obesity in Adolescence 174
  • 10 - Obesity and Schizophrenia 193
  • 11 - Thin Fat People 208
  • Part III - Anorexia Nervosa 209
  • 12 227
  • 13 250
  • 14 - Primary Anorexia Nervosa 284
  • 15 - Anorexia Nervosa in the Male 304
  • Part IV - Treatment 307
  • 16 - The Practical and Psychological Aspects of Weight Change 333
  • 18 - Outcome and Outlook 387
  • Index 389
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