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

By Hilde Bruch | Go to book overview
conviction of inner inadequacy, were the underlying factors which rendered these patients excessively vulnerable to real or dreaded rejection. As in these three girls, there are marked differences in the factors contributing to the serious disturbance in personality development. No general description can be given about the background features, except that they all used overeating and withdrawal from life in the face of overwhelming difficulties. The unfriendly social climate is only one of these difficulties, which a plump adolescent with a fairly healthy mental attitude can face with equanimity, and without becoming progressively fatter.More damaging are the individual attacks under which such youngsters suffer. Often it is the parents who are vehement in demanding that an adolescent, in particular a daughter, should be slim, and they will conduct harsh campaigns against even mild degrees of plumpness. Invariably this is a sign of disturbed relationships within the family, and youngsters having grown up under the influence of such pervasive discontent are ill- prepared to meet the new demands of adolescence. Inability to control their weight is only one aspect of the underlying immaturity and incompetence.Not uncommonly had physicians contributed to these difficulties. I mentioned before that frequently serious amphetamine addiction had developed from thoughtless prescriptions. I observed repeatedly that when one physician had outlined a reasonable treatment program, including correction of the severe emotional disturbances of the whole family, there was always another ready to promise a "get thin quickly" cure through a "special" diet, glandular injections, or reducing pills. The prevailing medical approach fails to take sufficient notice of the extraordinarily close interaction between physiological and psychological factors in obesity. This works a particular hardship for adolescents who want to do something about their condition but who become perplexed by contradictory advice, in particular by advice that contributes to the unbearable tension from which they suffer instead of helping them to achieve a more meaningful of life.
BIBLIOGRAPHY
1. Lidz, T., Adolescence, Chapter 10, pp. 298-361, in The Person, Basic Books, Inc., New York, 1968.

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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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