Psychogenic Classification of Obesity



There is a widespread notion that all obese people must have mental health problems that make them eat.

This notion is WRONG!

As discussed in a recent article by my good friend Tessa van der Merwe from the University of Pretoria, one psychological classification of patients with obesity is as follows:

Schizoid Obesity: this is a small minority of patients who display a lack of autonomy, have difficulty establishing boundaries between self and non-self and experience surreal feelings of being governed by external forces. These patients tend to become unbalanced in the long-term with a continuous psychopathological process after weight-loss treatments and will invariably fail most programs.

Egodystonic Obesity: this relatively large group of patients is characterised by living with their obesity in a conflicted way. They often display reactive depression and anxiety and have the continuous need for comfort eating, repeated dietary attempts at weight loss and a high degree of restraint eating.

Egosyntonic Obesity: this may be the majority of patients who develop obesity for a variety of reasons that might be personal, familial, hereditary or cultural. Despite their obesity, they live without psychological problems. They are often extrovert, talented people with a good sense of reality and body image, but with a total inability to resist social eating cues.

Does this classification help in practice? Appreciate any thoughts and comments on this.

AMS