Obesity means signiﬁcantly overweight, usually a body mass index (see deﬁnition later in this module) of about 32 or more, or more than about 30 percent above ideal weight. It is possible to be obese without being an eating addict, but the more severe the obesity, the harder it is to explain the phenomenon without suspecting that addiction is involved.
Using John Lovern’s Uniﬁed Eating Disorders Theory we can describe obesity as a cyclical eating disorder in which the cycles gravitate toward the overeating side of moderate. Over time, the cycles get much longer, and obese people may eventually give up trying to manage their weight at all. There may be long periods of time on rigid, very low calorie diets that are nearly fasting, alternating with steady overeating for months or years at a time.
Risk factors There are strong genetic links with obesity, so the best single predictor of whether a person wil become obese is to look at obesity in the family. This does not mean that having overweight parents and grandparents dooms you to be obese, however. It simply means there is a tendency.
Cultural factors Some cultures tolerate obesity, and some even encourage a fair amount of obesity. These cultures usually include more fat in their diets, and fat is often a sign of wealth rather than something shameful.
Obesity is especially tragic in adolescents. Poor self-image often starts there. Many obese people cannot remember a time in their lives when they were not signiﬁcantly heavier than their peers, when they were not the brunt of jokes and insensitive comments from family, friends, and strangers alike.
Obese children are discriminated against in all sorts of ways. Usually self-image is distorted at a young age, and these children grow up with lots of deﬁcits in interpersonal skills. Sometimes there has been no healthy bonding with others, and this may be aggravated by emotional or even physical abuse from others.
Some people who have been obese since childhood may develop serious personality disorders. Sometimes their shame, fear, and lack of trust are like that of abused children. Because they did not know how to stop the abuse (ridicule, threats, and others’ obsession about their fatness), they developed a pattern of eating to soothe this pain, which only aggravated the problem.
Adults are also targets of discrimination, in jobs and social situations. They are often bombarded by family and friends who say, “That’s all in your head. You can get a job if you try.” The reality is that they have a terriﬁc handicap. It is also true than many fat people will not take advantage of the opportunities they do have. The pain is tremendous.
Most obese people have already tried so many things to lose weight that it is difﬁcult to hope anymore. They are vulnerable to any scam that comes along that promises a cure, which is usually followed by severe discouragement and depression.
The traditional measure of obesity has been weight. This measurement is very misleading. For example, 154 pounds might be in the anorexic range for a person 6 feet 6 inches tall, but obese for someone who is 4 feet 10 inches.
Body mass index For a number of years the eating disorders profession has been using a measurement called the body mass index. This is weight (in kilograms) divided by height (in meters) squared. See the Weight module for an easy way to calculate it. There are at least two advantages to using it compared with ordinary weight. First, it does consider height, so there is some comparison between people of different heights. Also, the numbers that result are unfamiliar to most people and may produce less obsession. For BMI charts and more, see BMI in Weight.
Waist/hip ratio This determines whether the person is more apple- or pear-shaped, or whether they carry their weight more in their abdomen or their thighs. Pear shapes are healthier for any given weight because the weight puts less stress on the spinal column and the internal organs.
Problems in Treatment
It is very difﬁcult to break the diet mentality for obese people. There is so much pressure from family, friends, and the culture itself, and there are many old assumptions about being fat, dieting, and failure.
Factors in recovery Focus must be shifted to the process (now) rather than what it will be like when you have lost all the weight. If you are eating moderately and losing weight, even very gradually, you will feel great! Obese people are weight-lifters; your muscles are toned to lifting a heavier person, so you will feel like doing more each week.
Many obese people also have work to do on their emotonal, mental, and spiritual recovery. Self-esteem, assertiveness, social skills, codependency, and control issues are all areas obese peJple may need to address in recovery. Many ﬁnd individual and group counseling helpful. It is best if counselors have experience in addictive eating treatment. Of course, the ultimate solution involves a comprehensive solution such as the Twelve Steps.
Obesity, see also: Addiction, Adolescents, Bariatric surgery, Binge history, Bingeing, Biochemistry, Constipation, Craving, Diet mentality, Edema, Eating addiction, Eating plan, Exercise & activity, Fats, Feelings, Hunger & appetite, Nutrition, Physical aspects, Recovery, Sex, Therapy & treatment, Unmanageability, Weight.
Updated 6 Sep 2015
Addictionary 2 by Jan & Judy Wilson
is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.