The Psychology of Obesity

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An awfully pretentious title for early on a Friday, right? But today will be my first visit to a psychiatrist in many years, after a couple of very bad patient/doctor relationships - and telling myself to not worry about the visit today has got me thinking about why it is that a person becomes obese in the first place.

Visit any forum or message board dealing with obesity these days and you will find a few trolls - those individuals who have taken time out of their day to drop in and tell us that we are only "fatties" due to a lack of willpower. If we only had some self-control (as, presumably, these individuals believe they do) we would not suffer from this problem. To them, the condition of obesity is a product of nothing more than laziness. Running into an especially obnoxious troll post can infuriate me for hours afterward - which tells me that something inside that post has resonated with me. Apparently I, too, believe at least in part that if I had just tried a little harder over the past 20+ years, I would not be obese.

And here lies the problem with obesity, in a nutshell. The vast majority of us thinks that we alone are responsible for our condition. But, other than being fat, where is the evidence? The majority of us go to work, we raise families, we practice religious devotions, we do chores around the house - we do a hundred things a day that prove that we are not lazy - and yet we accept that the state of our bodies results from a failure in willpower.

Obesity sits in the same corner with drug addiction, alcoholism, and depression - conditions that a person who has never suffered from will never really understand. These afflictions of the mind are easy to marginalize and make fun of because they are invisible to the naked eye. A person on crutches wearing a cast is accepted as having a broken leg. But, in our culture, obesity is not accepted as a sign of a broken mind.

A few years back, Lor and I stopped by a local gym to check into monthly rates, thinking maybe we could get this thing moving on our own. The young and heavily muscled twerp behind the counter took one look at the two of us and suggested that maybe this wasn't the gym for us. We couldn't afford it anyway, so I just let it go. But I guarantee you that I went home and ate something afterward. "Healthy" society had just rejected me and made me feel bad. So, I went home and ate, which made me feel good.

Now, which activity do you think I return to most often? It is called a conditioned response - your mind drives you towards those things that feel good. The mind associates things which are good for itself (eating, sexual response) with pleasure, and things which are not good (being cast out of a social group, hitting oneself with a hammer) with pain. This is Mother Nature at work here, trying to secure the continued survival of a species. What Mother Nature did not count on is that we've now developed a cycle:

• There are so many things to eat which cause pleasure.
• Overeating develops obesity.
• Obesity causes rejection by social groups, which is painful.
• One retreats from the pain of rejection, by embracing the pleasure of eating.
• Back to step one.

This is, of course, a vast over-simplification - and I am no psychiatrist. But the logic is clear: why would I endure rejection and exercise (which is initially painful as well) when I could instead feel good by eating? Eating is a short-term pleasure, of course, but there is always another Quarter Pounder or Snickers bar just around the corner. I am not only eating things which are bad for me, then - I am also eating them more often.

See where this is heading?

I am not looking forward to bariatric surgery because the smaller stomach size will force me to eat less. I am looking forward to bariatric surgery because I will finally have the chance to look for "pleasure centers" that do not revolve around food. Weight loss will allow me to finally seek endorphin-releasing exercise. It will enable me to live a life where I am not constantly in pain. It will enable me to have a normal sex life. And, yes, it will enable me to interact with other people without the prejudice against obese people working against me. I am willing to have the majority of one of my internal organs removed and THEN go through all the normal work of weight loss, just to reset my association with food as the sole source of pleasure in my life.

It may seem unfair, but there it is. I have to live in the world as it is, not as I wish it to be.  I can only hope that my psychiatrist today agrees with me, and does not instead want to turn me into a multiple-year case study or something. Wish me luck!

Still Looking For Endorphins That Don't Make Me Fat,

- Hawkwind