Chapter 11 - When Illness Causes Overweight

Myths about Overweight | Organic Causes of Overweight | Emotional Causes of Overweight

It has been pointed out that over 95 per cent of our overweight friends got that way simply because they ate more calories than they expended in the process of staying alive, working, and playing. But some people are unwilling to accept so simple an explanation. They talk about mysterious causes of obesity.

This is a handy excuse. Our overweight friend shrugs his shoulders, sighs, and says, "Oh well, nothing I can do about it; thyroid, you know."

Singled out by Fate and his thyroid to be fat, our man might just as well consume a 200-calorie chocolate bar, or so he thinks.

Fact of the matter is that there are very few true cases of hypothyroidism.

Here are some facts about thyroid. It is the most important gland in controlling the rate at which you burn food. In rare cases inadequate production of thyroid hormone prevents the individual from burning up food at a normal rate. But there's nothing mysterious about it, for your physician can determine this condition by measuring your metabolism. If your metabolism is normal there is no chance that you are a thyroid sufferer. If you should suffer from hypothyroidism the administration of thyroid by mouth works wonders.

It does not work wonders unless you have a hypothyroid condition.

It can be dangerous.

There is plenty of proof that indiscriminate taking of thyroid pills to speed up metabolism disposes of your money instead of your fat. Hundreds of thousands of overweight Americans have consumed these pills without producing any change in their weight.

The only effects have been detrimental. Thyroid puts an added burden on the heart and circulatory system of a normal person. An overweight person must eat excessive amounts of food to maintain his overweight. If he is 30 per cent overweight, his organs are already working their rated capacity. When he takes thyroid, he overloads the capacity still more.

Remember, less than 1 per cent of the obesity cases are caused by disturbances of the thyroid. If you have any doubts, let your family physician be the judge of your condition.

Myths About Overweight

The thyroid myth is only one of many. Some women believe that change of life produces glandular changes leading to overweight. There is no medical evidence that your ability to burn food is altered by menopause. The accumulation of fat in this period of a woman's life usually reflects her decreased activity and unchanged food intake rather than variations in her metabolism.

The same is true of the old wives' (and young wives') tale that women gain weight after childbirth because of glandular changes. The usual cause is a continuation of the food habits of pregnancy. A pregnant woman requires more food during the second half of her term, but unless she resumes normal eating after the birth of her baby she will continue to grow—and grow.

Organic Causes Of Overweight

There are organic ailments which lead directly to overweight. Though they affect very few people, we will discuss them briefly.

First on our list is a vicious cycle which goes under the overwhelming name of functional hypoglycemia. To understand this you must realize two basic facts.

1. The pancreas produces the hormone insulin. Insulin metabolizes the sugar and sugar-forming foods which you eat. Insulin thus lowers the concentration of sugar in your blood.

2. When the concentration of sugar in your blood drops below normal the body's need for sugar is expressed by your ravenous appetite.

Among normal folk these two factors do not collide head-on. But Destiny presented Harry B. with a sensitive pancreas. When Harry consumes sugar, his pancreas responds in an abnormally strong fashion. It secretes so much insulin that there is a surplus after its job of metabolizing sugar has been completed. This surplus of insulin lowers the concentration of sugar in his blood below normal, creating an artificial hunger that causes Harry to consume more food, that causes his pancreas to secrete more insulin, that causes another lowering of the level of his blood sugar, and so on and on to the obesity of Harry B.

Harry's physician will solve his problem by prescribing a special diet. It will feature foods which are turned into sugar so slowly that his blood sugar will not rise high enough to overstimulate his rambunctious pancreas. For example, it takes the body several hours to convert half its protein intake to sugar.

Certain insulin-producing tumors of the pancreas cause the same vicious cycle as that observed in Harry B. Whereas Harry's abnormal appetite existed during the eating hours which set his cycle in motion, the tumor sufferers feel their pangs at night. They may wake up with hunger so intense that it leads to convulsions. But they are lucky in their way, for their tumors can be removed by a simple surgical operation. After that their violent hunger subsides to normalcy. This solves their obesity problem.

Certain rare injuries to an area of the brain called the hypothalamus can also cause excessive appetite, but it is obvious that only a relative handful of people have had such injuries.

Also in the rare category are tumors of the adrenal glands which give rise to Cushing's disease. This disease leads to extreme obesity, is usually associated with diabetes, and can be relieved by removal of the tumor.

The plain, unvarnished, and wonderful truth is that very few people are obese because of organic illness. This contrasts with the problems of the underweight. As we shall see in the next chapter, a substantial proportion of the underweight can trace their troubles to specific ailments.

Emotional Causes Of Overweight

Although organic illness is responsible for very little obesity, we cannot ignore the fact that emotional problems, too, may cause overweight. There are compulsive eaters driven to overeating by the pattern of their lives. These people require the services of trained, reputable psychiatrists. Detailed explanations of the factors which may lead men and women to this situation are not proper subjects for this book and could do more harm than good. As matters of general interest, however, and because they reflect our ever-widening knowledge of the human mind, here are some of the ideas propounded recently by outstanding psychiatrists.

In a limited number of cases the emotional disturbances that lead to obesity reflect a desire to return to the pleasures of infancy.

A baby's first satisfaction is in the sensation of eating. Some adults who are under emotional pressures subconsciously revert to this infantile satisfaction. Unable to experience adult gratifications, they seek release from tension by overeating.

If this sounds complicated and farfetched, think of your own normal reaction when things are not so happy as they should be.

Dr. S. C. Freed asked 500 obese patients the following question: "When you are nervous or worried, do you eat more or less?"

Seventy-four per cent replied that they ate more food or ate at more frequent intervals. Another 19 per cent said that they ate more when they were idle, bored, or tired.

Medical records offer plenty of proof that your emotions have an important effect on your weight. Many psychiatrists have had patients who ranged all the way from "skin-and-bones" underweight to extreme obesity during the course of treatment.

Overeating can stem from such emotions as frustration, anger, grief, anxiety, and guilt. People whose emotions are out of hand require more than new calorie relationships before they can reduce to their desirable weight. They require the services of skilled psychiatric specialists.

Some people try to substitute food for the satisfactions which are lacking in personal relationships with their families or in their jobs. But prowess at the dinner table cannot take the place of stable day-to-day living. These people need help in solving, or at least understanding, the real cause of their overeating. Once their emotional situations are under control, cutting down the calories is an easier job.
In some cases physicians have noticed a pattern of obesity in families which once suffered poverty or other hardship. With the improvement in their social and economic status, food has become available in plentiful quantity. To these people it may be symbolic of new security and of standing in the community. The parents look upon themselves as good providers. They seek the love and respect of their children by overwhelming them with the food which represents their new success.

In this way dangerous family eating habits, difficult to break in later years, are developed. Children brought up in a household in which achievement is measured by the quantity of food on the table, may continue this eating pattern on to obesity.

Physicians now recognize the importance which obese people may attach subconsciously to their physical size. The fat man may regard his body as a fortress, secure against an unfriendly world. He may say that he wishes he were thin, but in reality he may feel that his size gives him power and importance.

An obese person who is upset emotionally may feel that his awesome bulk will destroy his imagined enemies.

Such patients must be brought back to reality and must learn to see themselves in a clear and honest light. Dr. Hilde Bruch, one of the outstanding authorities in this field, has pointed out how frequently obese people have vast ambitions which they cannot possibly fulfill. They say that they would attain these impossible goals if they could lose their excess weight. Secretly they may wish to remain fat so that they will not be put to the test.

Dr. Henry W. Brosin has observed that a child who overeats "may be using food as an additional substitute for the thin rations of affection which the parents can offer." Other psychiatrists have observed with Dr. Brosin that an insufficient intake of love, affection, and understanding may lead to an overlarge intake of food. Emotions, like diet, have to be balanced for optimum health.

The problem of the relatively small number of compulsive eaters is very much like the problem of the alcoholic. For that reason, groups of obese people who get together and talk out their troubles can be as effective as Alcoholics Anonymous.

An experiment conducted by the U.S. Public Health Service in Boston bears this out. Once a week, groups of obese Bostonians met with specialists to discuss their problems of overweight. Two years after the discussions had ended 40 per cent of the patients had maintained their weight losses.

"Imprisoned in every fat man," goes a modern quotation, "a thin one is wildly signaling to be let out."

A discussion of ways by which the thin man can be released would require a book in itself. Our focus is on the typical overweight American, not on the compulsive eater who is not typical.

It is important for the reader to realize that an individual's "ideas" can cause both overweight and underweight. Each case requires individual attention. No blanket rules or regulations apply. Self-treatment is as dangerous as treatment by unqualified persons. If you are overweight, see your physician before attempting any remedy. If he refers you for psychiatric care, you can feel assured that he is exploring every possibility.

If emotional conflicts are at the root of your obesity problem, starvation diets, quack cures, and the advice of well-meaning but unknowing people are more dangerous than ever. They can aggravate your condition seriously.

See your doctor and trust him. He is the safe starting point from which to begin your successful campaign against obesity.

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