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To the Editor:—
In his paper on "Psychic Factors in the Development and Treatment of Obesity" (The Journal, February 8, p. 369) Dr. Freed laid particular stress on the etiologic importance of psychosomatic factors in the pathogenesis of obesity. In his communication April 5 (p. 1032) Dr. Freyhan emphasized the constitutional aspects. Both these factors play an essential role. After all, every case of obesity is brought about by "overfeeding," either absolutely or relatively. However, we would underestimate the complexity of the question if we believed that these two factors are sufficient to solve completely the problem of obesity (or likewise of emaciation). Even if factors such as temper, basal metabolism, alimentary extravagance, the specific dynamic effect of food and caloric consumption during and after physical exertion are properly taken into account, we are left with a number of patients whose tendency toward obesity remains unexplained. And, strangely, this is
Zondek H. OBESITY. JAMA. 1947;134(14):1197. doi:10.1001/jama.1947.02880310055021