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May 1968

Psychotherapy of Six Hyperobese Adults During Total Starvation

Author Affiliations

From the Medical Clinics, Peter Bent Brigham Hospital, and the Department of Psychiatry, Harvard Medical School, Boston. Dr. Rowland is a research fellow in psychiatry at Harvard Medical School.

Arch Gen Psychiatry. 1968;18(5):541-548. doi:10.1001/archpsyc.1968.01740050029005

PSYCHOTHERAPY was carried out on hyperobese adults during total starvation of 10 to 50 days on a metabolic research ward. Observations on six patients (one woman and five men) included the vicissitudes of aggressive and sexual impulses, the impact of fasting and weight loss on the patient's body image, and the psychological effects of the study on the patients. None of them had major physiological factors producing their obesity, and all six would be considered hyperobese by the criteria of Atkinson and Ringuette.1 All but one of the patients were seen for at least 20 hours.

Previous Studies  The difficulties involved in successfully treating "simple obesity"—that form of obesity which is primarily related to overeating and underactivity and which has no observable relationship to known physiological disorders—are well known.In 1959, Stunkard and McLaren-Hume2 reviewed the results during the previous 30 years from outpatient treatment

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