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To the Editor:—
Dr. S. Charles Freed, in his article on "Psychic Factors in the Development and Treatment of Obesity" (The Journal, February 8, p. 369) has emphasized the important psychologic aspects which have often been overlooked. The problem of obesity cannot simply be approached in mechanistic terms of "glandular balance." Dr. Freed has enumerated many more dynamic factors which are essential for a thorough evaluation of the complexity of etiologic factors of obesity. There is, however, also a great danger associated with this type of psychodynamic approach, which has again and again been stressed by our leading clinicians. It concerns the problem of causality and constitution. Psychosomatic concepts must be based on the fundamental question Are emotional factors truly etiologic agents or are pathophysiologic developments and personality characteristics both parallel processes, depending on inherent constitutional qualities?Dr. Freed has completely omitted to mention the constitutional aspects of obesity. One
Freyhan FA. OBESITY. JAMA. 1947;133(14):1032. doi:10.1001/jama.1947.02880140062023
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