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October 28, 1974

Psychoneurosis and Obesity— The Hen and Egg Dilemma

JAMA. 1974;230(4):591. doi:10.1001/jama.1974.03240040061041

Despite decades of concern—one might even say preoccupation—with obesity, its treatment remains an exercise in frustration. More than 90% of dieters regain lost weight after a variable temporary weight loss. What's more disquieting is the possibility that this weight loss may be attained at the expense of mental and emotional stability.

Such a possibility is indicated by Glucksman et al1 in their studies of six obese patients observed in a metabolic ward for an eight-month period of dieting. The caloric intake during the first six weeks was aimed at maintaining admission weight. During the following 15 weeks—the period of weight loss—only 600 calories were given daily. The caloric regimen during the last six weeks was adjusted to preserve the lowest weight achieved at the end of the weight loss.

The behavior of these patients was evaluated with rating interviews and psychological tests during the period of weight loss and the