Obesity


 The gastric bypass procedure is a surgical intervention for the

treatment of morbid obesity. Morbid obesity is defined by Charles

(1983) as "weight 100 pounds greater than, 100% over, or at least 200%

of, ideal body weight" (p. 122).

 Several investigators have sought to answer the question of whether

the morbidly obese have a greater incidence of psychopathology than the

rest of the population. In a recent issue of Integrative Psychiatry,

eight psychiatrists and psychologists who treat and evaluate obesity and

other eating disorders reviewed the lead article by Charles (1983).

Below is a summary of Charles' article and the commentary of her peers.

In her review of the psychological status of the morbidly obese, she

made the following statement:

 Because morbidly obese patients appear so "extreme" in terms
 of body weight, the common assumption is that major psycho-
 pathology plays some role in its development and/or
 maintenance. Studies to date are conflicting and have not
 established if such patients have a higher degree of psycho-
 pathology than obese persons or the general population. A
 contributing factor to the apparent discrepancy among study
 findings may be the fact that there are subgroups of this
 population who are more available for study and who are more
 highly vulnerable to psychiatric disability. (p. 122)

 The distinction between morbid obesity and other obesity was not

made until the late 1950s when surgical procedures were developed to aid

in weight loss. Psychologists and psychiatrists had decided that super-

obesity was an "extreme defense mechanism" (p. 123), and one study

reported that "97% of their 31 subjects had a psychiatric diagnosis"

(cited in Charles, 1983, p. 123). Since those early studies using

psychiatric diagnoses as a way of describing the problem, other studies