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Alfred Coodley, MD
Los Angeles

JAMA. 1975;231(6):571.

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To the Editor.—

Several issues are involved in Dr. Vaisrub's EDITORIAL, "Psychoneurosis and Obesity—The Hen and Egg Dilemma" (230:591, 1974). The two articles discussed (Glucksman et al¹ and Solow et al²) had to do with extremely obese patients, not with the common over-weight patient encountered daily in every doctor's office.

What is crucial is the recognition that overeating per se is usually associated with a primary psychological problem, partially dealt with by this particular form of behavior. Once obesity has been established, a host of secondary psychological reactions occur in response to the new enlarged body image and to the changed attitudes of those with whom the obese person interacts.

It may well be that intestinal bypass surgery as reported by Solow et al is effective for two reasons: (1) The patient can continue to eat as much as he or she wishes, thus partially dealing with whatever . . . [Full Text PDF of this Article]

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