Psychological aspects of severe obesity.

Studies of several overweight persons conducted before their undergoing antiobesity surgery have shown 1) that there is no single personality type that characterizes the severely obese; 2) that this population does not report greater levels of general psychopathology than do average-weight control subjects; and 3) that the complications specific to severe obesity include body image disparagement and binge eating. Studies conducted after surgical treatment and weight loss have shown 1) that self-esteem and positive emotions increase; 2) that body image disparagement decreases; 3) that marital satisfaction increases, but only if a measure of satisfaction existed before surgery; and 4) that eating behavior is improved dramatically. The results of surgical treatment are superior to those for dietary treatment alone. Practitioners should be aware that severely obese persons are subjected to prejudice and discrimination and should be treated with an extra measure of compassion and concern to help alleviate their feelings of rejection and shame.