The Psychical Functioning of Young Girls Who Have Been Obese since Childhood

Common obesity is an excess weight caused by the accumulation of stored fats. It is defined by a weight excess of 20% or more, starting from a reference weight establised by taking account of the subject’s height, sex and age, and which appears before two years of age or during the latency period (6-7 years of age) or yet again in the prepubescent period. Although it seems legitimate today to suggest the existence of a network of causal factors, of problem configurations implicated in this symptom, psychodynamic factors may in fact pre-organize infantile obesity. The specificity of the clinical picture leads us to think about the possibilities of treatment of loss which is as much narcissistic as it is objectal, and about the anti-depressive function of surplus weight as it is expressed through a repeated incorporative conduct. During adolescence, the reactualisation of infantile neurosis associated with the obligation to think differently about parental figures can influence the psychic functioning of the young girl and generate or aggravate a (childhood) obsesity. In this clinical study, included in a medico-psychological research action concerning anomalies of pubescent development in type-I diabetes and obesity, we put to test the hypothesis according to which the strong presence of the depressive (pregenital) problem-configuration in overweight young girls attests to the difficult psychic treatment of loss. This psychopathological study is made up of a clinical interview, projective tests (Rorschach and TAT) and two self questionnaires of depression (MDI-C) and self-esteem (Coopersmith). The results, obtained for ten young girls whose obesity was discovered during their infancy, makes it possible to disclose the transversal themes in which narcissistic fragileness, depressivity, the separation-individuation problem type associated with non-access to ambivalence and the identificatory problem-configuration are central.