Obesity, which paves the way for many diseases and is described as a global epidemic, threatens not only adults but also children and infants.
Obesity is a health problem that occurs as a result of excessive fat accumulation in the body and must be treated. If we are talking about a condition that requires treatment, we are automatically talking about a disease. This means that the issue is a health problem before anything aesthetic or visual. In the past, people described being overweight not as a health problem but as not being aesthetic, beautiful, or attractive. Even today, in some communities, the idea of “those who eat a lot are healthy and strong” is still idealized.
“If you find food, eat; if you see a stick, run” — when we remember that we grew up with sayings like this, which suggest “eat whatever you find, take every opportunity to eat because eating a lot should not be avoided,” we understand how our relationship with food has developed. However, when things get out of control, even in situations such as cardiac problems, hypertension, and diabetes caused by obesity — conditions that threaten the integrity of the organism — people still take the medication prescribed by the doctor but do not willingly follow a diet. The belief “nothing bad happens from eating too much, but if you stay hungry you get sick” still persists. Is obesity an epidemic? Or is it an issue that has already been emphasized and noted since ancient Greek civilization? The statements made by physicians and thinkers regarding eating behavior throughout history actually describe a long-existing reality — but perhaps because it was denied for various reasons until recent years, it is now described as an epidemic, as if it is something newly emerging. The saying of Lokman Hekim summarizes the seriousness of the issue: “When the stomach is full, the mind sleeps, wisdom dies, and the limbs become still.” (Lokman Hekim). Or the words of other thinkers: “Overeating is the yeast of disease.” (Feridüddin Attar) “Avoid eating again before digesting what you have eaten.” (Ibn Sina)
The number of those who die from being full is greater than the number of those who die from hunger (Proverb). From the past to the present, we can find many meaningful proverbs and sayings like this.
As can be seen, all the sayings above refer to a medical condition that can lead to serious consequences, even life-threatening ones. In other words, we can say that the aesthetic purpose of obesity treatment or joining a weight-maintenance program is far behind. Because slimming and looking good will eventually happen as a result — even if you do not aim for them — but they are not the primary or fundamental goals.
The saying by Cenap Şehabettin, “I pity those who are hungry in spirit more than those hungry in stomach,” actually indicates that obesity also has an internal, emotional, and affective dimension. In some people undergoing obesity treatment, the emergence of intense anxiety disorders or depression as they lose weight shows us that obesity has a function in a person’s psyche. Why would a person become more depressed or anxious as they lose weight? Why would someone want to continue being overweight even though they could lose weight and maintain it? Why break the diet, why say “I don’t trust myself to continue”? Could the fat, the weight, be a barricade? A shield between the inside and the outside world? What significance might it have for individuals who persistently maintain it? Is the real problem truly the inability to lose weight? Because many people start these programs feeling uncomfortable with their weight, and many do lose weight — and they themselves know this. Yes, in recent years, a new concept has emerged in obesity treatment: weight maintenance. Previously, people spoke about weight-loss medications, losing weight one way or another, large slimming centers, and short programs resulting in rapid weight loss. Now, however, experts say: “Yes, you lose weight, but you must maintain it.” Is this something newly realized? Why was the goal previously only to make people lose weight but not to help them maintain it? It appears that the focus was only on symptoms, on the visible aspects. As is known, in mental health, symptoms are the visible expression of what is internal — they are signals. So what is the internal conflict causing these signals? Why do people become depressed after losing weight? Why do they mourn the weight they lost? What I am saying may sound absurd, but absurdities, precisely because they are spontaneous, can contain interesting associations that reveal meanings between the lines. The lost weight and accumulated fat — are they only that? In one long-term psychotherapy session, a patient, through a slip of the tongue, revealed that the weight made him feel strong and symbolically equal in power to his older brother, who received more attention at home — and he himself was surprised by this. Some people openly say that being overweight protects them from others and makes them feel strong — something we all know. Yes, it is true that being overweight in childhood has disadvantages, and especially during adolescence — a period where the body is on stage — it is particularly difficult. But we must recognize this: obesity is not only the cause of hypertension, heart disease, and diabetes, but it is also the bodily expression of unexpressed emotional and psychological problems. If we deny this psychological component, then in future years, alongside “you lost weight but couldn’t maintain it,” we may hear, “you maintained it, but you ignored the psychological dimension.” Unless the organism is treated as a whole, treatments will always be incomplete and patchy.
Now I will talk about how eating behavior is shaped by the early mother–child relationship.
At birth, the infant does not actually perceive the mother — only the breast. In other words, the baby encounters a source of nourishment. The mother’s breast represents the mother, nourishment, something erogenous, a sense of safety, and the relief of hunger. At this point, the mother’s attitude — the presentation of the breast, how she offers it, what she feels while feeding her baby, eye contact while the baby suckles and becomes full, her capacity to calm the baby and move in harmony with them — all of these show us that eating behavior cannot be separated from its relational dimension with the mother. If we adapt the proverb “A woman must simmer together with the food she cooks, otherwise the meal will lack flavor,” we can say that unless the mother adds her interest, affection, and feelings of compassion to the milk she gives, that milk will not have a nurturing or restorative effect on the infant’s psyche, nor will it provide a sense of safety or maternal affection. Milk given merely as a duty satisfies hunger but does not carry deeper meaning. In obesity, although people say they enjoy eating, is there not talk of an uncontrollable urge? The expression “I enjoy eating” is the rationalized form of the issue. The organism has physiological needs, and beyond that, there are foods we enjoy — flavors we appreciate. But binge-eating, constantly thinking about food, wanting to eat at every opportunity is nothing but addiction. Addiction is not about pleasure — it is about need, dependency. Just as the infant is dependent on the mother’s milk. But if this dependency transformed into a pleasurable, relational experience, then emotional hunger would be met within the relationship and satisfaction would be found. Yes, I know — you already know that you eat due to emotional hunger, boredom, or anger. But you do not know why you use your body to meet these needs. Neither do I. Because every reason and every justification is personal and subjective. However, some research findings help us turn the subjective into something objective.
For example
- During the first 6 months of life, babies should be fed exclusively with breast milk
- Babies should not be forced to finish the bottle once they are full
- High-calorie foods should be avoided during childhood
- Instead of sugary and carbonated drinks, water, ayran, and milk should be preferred
- Children should be encouraged to eat vegetables, legumes, and salads
- Regular meals (3 main, 3 snacks) should be consumed and meals should not be skipped (especially breakfast)
- Food should be eaten slowly and chewed well; random snacking should be avoided
- Plenty of water should be consumed
- After serving, the serving dish should be removed from the table
- After finishing the meal, one should leave the table
- Processed foods should be avoided, etc.
We must not forget that obesity is a genetic, sociological, and psychological phenomenon.
I would like to end this brief reminder with a saying by Sadi.
One who is fond of his stomach cannot sleep for two nights: one when his stomach is empty, and the other when it is too full. (Sadi).
