Level of object representation and psychic structure deficit in obese persons.

The structural deficit and external regulation hypotheses of addiction state that addicts do not have adequate psychic structure with which to regulate painful affects internally. They instead use their drug of choice as an external regulator to self-medicate painful affects. This study tests whether the hypotheses can be applied to obese persons, for whom food may be the drug of choice. The level of object representation of 22 moderately obese and 24 normal weight subjects was compared using the Blatt Family Interaction Questionnaire. The mean level of object representation of both parents was lower for the obese subjects than for the normal-weight subjects. This finding supports the structural deficit and external regulation hypotheses of food addiction.