Written in 1980, this assessment by Peter G. Lindner, MD, still holds true today. Obesity is pervasive and comes at a high cost to individuals and societies. This big picture is populated by the individual compulsive eater who is held in bondage to their unhealthy relationship with food by their own hopelessness and defiance. What OA offers that can solve the issue for compulsive eaters is “ego reduction,“ a means of letting go or surrendering their self will in exchange for guidance and care from a power greater than themselves.

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[Note: The statistics quoted below are from 1980, when this appendix was originally published. See the footnote for updated information.]

I was most pleased, several years ago, to be invited as a representative of the American Society of Bariatric Physicians (a medical scientific society devoted to the study of obesity and allied conditions) to attend an annual convention of Overeaters Anonymous. I have since then attended several others. I was also privileged to attend some local group meetings.

The basic concept of Overeaters Anonymous is that compulsive overeating is a disease that affects the person on three levels—physical, spiritual, and emotional. Members of OA feel that, like alcoholics, they are unable to control their compulsion permanently by unaided will power.

Obesity is unquestionably one of the major health problems in the United States today. In fact, it is a problem common to all affluent societies. Estimates as to the number of overweight individuals in the United States range from ten million to more than seventy million, depending on what criteria are used to classify an individual as obese. Furthermore, in recent years there has been a steady increase in the number of overweight individuals. This is due to many factors. Chief among them is our success in creating an abundant food supply while our physical activity continues to diminish.

To indicate the magnitude of this menace, a Gallup Poll in 1973 revealed that 46 percent of Americans polled felt they were overweight, while less than 8 percent thought they were underweight. Out of every ten persons, four or five were doing something to control their weight. Senator George McGovern’s committee hearings disclosed that obesity nourishes a ten billion dollar industry, with one hundred million dollars yearly being spent for reducing drugs alone. The US Public Health Service estimates that at least sixty million Americans weigh more than they should. The most disturbing problem is that perhaps less than five percent of dieters are able to maintain weight loss for at least five years.*

As a physician, my main concern with the obese is the medical risks to which their obesity exposes them. Such persons have a greater than 40 percent chance of dying in any given year from heart disease, a greater than 30 percent chance of dying from coronary artery disease, a greater than 50 percent death rate from cerebrovascular disease (strokes), as well as an increased death rate from many other diseases. It has also been pointed out recently that the risk of developing diabetes is increased twofold by an increase of 20 percent in body weight. In women, there is also a significant increase in the development of uterine cancer associated with excess body weight. In a recent study of 75,532 fat women, there were sixteen diseases associated with obesity. Furthermore, obesity predisposes to high blood pressure, gallbladder disease, and the formation of gallstones requiring surgery. Even babies born of obese mothers have more than twice the infant mortality of babies whose mothers’ weights are normal.

Most individuals who join Overeaters Anonymous are aware of these risks. But, like alcoholics, they are unable to control their compulsion on any lasting basis. They have completely lost faith in life and in themselves. In OA, hands of understanding and strength are extended to them by people who suffer the same compulsion and who are now examples that there is an answer. This probably explains OA’s success with the hopeless obese person who has repeatedly failed with the usual methods of weight control. I was particularly impressed with the extreme friendliness and even love between members that was easily observable at meetings.

Many OA members are former participants (and dropouts) of commercial weight control groups. I observed a number of individuals who had been unsuccessful in the commercial organizations, but who had reached and maintained normal weight for a number of years after having joined Overeaters Anonymous. On being asked why they switched organizations, they were quick to inform me that the continual preparation of “free” foods and general preoccupation with food, as sometimes expounded, only kept their food compulsion alive.

When compulsive overeaters realize that they cannot control their eating behavior, they need to accept and depend upon another power—a power acknowledged to be greater than oneself. The interpretation of this power is left to the individual. Many, perhaps most, members of OA adopt the concept of God. But newcomers are merely asked to keep an open mind on this subject and usually they find it is not too difficult to work out a solution to this very personal problem, even if they are atheist or agnostic.

Psychologically, the obese individual is helped to attain a sense of the reality and nearness of a greater power, which replaces one’s egocentric nature. Then the person’s point of view and outlook will take on a spiritual coloring. Hence, one no longer needs to maintain a defiant individuality but can live in peace and harmony with the environment, sharing and participating freely, especially with other members of the group. This is a great therapeutic weapon that I, a physician who has dealt with obese people for more than twenty-seven years, can appreciate. The obese individual no longer defies, but accepts help, guidance, and control from the outside. As OA members relinquish their negative, aggressive feelings toward themselves and toward life, they find themselves overwhelmed by positive feelings of love, friendliness, tranquility, and a pervading contentment. These latter feelings were evident among the groups I attended.

A word frequently heard in OA groups is surrender. It can best be described as letting go. The individual gives up personal rigidities, relaxes and admits to being beaten by compulsive overeating.

The source of this feeling is almost always despair, which is so prevalent in newcomers to the group. It is all part of a crisis experience, with an overload of hopelessness. In the act of surrender, one does not just give up but accepts a power greater than oneself, reducing the ego and admitting the need for outside help.

The “ego reduction” can be very profitable to the personality makeup of this person. It is important to differentiate between submission and surrender. In submission, an individual accepts reality consciously but not unconsciously. There is acceptance that one cannot, at the moment, conquer reality, but lurking in the unconscious is the feeling that “there will come a day when I will be able to handle my problem on my own.”

Submission implies no real acceptance of one’s inadequacy; on the contrary, it demonstrates conclusively that the struggle is still going on. Submission is, at best, a superficial yielding, with the inner tensions still present. When the individual accepts, on an unconscious level, the reality of not being able to handle compulsive overeating, there is no residual battle. Relaxation ensues with a freedom from strain and conflict. This freedom is the aim of the OA groups, and complete surrender is manifested by the considerable degree of relaxation that is evident in the behavior of those who
have achieved it.

Once compulsive overeaters surrender at the unconscious level, their compliance with the disciplines of the program does not lessen with time, leading to the inevitable regaining of weight. They continue to get messages from the unconscious that the need for outside help will remain for a prolonged, if not indefinite, period. Their wholehearted cooperation is then forthcoming, and constructive action takes the place of skin-deep assurances that they will merely comply temporarily until the memory of their suffering and self-pity weakens and the need for compliance lessens.

Surrender, then, is an unconscious event. It is not willed by the individual. It can occur only when one becomes involved with one’s unconscious mind in a set of circumstances that signal the undeniable need for an external greater power. The definition of surrender can be understood only when all its unconscious ramifications and true inner meaning are glimpsed. Observed by others, such an individual manifests an inner calm and a “live and let live” attitude.

In analyzing Overeaters Anonymous, I have reached a number of conclusions. There appears to be a deep shift in the individual’s emotional tone, the disappearance of one set of feelings and the emergence of a very different set. The member moves from a negative state of mind to a positive one. This may have the earmarks of a spiritual conversion. Be that as it may, it is an effective transformation and essential for long-term success.

By this I do not mean to imply that there are never any slipups. Indeed, there are. But they are usually due to overconfidence as people are successful in the program and once again become too preoccupied with themselves. As long as they attend group meetings, help is immediately available, inspiring them to return to abstinence and to the Twelve Steps of recovery. They are neither judged nor scolded. There are no weigh-ins. They can share their past experiences, their present problems, and their hopes for the future with those who understand and support them and who speak their own language. Working with a sponsor, the individual converses with a person who has been through similar experiences. Thus the communication between these two is on the same level. When OA members become sponsors themselves, their loneliness is greatly alleviated. They are needed and accepted. This has a very potent, positive influence on weight maintenance.

OA literature suggests that the newcomer visit a doctor to decide upon a plan of eating suited to both physical needs and family habits. I can verify that this was, indeed, the policy with a number of patients whom I have referred to this group. OA is not concerned with the medical aspects of obesity, but with the compulsive nature of overeating.

It is my firm belief that Overeaters Anonymous has made a definite place for itself in helping the obese individual and renders a valuable service to such a person. The empathy and attention individuals receive at meetings during trying times can be of great therapeutic value. Overeaters Anonymous can help individuals restore their faith in themselves and in others and give them hope for recovery. There is no other organization, lay or professional, that has such a profound influence on the compulsive overeater’s thinking; and after all, it is our thoughts that precede our emotions, and it is our emotions that make us eat inappropriately and become physically obese. Recovery in OA is on all three levels. It may seem a tall order, but it’s one which has the greatest chance for success.

It has been an honor and a most exciting experience for me as a professional to have had the opportunity to get to know the members of Overeaters Anonymous. I will forever be grateful to them for the good work they do in combating a major health problem in the United States.

— Peter G. Lindner, M.D., 1980

* More than one-third of US adults were obese from 2011 to 2012. The estimates for overweight and obesity combined (BMI greater than or equal to 25) were 68.8 percent overall: 73.0 percent among men and 64.7 percent among women. An estimated 18 percent of children ages 6 to 11 and 21 percent of adolescents ages 12 to 19 were obese. (U.S. Department of Health and Human Services, Health, United States, 2013)

In 2012, costs associated with obesity accounted for $190 billion annually—121 percent
higher than previous estimates. More than 20.6 percent of all national health expenditures is spent on managing obesity and the related plethora of health problems, researchers said. (Amir Khan, Obesity in America: Healthcare Costs Double Previous Estimates, Journal of Health Economics, Vol. 31, Issue 1, Jan 2012, pp. 219-230)

Based on latest available surveys, more than half (53 percent) of the adult population
in the Organization for Economic Cooperation and Development (OECD), an international economic organization of thirty-four countries founded to seek answers to common problems and co-ordinate domestic and international policies, report that they are overweight or obese. The prevalence of being overweight and obesity among adults exceeds 50 percent in no less than twenty-one of the thirty-four OECD countries. On average across the OECD countries, 18 percent of the adult population is obese. (Overweight and obesity, OECD Factbook 2013: Economic, Environmental and Social Statistics)

Dr. Peter Lindner was past president of the American Society of Bariatric Physicians and chairman of its board of trustees. He received the 1975 Appreciation Award of Overeaters Anonymous in recognition of his work in the field of obesity and compulsive overeating and his efforts to bring the OA program to the attention of the medical community and the general public. Dr. Lindner passed away in 1987.

Overeaters Anonymous, Third Edition pp. 198–204.

© 1980, 2001, 2014 by Overeaters Anonymous, Inc. All rights reserved.