Language:
Abstract:
Adolescence is a period of great growth and development in which nutritional issues acquire enormous importance, not only due to the increased need for nutrients, but also due to the rapid change in self-image. Thus, adolescents are called upon to re-appropriate a transformed body image, but their bodies do not fit into a pure and simple reference to need, pleasure or reality, and are entirely subject to the complications of the psyche. During this period, nutritional disorders are common, compromise health and have been growing at alarming rates throughout the world, including in Brazil. Overweight and obesity have serious organic and psychological repercussions for individuals, since food goes beyond the simple instinctive satisfaction of a need, that is, of pure biological hunger. What they eat and their bodies are privileged means by which adolescents show us their sexual impasses. By articulating the fields of medicine, history, art and psychoanalysis, this article aims to investigate the issue of obesity/sexuality in adolescence, distinguishing it from an organicist and timeless naturalism.
Abstract:
Adolescence is a human developmental period where nutrition gains crucial importance, not only because the rapid development of all organs and its necessity of proper nutrients but also because of the self-image element in constant and rapid mutation. Thus, the adolescent is invited to recapture his body image in constant transformation (and already transformed) beyond the simple reference of the biological (linked to the necessity apparatus), also beyond his own pleasure or the external reality. This invitation is completely bound to the rules and complications of the adolescence psyche functioning mechanism. At this developmental life stage, eating disorders are common, jeopardizing the adolescents’ health and are increasing in alarming proportions worldwide and in Brazil especially. Obesity and its most visual symptom, overweight, cause relevant organic and psychological issues to the obese individual. Food becomes something bigger and beyond the pure instinctive necessity, the pure biological hunger. The adolescents through their food choice and quantity consumption with immediate repercussions in their body image tell us their sexual discontents. By interfacing and linking medicine, history, art and psychoanalysis, this article tries to investigate the pair obesity/sexuality problem within adolescence, thus differentiating it from an organic naturalistic and a temporal concept.
INTRODUCTION
When treating adolescents who seek out the outpatient clinic of the Center for Studies on Adolescent Health at the State University of Rio de Janeiro (NESA/UERJ), more specifically in the Obesity Prevention and Assistance Project, we observe in their statements the inexorably problematic relationship of the subject with himself and with his objects of desire. Food, in this case, takes on countless meanings, going beyond the simple instinctive satisfaction of an organic need, that is, of pure biological hunger. Many young people feel sick, uncomfortable, embarrassed, dissatisfied with their weight, like Paula, a patient who wants to lose weight but cannot, because the desire to eat is stronger than her. Hence, she forces herself to vomit when she eats too much. In her opinion, “what went in has to come out.”
When Fernanda was 12 years old, her mother (119 kg) locked her in her room so she would not eat. She screamed with rage: “You’re going to make me starve to death!”, saying she was afraid of starving to death and eating to live (“If I don’t eat on time, I get nervous and think I’m going to die”). This teenager feared death when the doctor asked her if she wanted to die from eating so much…
Regarding food, in the field of psychoanalysis, Freud(10) realizes that children bring into the world rudiments of sexual activity, already enjoy sexual satisfaction when they start to eat and persistently try to repeat the experience in the well-known activity of thumb sucking . The first recognizable sexual organization, the so-called oral or cannibalistic phase , during which the original connection between sexual excitement and nutrition still predominates, leaves permanent marks on every human being. Freud refers to a patient in whose dreams sweets and treats generally meant caresses or sexual gratifications; he refers to the height of a lover’s paroxysm when he says “I could devour her with love”; he points out the aversion to sexuality in an anorexic teenager. If, for example, the common possession of the labial zone by both functions is the reason for sexual satisfaction arising during the ingestion of food, then the same factor enables us to understand why there are disorders of nutrition and appetite as a result of some process in the sphere of sexuality. According to Freud, many of his patients who suffered from globus hystericus , constriction of the throat and vomiting gave themselves energetically to the act in their childhood. The symptoms actually reflect what consisted of satisfaction for the individual at a certain time, but which in the present gives rise to resistance and repugnance.
Adolescence is a period of great growth and development in which nutritional issues take on enormous importance, not only due to the increased need for nutrients, but also due to the rapid change in self-image. Having to face questions about their identity associated with a new body image, adolescents find themselves immersed in conflicts and more susceptible to somatizations. Oral disorders, which certainly include obesity in adolescents, reveal the storm of puberty, in which multiple, intense and unbridled sexual desires erupt, and very important bodily transformations that deeply affect the individual in question. In this fundamental period for each of us, the mouth, what we eat and the body are privileged means by which adolescents point out their sexual impasses, difficulties and traumas in their unique history, in short, their way of positioning themselves in the world(21).
“WHAT ARE YOU HUNGRY FOR?”[1] FATS, BEANS, PEARS OR TRANSGRESSION
Overweight and obesity in adolescence compromise health in general and have been growing at alarming rates worldwide, including in Brazil. Some authors believe that dietary patterns are part of the general health promotion approach and should not be isolated from other behaviors(13,17). Preventing obesity depends on encouraging healthy lifestyle habits, such as physical activity and its association with a quality diet(8, 23). During adolescence, we must intensify the prevention of the main nutritional risk situations, such as chronic malnutrition, anorexia, bulimia, obesity, etc.(6).
In the field of health promotion and obesity prevention, we would like to illustrate this concern through the curious article Your Child Is Fat (16), which announces childhood and adolescent obesity as a public health problem in the USA. Parents of 300 (out of 3,000) students aged 6 to 13 at East Penn School in Pennsylvania have received a strictly confidential letterwith the following warning: “your child is fat”. Almost a medical record with weight, height and body mass index (BMI). The correspondence, a reference for conduct for other American schools, is a warning about the harm caused by excess fat. Oliveira(19), in a study conducted among Brazilian schoolchildren in Belo Horizonte, concluded that the prevalence of obesity has been growing at an alarming rate in recent years, which requires immediate intervention to prevent the repeat of epidemic increases observed in various populations(24). In a bibliographic survey of medical literature from the last five years on the subject of obesity in childhood and adolescence, Escrivão(7) found that weight changes have serious psychological and organic repercussions, increasing morbidity and mortality from various diseases(5,22).
In the literary field, Luiz Fernando Veríssimo, in O Clube dos Anjos/Gula (26), uniquely illustrates the greed of human orality: man is man because he wants more. The surplus, the excess, the uncomfortable company of the body and its diabolical appetite decisively lead those strange angels of the story to the delights of a meal on death row. “And I confess that the prospect of dying increased my pleasure in food”, the narrator Daniel tells us. In the Angels’ Club, it is about killing people with an excess of what they like most, with terminal pleasures, lost cases in final ecstasies due to the desire for always more. Veríssimo’s angels do not know why they allow themselves to be poisoned at the dinners they inevitably attend. Let us remember Freud in his reference to the general dissatisfaction of children, always unsatisfied, as if they had never sucked at their mother’s breast, so great is the voracity of the infantile libido… In Inhibitions, Symptoms and Anxiety (10) he tells us: “the function of nutrition is most often disturbed by a lack of inclination to eat, brought about by a withdrawal of libido. An increase in the desire to eat is not uncommon. The compulsion to eat is attributed to the fear of dying of hunger, but this is a subject little studied”.
Turning to the artistic sphere, it is worth pointing out that the excessive desire to eat, marked by its historicity, has not always been stigmatized. In The Culture of Fat(14), Marco Miranda highlights Rubens and his models of elegant obesity that reflected the magnitude of flesh, joy, sensuality, massive limbs, broad poses full of promise and mystery. In addition to Rubens, Giotto, Goya, Rafael, Tintoretto, Masaccio, Renoir, Picasso and, more recently, Botero also preferred to portray women of undoubted robustness. Botero, for example, distorts reality and leans towards volume and exaggeration. Jorge Guido Brocca proclaims well-being in the abundance and exuberance of a fat woman’s forms. The excess weight, the silent cholesterol deposits, the overloaded arteries, the many meters of intestine in full operation manifest a sensual reality that symbolizes the cornucopia of human vision. For Brocca, a chubby woman offers all possible limits, from earthly pleasures to the breaths of inspiration.
If for André Burguière(2), in the Italian cities of the Middle Ages, popolo grasso (fat people) designated the ruling aristocracy and popolo grosso (thin people), the common people; if Rubens’ painting, in the 17th century, shows us how female bodies were appreciated at a time when thinness was a symbol of poverty and meat indicated opulence; if the plump body honored by the bourgeoisie of the belle époque symbolized a high status ; on the contrary, we live in a period in which fat is considered bad and obesity is vulgar . This is the aesthetics of thinness imposed by the media system, the perspective that blames those who eat. Living in a society that overvalues thinness in the style of Giacometti, Modigliani and Brancusi, the existence of an ideal weight and a standard of ideal thinness triggers depression and eating disorders in our culture. When avoiding fat, we are left with green beans, pears or transgression. Thus, one of the most outdated forms of freedom is being fat. And there are happy fat people.
In order to broaden the discussion, we infer that the desire to lose weight has a dramatic reason, the psychological and social adjustment to a society that considers obesity a kind of double deformation, physical and personality. Even without significant weight gain, a person is unlikely to be satisfied with themselves because they are constantly bombarded by young and inhumanly well-shaped examples in advertisements, fashion shows, magazine covers, TV soap operas and at the gym they frequent. Chubby men and women are mocked at school, do not find boyfriends in their teens and lose out to competitors when they face the job market. This is why weight loss drugs are used by so many people who are of a healthy weight or just slightly above the recommended standard.
According to C. Fischer, inHistory of Private Life (2), culture deregulates or perverts nature, that is, the wisdom of the body is deceived by the madness of culture. The modern consumer no longer knows what he eats; food has become an object with no known history. In short, we eat too much; we realize that we are hungry, but we are unable to discern the signs of our satiety. Paradoxically, the media encourages us to eat, encourages us to be thin and pushes us to the stove with recipes for losing weight. There is no shortage of cultivated bodies, especially in soap operas and reality shows , where men and women with astonishing muscles parade around. Influenceable and, to their deep dismay, often divided between skinny and chubby, teenagers are the first to run to the gym.
“WE DON’T JUST WANT FOOD”[2] THE DIFFERENT MEANINGS OF EATING
Body image disorders are common among adolescents, even those who do not have eating disorders. Due to social and cultural norms reinforced by the media, the issue of body weight is among the factors that determine the appearance and seduction potential of young people. Most adolescents are not satisfied with their own bodies. Boys, in general, overestimate their own thinness and girls, their obesity(4,9,20), which leads them to dieting behaviors early. Research conducted by Katiala-Heino(11) with 38,517 high school students in Finland found that young age at menarche is a risk factor for bulimic pathology. Early maturation is associated with a negative self-image, especially among girls, intensified by the cult of thinness in Western society. Adolescents who mature prematurely consider themselves different from their peers and sometimes resort to bulimia to avoid having their body image so altered. In this Finnish study, there was a statistically significant association between menarche/early sexual experience (from kissing to intercourse) and bulimic pathology. Obese individuals with body image alterations generally have a voracious appetite associated with a family history of obesity and attitudes of submission, passivity and avoidance of sexual activity(3).
Family relationships with obese adolescents have been investigated, aiming to understand the factors that trigger and maintain obesity. In a qualitative study with obese adolescents and their families, Muller(15) found that unresolved individual and interpersonal conflicts, such as difficulties in the mother/baby relationship, can lead the individual to develop a pattern of affective interaction related to food, which is maintained until adolescence. These adolescents are generally insecure, with self-esteem and sexuality problems, and food can be used as a substitute for affection or emotional comfort. Obesity in an adolescent can be a symptom of an existing conflict in which the large supply of food can mask the absence of love or even rejection. Obese individuals often try to camouflage impasses by reducing their life options. It becomes clear that the problem of obesity must be approached not only based on harmful hypotheses about hunger, but also from the point of view of eating habits and their significance. For H. Bruch, cited by Ajuriaguerra(1), in an overprotective environment, food is not offered only to appease a natural need; it acquires considerable emotional value. It is the only way to express affection, alleviate guilt and calm anxiety. Food replaces the love that the mother cannot express in any other way. The child, repressed and unsatisfied, increasingly demands food and desires immediate satisfaction, becoming a tyrant who cannot bear refusal. The French psychoanalyst Jacques Lacan(12), in turn, describes an infant suffocatingly stuffed with baby food by his mother, who confuses her care with the gift of her love. It is the child who is fed more lovingly who refuses food and does so as a desire (mental anorexia). A study conducted in Slovenia with 4,700 students aged 14 to 19, with the aim of examining eating habits and their relationship with some social and psychological characteristics, identified that among adolescents who were unhappy with their weight, poor emotional relationships with their parents, use of psychotropic drugs and suicidal thoughts were more frequent. Equally among boys and girls, dissatisfaction with their weight was associated with high levels of depression and low self-esteem(25).
The issue of eating and its disorders is related to cultural norms that differ from society to society and vary from time to time. In History of Private Life – From the First World War to Our Days(2), in a structuralist approach to cooking, inspired by the work of Lévi-Strauss, Mary Douglas concludes that the selection principles that guide human beings in choosing their food resources are not physiological, but rather cultural. It is culture that creates the system of communication between humans regarding what is edible, what is toxic, and what satiety. By referring to the ancient Mosaic rules of the table, the author shows us that they are part of a set of rules that govern both worship and ritual cleanliness, as well as behavior in matters of sexual and marital relations.
After all, why do we eat?
FINAL CONSIDERATIONS
Through an interdisciplinary perspective on the field of health, through a brief articulation between the areas of medicine, history, art, and psychoanalysis, we aim to investigate the issue of obesity and sexuality in adolescence, distancing ourselves from an organicist bias. This is confirmed by, for example, the various studies in the public health sphere raised by Escrivão(7) when they point out the importance of psychological repercussions in the domain of weight changes, as well as the revealing investigations of Muller(15) pointing out, in sexually insecure adolescents, the substitution of conflict for food. In the field of history, we observe that human dietary rules are cultural in nature and vary according to the times, as evidenced by Mary Douglas(14). In the artistic sphere, the painter Rubens values the elegant and sensual obesity of his models, while the writer Veríssimo emphasizes the deadly pleasure and libidinous voracity in the act of eating.
We conclude in this theoretical essay that adolescence, far from being a moment of development of an evolutionary essence supposedly called individual, implies, for the subject who goes through it, a reformulation of great proportions in his subjective positioning. The adolescent is called upon, at a certain point of unmooring, to have to reappropriate a transformed body image. Now, if the body is not inscribed in a pure and simple reference to necessity, pleasure or reality, being entirely subject to the complications of the psyche, we can say that, in the case of humans, the subjective corrupts the biological. Obesity in adolescence, then, implies multiple factors that are not limited to the mechanical and compulsive act of overeating. Consequently, no longer inscribed in a pure and simple nosology or taxonomy, obesity in each subject and in adolescent subjects, singularly, irreducibly comes up against a strange limit of the whole problem of desire.
By considering this article in the light of psychoanalysis, we can state that, for us, the body presents itself in the dimension of discourse, in the realm of language and, in short, it will always be that intimate stranger that denaturalizes the organism. Although Freud initially sought the foundations for his discoveries in science, the biological, physiological and chemical models will grope in novelty and mystery. The Freudian drive as a borderline concept between the spheres of psychology and biology reveals to us from the beginning that it is not simply the genitals, but many other parts of the body, especially the mouth, that constitute the seat of sexual excitement. Let us recall his work The Scientific Interest of Psychoanalysis , in which Freud states, in 1913, that sexuality is not merely a function that serves the purposes of reproduction, on the same level as digestion, breathing, etc.
At NESA, our work is interdisciplinary and each professional, in their specialty, seeks not to be reduced to a mere specialist in their office. Thus, we do not deal with obesity, sexuality and adolescence as abstract concepts wandering in the Platonic field of ideas, but rather with young people who say they are obese and who, in the construction of their sexual identity, outline a unique story about their discomfort.
In the field of health, we know that it is not enough to guide obese adolescents in relation to their eating habits. By producing in their speeches a close and distressing link between sexuality and obesity, radically exposed to the reality of sex, to the reality of the body, adolescents constantly create meaning about their issues, and it is to this that we must be attentive, permanently providing them with a space to listen. Their bodies are radically opposed to the body of the Cartesian man-machine that is reduced to a set of springs and gears, a mass of bones and flesh, articulated mechanics compared to a clock composed of washers and counterweights. Our greatest challenge is to think of the body in its multiple dimensions, not restricting ourselves to aesthetic standards. When caring for obese adolescents, they, in turn, produce a discourse about their own body, that is, they subjectivize it. On the other hand, when we listen to them, we, as health professionals, give new meaning to what this subject addresses to us. By doing so, we favor the opening of a space that excludes rigid dichotomies of right/wrong, good/bad in terms of eating behaviors and we can, therefore, create the constant possibility of promoting health and well-being, knowing that they are always contextualized and contextualizable.
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1. Psychoanalyst; Master’s degree in Clinical Psychology from the Pontifical Catholic University of Rio de Janeiro (PUC-RJ); Bachelor’s degree and degree in Philosophy from the Institute of Philosophy and Social Sciences of the Federal University of Rio de Janeiro (IFCS/UFRJ); Doctorate in Communication from the School of Communication (ECO) of UFRJ; Psychologist at the Center for Studies on Adolescent Health of the State University of Rio de Janeiro (NESA/UERJ).
2. Adjunct Professor at the School of Medical Sciences (FCM) of UERJ and NESA/UERJ; Bachelor’s degree in Medicine from FCM/UERJ; Master’s and Doctorate in Medicine from the University of São Paulo (USP/Ribeirão Preto).
[1] Excerpt from “Comida”-lyrics and music by Arnaldo Antunes, Marcelo Frommer and Sérgio Brito.
[2] Excerpt from “Comida”-lyrics and music by Arnaldo Antunes, Marcelo Frommer and Sérgio Brito.