In endocrine diseases, the psychological state must be considered, as this is fundamental for adherence to treatment. Particularly in obesity there may not be a genuine mental disorder, but psychological factors have a fundamental importance in controlling the feeling of satiety, in any case in the obese there may be a primary pathological alteration that originates the problem, likewise could be the result of an abnormal behavior as a reaction to an unresolved problem and it is also necessary to take into account both the alterations that occur as a result of self-image and anxiety or mood swings.
In eating disorders and obesity in particular we must remember the famous aphorism of Dr. Marañón: there are no diseases but patients, so it is necessary to consider the psychological aspects, bearing in mind that the origin and maintenance of the problem influence cognitive variables (belief system), affective variables (management of unpleasant emotional states, tolerance to frustration) and environmental variables (customs, family habits), being important to take into account the traits of personality and the environment of the patient who consults.
To achieve a basic internal strengthening is essential to provide support, give information, educate, facilitate the expression of possible conflicts, modify the distortion of self-image and low self-esteem, aiming to improve their own vision of themselves and their expectations of effectiveness and achievement.
Obesity is undoubtedly a disorder whose origin, clinical expression and treatment can only be structured with a biological, psychological and social approach. In this sense, obesity is no different from the processes that the accepted classification considers to be genuine, quantitative intake disorders (anorexia and bulimia nervosa) or, strictly speaking, from the vast majority of the processes included in axis I (clinical disorders) of the DSM classification systems (diagnostic and statistical manual of mental disorders, published by the American Psychiatric Association).