What is the link between a lack of self-esteem and obesity?

For some of you, overeating is about the petrifying fear that you don't deserve to be thin. How do I know this? Not through studies, or research—but through real-life living, through my patients, through eavesdropping on a cavalcade of doughnut addicts.

Here, I have to step out of the safety zone of hard science into an area that's typically not studied by the white-coat-and-goggles set, because the mental, emotional, and deep psychological issues involved with obesity are simply very difficult to "prove" in a Western sense. So let's start here: Many people—women especially—lack the self-esteem for weight control. (In fact, the most common reason that a woman doesn't take care of her own health is because she puts others' needs before her own.) But let's dive deeper: What is self-esteem?

Let us assume our general sense of self-worth comes from two forces: overcoming obstacles and accomplishing some kind of goal. In the case of maintaining a healthy body weight, what happens if you don't overcome an obstacle (the box of Ding Dongs) and don't accomplish something (your goal weight by your high school reunions)? Yep, your self-esteem plummets faster than ratings for summer reruns.

To resurrect it, you need to find ways to overcome and accomplish—without making the very standards by which you measure your life unrealistic weights, measurements, and stricter-than-boot-camp eating habits. This entails finding what I call soul-level satisfaction.

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