title: [The shame cycle in obesity].
abstract: BACKGROUND
  In Western countries obesity is currently a major public health issue. Part of a complex system, it should not be studied alone. Yet it is often seen only as the result of qualitatively and/or quantitatively deviant dietary-intake and is seldom questioned as a symptom in the psychoanalytic sense, i.e. as a part of a package that makes sense.
  
  
  OBJECTIVE
  The purpose of this article is to highlight the importance of shame in the psyche of obese subjects as "subjective backup". The author questions the experience of shame in obese subjects as the cornerstone of this symptom in the psychoanalytic sense.
  
  
  METHODS
  While reporting a clinical case, the author notes the occurrences of shame in the discourse of the patient. The subsequent analysis is presented based on the transferential and counter-transferential relationship. To carry out this study, the author drew on a device supporting catharsis.
  
  
  RESULTS
  The author addresses successively: the complaint of obese subjects and the effect of shame, their shame as the alpha and omega of bulimic crises and lastly their body as a work of art by building a monstrosity. The author concludes with the social dimension of shame and how it is part of the symptom of body transformation in obese subjects.
  
  
  CONCLUSIONS
  It appears that pathological shame reveals a difficulty to maintain a sense of existence. For this reason, it seems important to consider this effect and to establish a framework for the emergence of the latter in the consultations of patients with eating disorders. Under these conditions, the patient is able, on the pedestal of shame, to voice his shame of being and to support a subjectivity.
authors.affiliation: LAPCOS EA 7278, université de Nice Sophia-Antipolis, Nice, France; EPS EA 4686, université de médecine de Brest, 22, rue Camille-Desmoulins, 29238 Brest cedex 3, France. Electronic address: brigittekarcher@yahoo.fr.
authors.forename: B
authors.initials: B
authors.lastname: Karcher
mesh_terms: D000328:Adult; D002032:Bulimia / Q000523:psychology; D005260:Female; D006801:Humans; D009765:Obesity / Q000523:psychology*; D012752:Shame
keywords: Addiction; Boulimie; Bulimia; Honte; Obesity; Obésité; Shame; Subjectivity; Subjectivité