Epistemology, family patterns, and psychosomatics: the case of obesity

A family systems model of obesity is developed that attempts to integrate systems epistemology, Minuchin's work on psychosomatic disorders, and a review of the literature on obesity. The model presents obesity as being inextricably embedded in relationship patterns that fundamentally influence its etiology and maintenance. It is argued that the emergent properties of these relationships need to be the focus of analysis, rather than the elementary components residing within the individual, which are emphasized in traditional theories of obesity. The radical shift involved in moving from the traditional mechanistic models to a systems perspective is also discussed because these approaches are based on different epistemologies. The fundamental differences between these epistemologies are important and often underemphasized, which has led to much confusion in past research. Based on the model developed here and supportive data from the obesity literature, the conclusion is reached that obesity research and treatment are likely to be advanced by adopting a systemic approach.