Mental Illness Impacts Quality of Life

Hansel and Gretel

In the fairy tale “Hansel and Gretel,” a child is captured by a witch who feeds him so he will be nice and plump to cook and eat. The story has analogs in many cultures. The website TV Tropes gives more than 30 examples of stories (including a Simpsons episode) in which one or more characters are overfed for the eventual purpose of becoming the main course of somebody’s meal. The page, titled “Fattening the Victim,” explains:

A character tries to fatten another character like livestock … in order for the latter to be bigger to eat, or die of obesity. If the guest refuses to eat, the character might try force feeding them instead … Another variant is when the victim convinces their captor to “fatten them up” first to bide time for an escape plan.

Ideas make their way into popular culture, as they did into fairy tales (the pop culture of their era) for deep archetypal reasons. At some point in human history a psychologically valid principle was recognized, and, through storytelling, taught to children and the population at large. The process of fattening is the precursor of victimhood. A victim is someone with a throwaway life, a disposable unit sacrificed for the selfish or sick needs of another. Nobody wants to be that.

Do some parents suffer from mental illnesses that compel them, like fairy tale witches, to fatten up their kids? Do some children instinctively recognize that, like Hansel, they are trapped by a powerful and dangerous adversary? Can kids intuitively sense when they are being used to serve a parent’s selfish or sick needs? What does that do for their quality of life?


Childhood Obesity News described emotional incest and Folie à deux, two parental mental illnesses that would negatively impact any child and could very well account for a percentage of childhood obesity cases. There is another rare and potentially deadly condition. Picture this harrowing plotline:

A person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. The adult perpetrator … directly produces or lies about illness in another person under his or her care, usually a child under 6 years of age … even willing to have the child or patient undergo painful or risky tests and operations in order to get the sympathy and special attention given to people who are truly ill and their families.

While it sounds like a Stephen King story, this is actually a real mental illness, Factitious Disorder Imposed on Another (FDIA), which used to be called “Münchausen syndrome by proxy.” The people diagnosed with FDIA are usually mothers, usually notorious liars, and often they have enough medical knowledge to dole out slow poison or otherwise control a lengthy course of illness in the victim. FDIA is so serious that dealing with it requires a whole raft of personnel— “a team that includes social workers, foster care organizations, and law enforcement, as well as the health care providers.” But wait, it gets worse. The Cleveland Clinic says:

In some cases, a child victim of FDIA learns to associate getting attention to being sick and develops factitious disorder imposed on self.

In other words, a certain number of FDIA victims find their condition rewarding enough to take over and purposely cultivate it, either consciously or unconsciously. At some deep level, the psyche believes it is better to be special, even in a messed-up way, than to be nothing. This disease of “factitious disorder imposed on self” used to be called Münchausen syndrome. Put it together with the fact that in our society, the condition of morbid obesity is very easy to self-perpetuate, and a causal relationship might be found.

But although it is a mental illness, FDIA is also criminal child abuse. It is beyond shocking, and no one wants it to be true. But since there is such a disease, why not ask an interesting question? Has a mother, suffering from FDIA or a similar mental aberration, ever purposely allowed a child to become morbidly obese? Would that be a prosecutable offense?

If a parent’s mental illness causes a child’s morbid obesity, can she or he be punished? Forced into treatment? Held morally responsible? Taking children into protective custody and releasing them to foster care are measures usually considered extreme. Sometimes, even to seasoned and non-judgmental health care professionals, they discouragingly seem to be the only answers available.

Your responses and feedback are welcome!

Source: “Fattening The Victim,”?, undated
Source: “Munchausen Syndrome by Proxy,”
Image by Morgaine


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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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