Obesity is a complex condition that impacts on multiple aspects of functioning and can result in serious health conditions and reduced life expectancy and psychological distress. Obesity disproportionately affects women and current incidence rates are indicative of a ‘global epidemic’. The aim of this study was to explore experiences of interpersonal and intrapsychic emotional functioning, and the functions of food and eating in women who were severely or morbidly obese. The final participant sample were seven adult women all in the morbidly obese range (BMI ≥40kg/m²), all of whom were under assessment at a psychological therapies service. The women were interviewed using a semi-structured interview schedule and transcripts were analysed using Interpretative Phenomenological Analysis (IPA). The following four master themes were derived from their transcripts: 1)‘Uncertainty in Close Relationships’, 2)‘Behind the Mask: The Pursuit of Self-Worth’, 3)‘Emotional Expression: The Conflict of Sharing or Withholding’, 4)‘The On-Going Battle with Weight and Emotions’. The study findings highlighted the complex and multidirectional relationship between interpersonal experiences and functioning, self-worth and emotional functioning and the development and maintenance of problematic eating patterns and weight difficulties. Early interpersonal experiences had influenced the development of the self and expectations of relationships. Problematic relationships with food and eating had developed in response to the distress of intra- and interpersonal functioning. The consequential weight difficulties were experienced as frustrating and distressing and difficult to overcome, further impacting on emotional distress and self-worth. The findings have implications for treatment approaches, emphasising the importance of non-stigmatising multicomponent services that empower and offer therapeutic interventions focusing on problematic relational patterns and self-worth and the development of adaptive coping mechanisms. This study has the capacity to inform future research on relational and intra-psychic emotional factors in the development and maintenance of obesity and consideration of the mediating mechanisms of emotional eating.
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