[Extreme obesity due to feelings of inner emptiness: structural-developmental disorder illustrated by the case of a young morbidly obese patient].

Structural-developmental disorder, which is characterized by a lack of mentalisation, is explained in this article using the case of a morbidly obese 19-year-old woman. Mentalisation refers to the ability to understand behaviours on the basis of mental states such as thoughts, feelings, and desires. Not being able to mentalise properly has serious consequences, which became apparent during contact with this patient. Although problems with mentalising may not be a contraindication for bariatric surgery, substantial follow-up is necessary to ensure compliance in the long run. Additionally, knowledge about structural-developmental disorder may help to decide which kind of interventions may be most effective.