Addiction Studies Cover New Ground

inside the alchemist

In the old days, it was clear what the addictors or addictogens were: heroin, cocaine, amphetamines, alcohol, and nicotine. Then came the recognition of unhealthy and counter-productive attachment to activities that had seemed neutral or even benign, and the world acknowledged the existence of shopaholics, workaholics, exercisaholics, and so on. Process addictions became a regular feature of the landscape.

Then came a suspicion that maybe all addictions are behavioral addictions. In that scenario, compulsive overeating is not so much about dependence on a particularly irresistible type of food, but largely about dependence on the activity or process of eating.

As Childhood Obesity News mentioned, the 1st International Conference on Behavioral Addictions is regarded as a milestone in some circles. A presentation by Robin Elizabeth Pope of the Max Planck Institute, called “A periodisation analysis to see how to reduce behavioural addictions,” offered some interesting ideas along with a schema of how a gambling addiction might be interpreted under this paradigm. Pope writes:

Pharmaceutical solutions are based on a static theory that behavioral addictions stem from chemical imbalances. This theory has minimal efficacy…

Her approach is to instead investigate how people get common sense and how they learn and implement good decision-making. In other words, how they get the coping abilities or life skills that keep people sane and happy, and prevent them from falling prey to addiction of any variety.

At the same conference, a researcher from the IM Sechenov Institute of Evolutionary Physiology and Biochemistry spoke about a new way of classifying nonchemical addictions. Alexei Egorov does allow for the existence of chemical addictions, but is strongly interested in behavioral addictions as well. He identifies the six characteristics that both kinds share: salience, mood changes, tolerance, withdrawal symptoms, conflict, and relapse.

World Full of Addictors

The possible non-chemical addictions are so numerous they could encompass almost anything. (Perhaps Egorov has contemplated the possibility that he is addicted to enumerating non-chemical addictions.) As for classifying them, he recognizes five major categories, each with its accompanying sub-categories. The first four major groups encompass gambling, erotic, socially acceptable, and technological addictions. The fifth is food addictions, divided into overeating and starvation. Egorov says:

Long-term experience shows that one addiction can easily transform into the other, which happens both in chemical and nonchemical addictions.

His overarching idea is that addicts are not so much cured as diverted into socially acceptable addictions. Often this doesn’t work out well. To be a former alcoholic and a current sugar, coffee, and cigarette addict is not such a great thing. An addict may never be truly healed, but replacement therapy can transform a person by substituting a socially acceptable nonchemical addiction such as exercise. Sometimes that is the best a therapist can do, and it’s nothing to sneeze at.

Your responses and feedback are welcome!

Source: “1st International Conference on Behavioral Addictions,” mat.org, 2013
Image by Tom Stohlman

 

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

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.
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Presentations

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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