Dr. Robert Pretlow at the Symposium

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We refer, of course, to the symposium that Dr. Pretlow chaired at the recent World Congress of Psychiatry. The exchange of ideas was titled “The applicability of addiction-model methods for disordered-overeating and obesity intervention,” and the other participants were Dr. Nicole Avena, Dr. Caroline Davis, and Dr. Fernando Fernandez-Aranda.

Dr. Pretlow’s presentation, “Specific addiction-model methods as treatment for obesity,” can be seen and heard online. It begins by mentioning bariatric surgery, which although often successful, is not the most suitable answer for young people (and residential immersion programs). The question here is, can inpatient rehab methods be replicated in a way that makes them widely available at a lower cost?

These establishments use addiction-model methods, which for some practitioners is a sticking point. But in practical terms, and despite the reluctance of the Diagnostic and Statistical Manual to define it as such, treating compulsive overeating as an addiction seems to work pretty well. Although it may not line up exactly with the descriptions of substance addiction, disordered overeating has a lot in common with such maladies as sex addiction and gambling addiction.

It all boils down to a dopamine rush in the brain, which is all too eager to latch onto any stimulus that eases emotional distress. There is also the motor addiction component, which will be discussed further.

On the question of why kids overeat, perspectives are provided by several young people via audio recordings of their own words, and some of them are not shy about using the “A” word. It is tempting to recall the ancient folk wisdom: “If it looks like a duck, walks like a duck, quacks like a duck…” Again, the point here is that addiction methods have a good chance of working, so the smart move is to put aside quibbling over the fine points of terminology, and go ahead and do what works.

Discussion follows on how best to duplicate what a rehab center accomplishes, without the necessity to displace children from their homes to costly facilities. To wrap up, Dr. Pretlow goes over the principles that he applied in developing the W8Loss2Go smartphone application.

This is worth repeating. The central idea that Dr. Pretlow took to the WPA is expressed in these words:

I hope our evidence will convince you first, that obesity is primarily a psychological problem, second, that it resembles an addictive process, and third, that psychologists and psychiatrists are the best professionals to treat it.

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Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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