Everything You Know About Thrifty Genes Is Wrong

The thrifty gene hypothesis, introduced in 1962 by James V. Neel, M.D., Ph.D., originated as an effort to explain diabetes, and then expanded to potentially account for obesity as well. (He later noted that this paper was written “before the clear distinction between type I and type I1 diabetes had been drawn, but in retrospect it was directed at type II.”) Dr. Neel defined thrifty as “exceptionally efficient in the intake and/or utilization of food.” The provocative paper suggested ways to test the hypothesis, and the through line boiled down to:

In this essay an hypothesis has been advanced which envisions diabetes mellitus as an untoward aspect of a “thriftiness” genotype which is less of an asset now than in the feast-or-famine days of hunting and gathering cultures.

In the late 1960s, people thought this sounded likely, and that type II diabetes had a genetic origin, though nobody could pinpoint the exact genes involved. The prevalence of such a gene or genes could have occurred in order to survive intermittent starvation. The idea that humans might be genetically hardwired to accumulate body fat and then hold onto it made a certain amount of sense, because throughout most of history, food insecurity was the norm for just about everyone.

Outsmarting decay

In the old days, salt and spices were incredibly valuable because they preserved food. The existence of, and trade in, spices made it somewhat easier to alleviate the ravages of famines caused by weather, enemy action, and the like. Several gigantic advances in human ingenuity had to happen before we could know the confidence that comes from having a stash of canned goods in the basement.

But, according to Neel’s theory, genetic progress did not keep pace, and humans are still under the influence of a genotype that wants to prepare us for a famine that we will never actually experience. (While this may be true of the majority of people in developed countries, such confidence is certainly not universal.)

The thrifty gene hypothesis proposed that one of the chief survival instincts is the imperative to absorb whatever food is available, in order to store fat so the body has energy to burn when times are hard and food is scarce. Also, that another survival instinct is based on built-in safeguards that prevent the body from letting go of that stored fat. One of the details is a belief that trying too hard to lose weight, by limiting caloric intake, can actually have the opposite effect, by sending the body into “starvation mode” which makes it try even more desperately to conserve its stored fat.

Starvation a la mode

A fitness guru known as Jay, whose work has appeared in at least a dozen major publications, explains the thinking behind the starvation mode school of thought:

[T]he fundamental concept behind what causes starvation mode is this: Being in too much of a caloric deficit is supposedly capable of stopping weight loss. When you eat too little and/or burn too much, your body’s survival response is to hold on to all of your fat and slow your metabolism enough to prevent you from losing anything (or potentially even cause you to gain additional fat).

Jay says there is no such thing as “starvation mode,” and that a caloric deficit always produces weight loss. There is, however, such a thing as adaptive thermogenesis, meaning that the metabolism does slow down during weight loss — but adaptive thermogenesis is never influential enough to either stop weight loss, or to cause weight gain.

(To be continued…)

Your responses and feedback are welcome!

Source: “Diabetes Mellitus: A ‘Thrifty’ Genotype Rendered Detrimental by “Progress”?,” NIH.gov, 1962
Source: “Starvation Mode: Is It A Myth?,” AWorkoutRoutine.com, 11/19/22
Image by Esteban Chiner/CC BY-SA 2.0

Fatsploitation and Perception

A while back, Childhood Obesity News mentioned the case of Connor McCreaddie, a British boy who, at age eight, weighed more than 200 pounds. The child welfare authorities attempted to remove him from his mother’s custody and place him in foster care. The TV show about this conflict attracted so much attention that according to some observers, it almost single-handedly invented the fatsploitation genre. A contemporary tabloid publisher referenced the “feeding frenzy” that occurred as media producers everywhere searched for an even more obese child to capitalize on.

Journalist Nick Harding defined fatsploitation as the type of entertainment where the morbidly obese “are wheeled out on reinforced gurneys for our entertainment.” That’s not quite the same as a sober documentary in which the expectation is impartial reportage of historical events, without interference or influence from the filmmakers.

Of course, this very high standard is not always attained, but trying for it is still miles away from the foolishness and fakery that are the hallmarks of “reality” shows. Still, Harding says of the fatsploitation cheap shots, “if no one watched them, they would not get made.”

Minds are invaded

It has been suggested that such wide exposure to the most egregious cases has led to members of the public having counter-productive thoughts like, “As long as I’m smaller than that guy who the fire department had to demolish a wall to get into an ambulance, I’m okay.”

For a while, the level of awareness raised by the media was helpful, but eventually reached the point of diminishing returns. Harding quoted Professor Paul Gately, technical director of Carnegie International Camp, the respected youth weight loss program:

Programmes that concentrate on the extreme are pure entertainment and not relevant to 90 per cent of the public who see the very obese and say, “I’m not like that, I can have another cream cake… I am not that bad, I can carry on along the same path”. When they finally realise it is time to act, it is far too late.

Due to this distorted perception, adults not only see themselves as okay but…

75 per cent of parents with overweight children define them as “just right”, and half of parents with obese children classify them as being in the normal weight range.

Technically, such parents may be correct. How are they supposed to perceive their own child as dangerously obese, if most of the other kids in the class are even heavier? Perhaps “normal” is a word whose usefulness in this context has come to an end. But that is for another discussion.

Your responses and feedback are welcome!

Source: “Unhealthy appetite: Is ‘Fatsploitation’ fuelling the obesity crisis?,” Independent.co.uk, 10/23/11
Image by HS You/CC BY-ND 2.0

Fatsploitation Is Alive and Well

We looked at how, when a TV show cast an actual size 16 woman as the lead, the earth practically stood still. It might almost be possible to suspect that this was done on purpose to increase the number of viewers by inviting the “hate-watch” audience, which if true, would certainly be one type of fatsploitation. We saw how a popular “reality” show might be fairly accused of fatsploitation.

One method of exploiting people is to use their issues as leverage to sell them things. A troubling aspect of the plus-size clothing business is that so much of it seems to concentrate on the sexy angle, which caters to the “male gaze” of men who prefer large ladies, but does little to benefit the plus-size woman who just wants to look good at the office, in church, or at the PTA meeting.

Questionable motives?

Writer Rachael Hope, who self-describes as a “rad fatty” with an “epic sweet tooth” enthusiastically supports size-inclusive brands, but at the same time makes several accusations at manufacturers, particularly those in the clothing business. One of her pet peeves is their use of such terms as inclusive; extended sizes; and “options for everyone” when their products are, at best, marginally more inclusive. Also, the definitions and standards for “plus” and “extended” are vague, arbitrary, and not consistent among different companies.

It is admirable that clothing makers provide for ladies’ sizes of 14 or even 16. But upon examining a typical catalogue, Hope learned that, in that company’s estimation, “everyone” includes only the people who are smaller than size 20. It seems that some daring companies will provide for size 20 or even 24, if the customer doesn’t mind jumping through some hoops to find their offerings either online or through brick-and-mortar establishments. Even then, she tries to be forgiving, but it is a challenge:

While many major retailers have finally extended their plus-size offerings beyond size 14, the number of items offered in the category is consistently less than the number of those in the standard range.

The upscale Macy’s chain, for instance, offers 1,000 styles of denim for so-called standard-size women, but anyone shopping for plus sizes has only around 350 options. Manufacturers, says the author, over-promise and under-deliver. They capitalize on the hopes and bodies of obese people, and bill them unreasonably for the sin of being overweight. Some brands, she says, “charge a premium for clothing over a certain size rather than spreading the cost equally among all of their items.” She adds,

The fact that we’re even using XL as a label is fraught with meaning — you are extra, you require extra, you require beyond what is “normal” for us to give.

Your responses and feedback are welcome!

Source: “Your Brand is Not Inclusive: Stop Using Fat People’s Hope as a Marketing Tactic,” Mediium.com, 02/19/21
Image by Reba Spike/CC BY 2.0

Is Laughter Always Good Medicine?

In the context of wondering whether fat acceptance serves the greater good, we have talked about Mindy Kaling before. In show business, there are certain iconic entertainers who can get away with being overweight or obese, and she is undoubtedly one of them.

In the past, it was always easier for men. Women were a different case. Tim Goodman observed in Hollywood Reporter that as time went on, African-American women were granted the rare privilege of being super-size actors and singers. And then eventually, a certain number of white women were accepted despite their weight. But even when circumstances began to change, there was still an attitude:

You’re either thin and hot or you’re overweight and funny.

Goodman notes that generally, on TV and in movies, plus-size actors of both sexes are “shoe-horned and dismissed into safe, nonthreatening roles.” Nowadays in visual media, in relation to sex, the playing field for performers may be approaching level. One credible explanation is that the average American woman is closer to Mindy’s size than ever before.

At any rate, we mention a couple of matters that provide a good jumping-off place to look at one type of fatsploitation — misguided humor. Okay, granted, “comedy often is a better spotlight for tough issues than drama,” as Goodman wrote. Still, around this subject, there seems to be a lot of gratuitous stereotyping, disguised as humor.

Some years ago, journalist Ashley Ross made a point, also while discussing Mindy:

It’s become more acceptable to discuss body realism as opposed to idealism, but is all this talk about bodies helping women with self-image issues or eating disorders, or does this new focus fuel our obsession with how we look? If anything the conversation is even more focused on appearances than before.

Ross says that at times the jokes were “actually hilarious and very relatable.” But then, there would be something like a scene where Mindy sat on a guy’s lap, followed by the chair disintegrating under their combined weight. The thing is, because Kaling wrote her own show, her audience was never of one mind. When a celebrity tries to change the dominant culture, there are always some fans who say “too far” and others who say “not far enough.”

Is laughter good medicine? Not always, suggests Dr. Kenneth Weiner, who founded the Eating Recovery Center. Instead, he feels that it tends to reinforce the constant tendency to compare bodies, and may even contribute to the increase in eating disorders. Disparaging and demeaning oneself, fat-shaming oneself, may gain superficial and temporary acceptance, but it will hardly suffice as a Life Plan. He says,

Poking fun at yourself because you’re larger? If anything, I see that as part of the problem.

Your responses and feedback are welcome!

Source: “Race, Weight and Beauty: How ‘The Mindy Project’ Is Both Funny and Important,” HollywoodReporter.com, 09/25/12
Source: “Even Mindy Kaling Can’t Win the Body-Image Wars,” TIME.com, 04/14/14
Image by inUse Experience/CC BY 2.0

“More to Love” — An Alleged Reality Show

Back in 2009, people watched a so-called “reality” dating game show whose host was a plus-size model called Emme, which may have been its only redeeming feature. Emme’s brand is “curvy and confident” and she had been, in 1994, the first plus-size model on the magazine “People’s 50 Most Beautiful” list.

The purpose of “More to Love” was to find a life partner for 26-year-old Luke Conley, who weighed over 300 pounds. So the producers recruited 20 women who weighed between 200 and 300 pounds, in hopes that he might propose to one of them. Reviewer David Hinckley generously allowed that perhaps the project aimed to “help humanize plus-size women,” but in his view, it failed. Why? Because…

Contestant after contestant confesses, in the introductory moment, that they don’t like being big. They not only don’t like being big, they hate that they have tried to be thin and failed.

He theorized that the 20 contestants — five of whom were immediately jettisoned in the first round — were involved with the show out of sheer desperation. One of them had never been asked out on a date. Another had experienced three first dates; period. A third was an actual rocket scientist whose dating game was at grade-school level. The others included a waitress, a teacher, a fitness instructor, and a motivational speaker. One wept and asked, “What if I’m alone for the rest of my life because I’m overweight?”

Hinckley characterized this outburst as “up-front oversharing.” However, in the context of sensationalized vicarious emotional angst marketed as entertainment, excess is exactly what the audience is hungry for, and maybe oversharing could more accurately be described as feeding the psychic vampires. He, for some reason, held the possibly naive belief that “there’s no pleasure in watching… sadness.” On the contrary! Viewers eat this stuff up and ask for more.

Home influence

It was Bachelor Conley’s mother who convinced him to take a chance with “More to Love.” She figured his odds of meeting The One were as good there as anywhere else. (And when 20 potential life-mates are just served up like chicken wings on a platter, it seems like deciding to participate would be a no-brainer.)

There was a spa date with six of the contestants, then a one-on-one encounter for a couple’s foot massage, and another for a double wine bath. There were conversations. and one of the women told him she didn’t like thinking about him being with the others. Another shared the sadness of losing her mother as a child. Luke told her he loved her sexy confidence.”

Journalist Kari Croop from Common Sense Media assured parents that despite some spicy dialogue and on-camera makeout sessions, “More to Love” was actually “a lot tamer than other reality dating competitions,” with overall a quite positive tone — “It’s all about accepting people for who they are inside.” The content offered an opportunity for family discussions about weight. Croop remarked,

It means well, but it loses points for things like posting how much participants weigh alongside their name, age, and occupation. After all, if who we are inside is what’s truly important, why is that necessary? Is the show sending girls positive messages about body image, or is it sending mixed signals? Would the show be substantively different if the person looking for love was a plus-sized woman instead of a plus-sized man?

Indeed. It did seem to send the message that while the chance to compete against other large ladies is the best that an obese women can hope for, a corpulent man is entitled to have his pick of the crop. A woman caller to a talk show said,

If the intent was to show that overweight women can be just as alluring and glamorous as the size two models on “The Bachelor,” it failed miserably. The focus was still on how fat they were, and they came off as pathetic.

The majority of the viewing audience is probably overweight but I’m sure they have no desire to watch people who look just like them in this type of reality show. We prefer to escape the reality of our own less-than-perfect bodies by identifying with beautiful people.

Fat activist Marianne Kirby did not find “More to Love” inspirational, and was asked by an interviewer if the show challenged stereotypes or actually perpetuated them. She replied,

It’s also a lot of women crying about how this is their last chance at love, which really does play into this being a spectacle.
If you watch the regular version of “The Bachelor,” there’s no food at that cocktail party, much less chicken teriyaki, meat on a stick dripping all over their fancy dresses.

There’s all of this great message of acceptance stuff. But there’s all this backhanded, we’re-still-going-to-make-fun-of-you, you know, stuff going on in the editing and the casting and the way people are portrayed.

Kirby also remarked that she doesn’t mind fat jokes — it’s just that none of the ones she has ever heard are funny.

Your responses and feedback are welcome!

Source: “FOX reality show ‘More to Love’ weighed down by sad confessions from plus-size participants,” NYDailyNews.com, 07/26/09
Source: “More to Love,” LATimes.com, 2009
Source: “More to Love,” CommonsenseMedia.org, 2009
Source: “The Plus-Sized Romance Of ‘More To Love,” NPR.org, 07/29/09
Images by Igor Grabar and DanilKuzn/Public Domain

“My Mad Fat Diary” — A Series

The British series “My Mad Fat Diary,” set in 1996, lasted three seasons or 16 episodes. Young Rae Earl (played by Sharon Rooney) spends four months in a mental health institution, because of depression, body image problems, and self-harm. (In England, mad means crazy, not angry.) To complicate matters, her mother has a new husband and is expecting a baby. Rae thinks of herself as a “pointless blob” and utters humorous voiceover narration about her “turbulent” life.

Vulture reviewer David Renshaw wrote,

Scenes between Rae and psychiatrist Dr. Kester are something of a pressure release valve, allowing her to voice her insecurities out loud, safely, and consequence-free.

After being discharged, she returns to school where bullies call her Jabba. She finds a friend group, and manages to keep them ignorant of her spell in the psych hospital. In one episode, the gang has a pool party, and Rae gets stuck in a slide and unintentionally reveals the scars left over from cutting herself. Still, she manages to turn it into a laugh.

Against all odds, she attracts Finn, “the handsome and desired one of her group,” and they engage in a lot of amorous activity. To her surprise, Rae learns that she is not the only adolescent experiencing anxiety and dread. Renshaw also wrote that the series “refuses to let its characters be shamed or embarrassed by the things they fear.”

But negative events continue to happen. A fellow mental hospital patient and friend dies from over-exercising and refusing to eat. Meanwhile, there are still bullies in Rae’s life

Real life

The show has been called unusually honest about mental health problems, as well as uplifting and perfectly cast. Not surprisingly, the series was based on a non-fiction book (and its sequel) by the real Rae Earl. In 2015 she published an article reflecting on the surprising popularity of her story. She came of age in the 1980s,

But some things absolutely resonate with teenagers today. My awkwardness, my hatred of my body, my absolute sense that everyone “had it all sorted” and had a better life than me. Sadly those things are not going to go away. Neither will that most acute of existential adolescent problems – the feeling that somehow, in some way, you are missing out.

I know from the feedback I get that there are readers desperate to see more about ordinary young people coping with conditions like anxiety, depression, bi-polar and schizophrenia… There’s still a real need for characters who have a mental illness — but are not defined exclusively by it.

A website for parents says,

Very few shows deal with mental health and body issues as well as My Mad Fat Diary; in one poignant scene, Rae “unzips” herself and steps out to reveal a smaller body, an image that many teens dealing with the pressure to be thin can relate to.

The series was nominated for several British TV awards and won three; two for drama and one for best actress. It still has a rather cult-like following.

Your responses and feedback are welcome!

Source: “It’s Time to Start Watching My Mad Fat Diary,” Vulture.com, 04/28/22
Source: “My Mad Fat Diary box set review,” TheGuardian.com, 08/27/15
Source: “Why today’s teenagers still want to take a peek inside My Mad Fat Diary,” TheGuardian.com, 07/01/15
Source: “My Mad Fat Diary,” CommonSenseMedia.org, undated
Image by Fredrik Rubensson/CC BY-SA 2.0

A Movie About an Addict — “Luckiest Girl Alive”

“Luckiest Girl Alive,” a film that has been described as “tragedy porn,” is first of all not for kids. The protagonist is a big-city powerhouse type of woman who reminds people that she attained what is known as a “figure” by skipping lunch for six years. New York Times reviewer Amy Nicholson says that the character Ani “wears success like a bulletproof vest” and…

[…] has achieved a trifecta of status symbols: a prestigious education (acquired via scholarships), a slim body (acquired via an eating disorder), and a posh fiancé (acquired via emotional suppression).

It all began with a novel by Jessica Knoll. In the book, speaking of her upcoming wedding, Ani tells a friend she is going “Full ano,” meaning “full anorexic,” because size 2 is just too elephantine to be endured. At one point she says, “Petite is what they call short fat girls. I should know: I used to be one.” As an adult, she spends $1,200 a month on fitness training, a habit that could indicate an extremist personality.

But there is more to Ani’s story.

Flashbacks recall her teen years, when she was, in fact, not a short fat girl. Okay, at one point a high school boy calls her a “wide load,” but any female might be targeted with such a remark by a callous male who hopes to make her feel bad about herself, because negative attention is better than none. There are other glimpses of her childhood and youth and (although her alleged former obesity is not a visible theme) mental health professionals will draw their own conclusions.

Ani’s weight problem is all in her mind, planted there by her mother. The maternal psychological warfare caused her to develop body dysmorphia and an eating disorder. As a grownup, she is both a survivor who has created an ostensibly perfect life for herself, and a victim haunted by ghosts from the past. Novelist Knoll told the press that she did not intend the character to “qualify as a good, pure victim,” and eventually, the viewer finds out why. It has to do with horrific events in the past, which we won’t go into here.

The point

Recall how, in the drug world, a familiar cliche is the desperate user crawling around searching between carpet fibers for a few molecules of cocaine. In “Luckiest Girl Alive,” a great moment beautifully illustrates addiction. In this iconic scene, Ani and her future husband finish up a restaurant meal. He asks the server for a takeout box and leaves for the restroom. In an astonishing tour-de-force, Ani wolfs down the remaining pizza slices. She then compounds the deception by telling her beloved that the waitress spilled soda on the pizza — embellishing the lie with a detail that it also landed on Ani’s skirt.

What a perfect illustration of addictive behavior! No doubt this character rationalizes to herself that she is lying only to protect her fiancé. There is no point in hurting him by revealing information he doesn’t really need to know right now. Some day, when she’s better, she’ll tell them and they will laugh about it.

Part of addiction is that people get hooked on the stories they tell themselves and others. They become enamored of their own cleverness and resourcefulness, and learn to enjoy inventing an alternative reality and tricking people, even their nearest and dearest. Especially them.

No doubt Ani has convinced herself that she is doing the right thing by shielding the man from the truth, at least temporarily. In fact, if he knew the favor she is doing him by hiding the harsh truth, he would actually be grateful. Addicts can talk themselves into anything.

Your responses and feedback are welcome!

Source: “Luckiest Girl Alive by Jessica Knoll,” TheLiteraryPhoenix.com 07/18/18
Source: “Mila Kunis confronts dark truths new Netflix film ‘Luckiest Girl Alive’,” Cleveland.com. 10/05/22
Image by Photography Montreal/Public Domain

Salute to BrainWeighve’s Carly Hurt

Here is a shoutout to someone who has been an integral part of Dr. Pretlow’s projects for a long, long time. Now in her early 20s, Carly Hurt has used earlier iterations of BrainWeighve concepts for her own weight loss, and will serve as a teen coach for the clinical trial with the app. She says,

I was a part of one of Dr. P’s weight loss studies back in 2014-2015. The next year I started sharing my continued weight loss struggles with him and I began helping out with the gift of knowledge towards future studies and the app itself!

The information I have learned while working with the app has been an incredible part of my weight loss journey. Being able to share what I’ve learned about the displacement activity has not only helped me better understand it, but has helped me support those around me who also struggle with weight loss.

Carly has been awarded an associate degree with a concentration in psychology and is currently finishing up a bachelor’s degree in Elementary Education. Last year, she married her high school sweetheart, and recently they were joined by a baby boy. They plan to “teach him from a young age how to deal with weight management the way our brains were wired to!”

Carly’s use of the displacement intervention is extensively covered in this presentation, beginning at Slide 28. Don’t miss Slide 31! In Slide 33, she emphasizes the importance of making concrete, detailed plans about how to handle various aspects of an unsatisfactory situation. Again, it is apparent that actually putting things in writing is the key to effectiveness. The brain seems to recognize a written intention as something like a contract with the self.

Childhood Obesity News has, of course, noted Carly’s contributions before. Her experiences were also featured in another post discussing these topics. The archived post called “Bully Wrangling” gives a picture of her own struggles in middle school. Basically, she has had firsthand experience with the situations she now counsels younger people about. Blessed with a very wise mother, she came to the realization that one reason some kids act so ugly is a reflection of their miserable home and family backgrounds.

Carly’s Corner has been a popular area of Dr. Pretlow’s W8Loss2Go site and it carries over into the BrainWeighve app, where her helpful videos are posted. “Bullying” is one. Others in her collection address such topics as Triggers, Boredom, Displacement, Shame, Openness and Honesty, Slip-ups, and Motivation.

Your responses and feedback are welcome!

Dr. Pretlow’s Presentation and BrainWeighve

The core of the reconceptualization proposed by BrainWeighve is,

Moving the opposing drives out of equilibrium, by resolving the person’s underlying problem/stressful situations, theoretically should mitigate the displacement mechanism and serve as a treatment for addictive overeating.

In addition, people are able to retrain their brains to accept, and work with, alternative displacement mechanisms that are less harmful and more helpful than eating. Other ways to use mental and physical energies include hobbies, breathing practices, running around outside, and many more. They can be called upon to substitute for the unhealthful types of eating, like recreational eating, emotional eating, and eating that happens in a futile effort to resolve the conflict of competing drives.

The Dread List

(If someone hasn’t registered that horror movie title already, it would probably be a good investment.). The Dread List feature is very popular with the kids who have given it a test run so far. For each tempting or repulsive situation, the object is to develop a specific plan and try it out. (And of course, it’s never too late to mention, the subconscious part of your brain is much more likely to join in a group effort, if you take the trouble to communicate with it by hand, either in writing or printing.) If that plan doesn’t give satisfaction, then regroup, course-correct, and devise a new plan.

A road out of the swamp

Help is available in the form of coping strategies suggested by other young people who have found them useful. By the same token, every new participant in the BrainWeighve program has the opportunity to contribute to the world by adding their successful strategies to the community’s wisdom trove.

Of course, a person can make a dread list and a plan list for personal use only. There is no compulsion to share. But then you start to realize that, if you share, someone very much like you will discover that they’re not the only 14-year-old who hates to shop for clothes, and that will be a good thing. So you take as much privacy as you need, until you feel comfortable contributing to the conversation.

But wait, there’s more

The purpose of the BrainWeighve phone app is not just to encourage the user to adapt to different, non-caloric displacement activities. That might be called (unkindly) just another method of running away from problems. Learning to make constructive use of the overflow brain energy is a step, a necessary and very useful step, and a powerful tactic that can help every day as life progresses.

But non-fattening activities alone are not the whole answer, or the ultimate solution to any one problem. Discovering more adaptive displacement activities is a stage, not a destination. The program goes further, and actively encourages facing up to difficult situations and dealing with them in appropriate and effective ways. What’s not to like about that?

Your responses and feedback are welcome!

Source: Robert Pretlow, M.D., Suzette Glasner, eHealth International of Seattle, WA, and UCLA Integrated Substance Abuse Program

Dr. Pretlow’s Obesity Week Presentation

The two references for this post are Dr. Pretlow’s recent talk at the Obesity Week conference in San Diego (audio recording) and the visual aspect, the poster illustrating and describing the basic concepts behind the question, “Should Obesity and Eating Addiction Be Reconceptualized as Displacement Behavior?”.

Why is the apparent food addiction that leads to obesity, like other addictions, so difficult to control? Because no matter what the problem, chances are that ingesting more substances, including food, will be inappropriate to the situation, and will go exactly 0% of the way toward alleviating it.

In the animal kingdom, if a bird is threatened with some kind of hostile situation and pauses to tidy its feathers, this displacement behavior might simply delay the necessity to choose between fight or flight. Or maybe the enemy will become bored or distracted, and move on. In either case, the decision to take a preening break might not do permanent harm.

On the other hand, if a student is unable to decide whether to show up for an exam or skip school, eating an entire pizza offers no possible benefit. Whether the choice ends up being fight or flight, or even staying up and studying all night, the person will likely still be heavier at their next weigh-in. Pizza consumption is, in other words, a maladaptive displacement behavior.

No surprise

It comes as no surprise that the conclusion drawn from the trials done so far by eHealth International of Seattle, Washington, and UCLA’s Integrated Substance Abuse Program is,

Reconceptualization of obesity and eating addiction as displacement behavior may be warranted and treated accordingly.

In some cases, displacement behavior can be adaptive, though in many other cases, the opposite is true. As the poster says, “Sheep threatened by a predator will graze despite the danger.” People threatened by an unfaceable situation will eat, both the wrong stuff and a lot of it.

When such a conflict is underway, the conflicting impulses to follow two competing drives can build up “an overflow of mental energy that expresses itself in a third drive, in this case, feeding.” Once the brain has generated a lot of energy that has to go somewhere, then what?


Maybe, what comes along next is a sensory cue — the smell of baking pizza, or the sight of a bag of chips on the kitchen counter, or the voice of a TV huckster whose job is to convince the viewer that she or he cannot survive for another minute without a raft of peanut butter cups. “The displacement mechanism is triggered by sensory cues,” say Dr. Pretlow and coauthor Suzette Glasner, Ph.D.

And contemporary life is full of those cues. We can barely turn around without being confronted by the sight of food. In fact, we don’t even have to move. A perfectly stationary person can be beleaguered by cues that demand, “Think about eating!” Social media platforms are full of not only advertising, but the favorite recipes of our online friends, and photos of their brunch plates.

Broadcast media need advertising to pay their bills, and will bombard a person nonstop with reminders to chow down. We are constantly being cajoled. “Got a problem? Eat. Is somebody mad at you? Buy them something to eat. Do you want to be popular and beloved? Bring food. Are you sad because bringing food didn’t make you popular after all? Eat more.”

In some quarters, the idea of intermittent fasting has caught on. If only we could have intermittent advertising, like maybe a 12-hour truce each day without any reminders of food. But the world doesn’t work like that.

(To be continued…)

Your responses and feedback are welcome!

Source: Robert Pretlow, M.D., Suzette Glasner, eHealth International of Seattle, WA, and UCLA Integrated Substance Abuse Program

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

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.
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.

Food & Health Resources