Labels, Food Addiction, and the FDA

Carbs Nation

Here’s an insightful piece by Adi Narayan, who habitually writes about science and medicine for Time. Called “Building a Better Label,” it is, not surprisingly, all about the rules set by the Food and Drug Administration (FDA) regarding the nutritional information required on food packaging. I, for one, learned something from it:

The recently passed health-care bill calls on the FDA to set a national standard for instituting calorie and fat labeling on restaurant menus. Under the ruling, chain restaurants with at least 20 locations, as well as vending machines, would be required to display nutritional information prominently.

Narayan explains the mysteries of “front-of-pack” claims, the misleading nature of “fortified” foods, and the quest for consistent and evidence-based labeling. It’s been about 10 years since the code was last revamped, giving manufacturers plenty of time to work out clever ruses and make end runs around the regs. Narayan shows how a lot of food labeling is in direct contravention to government regulations. (Question: So, how much good will additional rules accomplish?)

A while back, the Deputy Director of the FDA, Joshua Sharfstein, Jr., issued an invitation to pediatricians, asking, “What can the agency do to advance the health of children?” As we know, childhood obesity is the top pediatric problem in the United States and, fortunately, the problem on which the most attention is currently focused, thanks to First Lady Michelle Obama’s passionate interest and her spearheading of the Let’s Move! campaign.

In response to Sharfstein’s request that pediatricians provide the FDA with their thoughts on potential actions, Dr. Pretlow wrote a letter about food addiction in children, hitting some of the major points made in Overweight: What Kids Say. The book, of course, presents a distillation of the thoughts and feelings contained in 133,000 messages sent by the young to the Weigh2Rock website. (The number is larger now.)

After 10 years of paying attention to these messages, some things are clear in Dr. Pretlow’s mind. Mainly, literal addiction to highly pleasurable foods is a major cause, if not the major cause, of the childhood obesity epidemic. The evidence comes straight from the source: the children and teens who face daily opprobrium because of their weight. Speaking doctor to doctor, he wrote,

This assertion is supported by neuroimaging PET data, which shows that low dopamine D2 receptor levels in the hypothalamus of the brain are strikingly similar in obese and drug addicted individuals.

We won’t print the whole letter here, just some highlights.

Probably very few of these kids know the scientific definition of ‘addiction.’ Nevertheless, they do know that something very powerful is driving them to consume large amounts of highly pleasurable foods, in spite of full knowledge of the dreadful effects of inevitable weight gain.

One problem, of course, is that mainstream medicine doesn’t seem eager to accept the obvious fact that food addiction is real. A very large problem is that some foods are truly nutritious; others may not carry much of a nutritional payload but are not actively harmful; and yet others are dangerous because of their hedonic or hyperpalatable properties — the alluring traits that can literally turn them into addictive substances for many growing children. Drawing the lines between these categories requires the wisdom of Solomon.

The FDA is in charge of making sure the food we buy and eat is safe. When the guidelines were put in place, there was no consciousness of the potential addictive qualities in some foods, so the federal agency doesn’t have a legal duty to scrutinize hedonic or hyperpalatable properties of foods. Basicially, its hands are tied when it comes to making an impact on the connection between food addiction and childhood obesity.

The Office of Pediatric Therapeutics offered reassurance that the FDA does try to offer helpful information through the requirement for nutrition labeling which manufacturers must follow. There is much more information at the Center for Foods website, which describes and tells how to participate in the “Make Your Calories Count” program. It also explains what kinds of claims can and can’t be made by food companies.

While the FDA has the power to insist that certain information must appear on the package, only a minority of the eating population really makes good use of that information. Plus, as Narayan reported in the article mentioned above, manufacturers have their sly ways of conforming to the letter of the law while evading its spirit. Labeling information has not prevented the childhood obesity epidemic, so there may not be much to hope for from any additional labeling rules. Perhaps what is needed is not more of the same, but a whole different approach.

Any thoughts about the usefulness of nutrition labeling, or the viability of the addiction paradigm when it comes to food?

Your responses and feedback are welcome!

Source: “Building a Better Label,” Time, 05/02/10
Image by tanvach, used under its Creative Commons license.

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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.

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