Ending Childhood Obesity Through Healthy Eating & Exercise?

I recently witnessed two teenagers in a group, one advising the other how to lose weight. The first teen glibly proclaimed,

All you gotta do is eat healthy and exercise!

Whereupon, the second teen indignantly retorted,

That is sooo not it!!! I know what to eat, I just can’t resist bad food!! And exercise is, like, impossible!!! I get so outta breath and my feet and knees hurt!

At 13, she weighed in at 5’5”, 257 lb.

In an online poll, most overweight kids report that they’re overdosed on healthy eating information. They’re deluged with it in school and it really doesn’t seem to help them. As one 13-year-old girl (5’4”, 240 lbs) noted:

I took a poll at my school. 95% knew a lot about eating healthy but 99% said that they really didn’t do any of the stuff we learn about.

This information comes from an interactive website for overweight kids called Weigh2Rock, moderated by medical professionals. It has tapped into a vast knowledge base: nearly 30,000 unique overweight teens and preteens have posted more than 135,000 messages on this site over the past 11 years.

And, confirming what these kids say about exercise, a new report from the EarlyBird Diabetes Study suggests that physical activity has little, if any, role to play in the obesity epidemic among children. Plus, a recent review study confirms that healthy eating and exercise may not be the answer.

Yet, healthy eating and physical activity comprise the very fabric of current childhood obesity interventions and initiatives, such as First Lady Michelle Obama’s laudable “Let’s Move” campaign. A 14-year-old girl (5’4, 230+ lb.) commented about Ms. Obama’s campaign in a website poll:

There are actually alot of activities in my school, like intramural sports and i was in them, didn’t help a smidge. And there ARE healthy affordable foods where i live, it doesn’t mean that we buy them. I don’t think she has thought about the fact that there are multiple mcdonalds in every town. For years people have had programs and activities to help obese people and it hasn’t really helped. There are many holes in this plan.

So… if the healthy eating and physical activity approach is not working for childhood obesity, what do we do now?

About a third of the thousands of overweight kids, who’ve shared their struggles on the Weigh2Rock website, explicitly say that they turn to food to ease sadness, stress, anger, loneliness, fatigue, and boredom, as well as the pain of being obese itself. For most, this “comfort eating” appears to be unconscious, mindless. The disaster is that they become hooked on this behavior and unable to stop, even when distressingly overweight or obese because of it. Food companies understand this and market with slogans like “Comfort in Every Bar” (Milky Way candy). These kids say they hate being fat, yet they struggle to resist incessant thoughts and urges to eat food “that tastes good,” e.g., junk food and fast food, knowing full well that eating those foods will result in additional weight gain and further damage to their lives. Many say that their eating is “out of control.” A post from a 16-year-old boy (5’6″, 230 lb.) exemplifies this struggle:

does anybody have any info on how to resis the urge 2 eat, knowing that later on you’ll regret…i need help bad!

This compelling evidence points to a serious dependence on highly pleasurable comfort foods (i.e., addiction) as a major component of the childhood obesity epidemic, not unlike addictions to tobacco, alcohol, and even drugs. These research findings are summarized in an article in the peer-reviewed journal, Eating Disorders.

What these kids say is confirmed by a brain scan study at Yale University published this month, which revealed that that the brains of adolescent compulsive eaters “light up” when shown the foods they crave, like milkshakes and donuts, the same way the brains of drug addicts “light up” when shown the drugs they are addicted to. Many kids — when stressed, depressed, or bored -– appear to use highly pleasurable food as a “drug of comfort,” which is more acceptable than tobacco, alcohol, or drugs of abuse, but nearly as addicting. Children have difficulty obtaining tobacco, alcohol, or drugs but have ready access to highly pleasurable foods.

Kids even describe their addiction to comfort foods, for example a 15-year-old girl (5’1”, 335 lb.):

HOW can I stop BEing ADDICTed to FOOD???? In SCHOOL I can’t even LISTEN because of how UNCOMFORTable it is to be SO HEAVY but ALL I want is to go HOME and have ICEcream or COOKies to feel BETTER

Medical science is resisting the notion of food as an addictive substance. Why? One reason may be that much of obesity scientific research is funded by the food industry, which is deathly afraid that their products might be labeled as addictive substances. This likely would open up a liability nightmare, as well as extensive federal regulation of food. A second reason is that obesity researchers have substantial vested interests in areas such as nutrition, metabolism, and exercise. Plus, physicians generally are uncomfortable with a psychological approach to a physical problem. And, for nutritionists and dietitians, the term “food addiction” is inherently a non sequitur. One dietitian, Christy Harrison, a writer with the Slate Group, rejected this post as a “counterintuitive position.”

Your responses and feedback are welcome!

Read Part 2: Food Addiction and Childhood Obesity: Now What Do We Do?

Image purchased from iStockPhoto.

8 Responses

  1. Dear Dr. Pretlow:

    As a nutritionist (and former social worker), I would like to place my vote as to the position of this post. Having only recently come across this website, your book and the weigh2rock site, I would say your post is a breath of fresh air.

    Whether in social work, working with young clients dealing with eating disorders or the past decade in nutrition, where I saw the presenting issue with an increasing number of my clients, both young and old, being obesity, I can attest quite clearly to the addictive component and physical/emotional interplay between food and many people carrying excess weight.

    The issue loomed so large that I finally put together a family-based program that can both prevent and deal with childhood obesity. Unlike an “everything in moderation approach”, the Kids in Balance program (documented in the book “Overweight Kids in a Toothpick World”) recognizes the emotional and physical addictive nature of certain foods and advocates a gradual reduction of and then total elimination period for foods of that nature. The program simply and clearly walks families through three stages of dietary and lifestyle change, provides easy tools (i.e. goals and motivator worksheets, kid-friendly recipes, menu plans, food/mood/activity logs) to assist in the journey, and offers the option of encouragement via a weekly email newsletter.

    When I came across your sites some weeks ago, I was very encouraged to see similar recognition and recommendations re: food choices and approach to the challenge of excess weight. Please keep up the good work of helping families understand there are many weight loss falsehoods that are making it virtually impossible for their children to reach a healthy weight range. Recognizing that a one size dietary plan does not fit all; understanding that weekly weight loss goals are less important than following through on healthy choices that are completely within your control; realizing that while reaching a healthy weight is important, doing it in a way that does not increase stress and stress eating is equally important; and totally busting the “everything in moderation” myth are all steps on the journey to optimal health.

    Keep up the good work!

    Brenda Wollenberg BSW RHN RNCP
    Registered Nutritional Consulting Practitioner
    Choices Lifestyle Management
    Langley, BC


    1. Brenda,
      Thank you very much for your comment. I likewise am so encouraged that someone else believes that addiction to certain foods and food-like substances is behind the obesity epidemic in children and adults. And, in treatment you also take the addictive food elimination approach – yes!! This is a tough row to hoe, as there is such resistance to the idea within both the professional and lay public arenas. I did a poster presentation on “Food Addiction in Children” at the 2010 Obesity Society scientific meeting. There was nothing else at the meeting in regard to food addiction, except one private symposium outside of the conference proper. An attendee who viewed my poster and “got it” predicted that within 5 years that conference will consist almost entirely of food addiction presentations. Keep your fingers crossed… – RP

    1. The addictive ingredients are anything that tastes good, Gerrie. The pleasure of the food numbs emotional distress, at least briefly, and the brain will set up pathways to keep that going, hence development of the addiction. Sugar, salt, fat, and high-tech flavorings are the usual suspects in food. Processed food contains a lot more of this stuff, because what tastes good is what sells. There’s a video clip at http://www.blubberbuster.com/school/losing_so_hard.htm , in which a fast food magazine editor states, “Part of the reason for the success of fast food is the comfort food level of it.” In other words, fast food tastes really good, so it briefly cancels emotional discomfort and thus is addictive. – RP

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  3. I have a granddaughter who is 8 years old and weights around 147 pounds. When she was born she acted like she was starving. She would suck her bottle so fast, she would choke. I use to think that it was the nipples of the bottles. Then she acted like she was hungry right after she had just finished her meals as she got older. I am so concerned that she may have an addiction to food. She’s pretty active right now but she wants to eat all the time. I don’t want to give her a complex by me talking about her weight all the time. What can we do!!!

    1. It is distressing to see someone we love in this kind of trouble. Has your granddaughter had a complete physical exam with the thought in mind of looking for something that might explain this?

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Profiles: Kids Struggling with Weight

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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.
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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