Food Addiction and Childhood Obesity: Now What Do We Do?

(Part Two of a Two-Part Post — View Part One)

The first part of this post had to do with the fact that the “healthy eating and exercise” approach for ending the childhood obesity epidemic just isn’t working. Compelling new evidence now points to actual addiction to highly-pleasurable comfort foods, like junk food and fast food, as the predominent cause of childhood obesity. Based on this knowledge, if we are to turn the tide of this horrific epidemic, a major paradigm shift is needed. We must attack childhood obesity in the same manner as we do other addictions. A 13-year-old girl (5’, 128 lb.) responded to a poll asking if junk food access by children should be restricted:

OMG THIS WOULD HELP SO MUCH!! … i find myself at the deli buying candy behind my moms back ugh.

Proposed Action Items

Some of the following action items may be considered too radical. Even so, their implementation might render a reality First Lady Michelle Obama’s dream of eradicating the childhood obesity epidemic within a generation:

  • Substance dependence methods should be incorporated into overweight intervention programs for youth. For example, obese kids will need to go through a withdrawal process to get off highly pleasurable foods, as this 15-year-old girl (5’10”, 209 lb.) describes:

if u can have enough self control and stay off the sugar for two weeks you stop craving sugar completely..

  • Current childhood obesity initiatives and interventions should all be examined through a “psychological food dependence – addiction lens.” Do such programs help psychological food dependence – addiction? If not, kids may become discouraged when the programs fail to help them lose weight or maintain their weight. Discouraged kids may comfort-eat more and seek help less, a vicious cycle. Nevertheless, parts of current programs may serendipitously help food addiction. For example, fun physical activities relieve stress and depression, the underlying causes of food addiction, although striving to eat 5 servings of fruits and vegetables or walk 10,000 steps a day may not.
  • Campaigns and interventions that promote healthy eating and exercise may thus be counterproductive. Those programs should instead educate kids as to why they overeat; how to reduce their stress, loneliness, and depression; and how to cope with life without turning to food.
  • Obese kids need major support to break their addiction to highly pleasurable foods and avoid relapse. Interventions should include such support via mentors and peers. Counseling should be provided for kids in need of it.
  • Factors that produce stress, loneliness, and depression in kids should be addressed, as such are the underlying cause of comfort and stress eating and resulting food addiction. Fun activities with other kids should be provided after school and on weekends in order to combat social isolation, a main factor. The inability of many heavy kids to participate in sports should be accommodated with activities such as hobbies, non-strenuous games, learning to play musical instruments, etc.
  • Insurance should cover treatment of morbidly obese kids in residential centers, rather than paying for bariatric surgery. This should include coverage for follow-up after discharge and “halfway houses,” to gradually reintroduce the kids to the temptations of comforting, highly pleasurable foods in the real world and to develop coping skills that don’t involve eating. Follow-up should continue indefinitely once the kids return to their home environment.
  • Junk food and fast food should be banned in schools, as well as such outlets in the vicinity of schools.
  • Foods that kids say they have the most problem resisting should be taxed, in the same manner that taxation of tobacco products has shown success in decreasing tobacco use.
  • Ideally, sale of junk food (including sugar-sweetened beverages) and fast food to minors should be restricted, similar to restrictions with tobacco.
  • Childhood obesity campaigns should promote overeating as “not cool” and junk food as “yuck!” Celebrities such as rock stars and athletes could help tremendously.
  • Parents should be educated not to use food to soothe, comfort, or reward their children or as a way to buy love. Parents should likewise be made aware of the signs of comfort eating and food addiction.
  • New terms should be coined to describe foods or food-like substances which may be addictive. Terms such as “addictafoods” or an acronym like “PDFs” (psychological dependence foods) might be appropriate.
  • An indicator of food addiction potential should be required on food labels, for example a scale of 1 to 3. The most addictive foods (level 3) should also have a warning label similar to cigarettes: “Warning: This food may be addictive and cause obesity.”
  • Federal corn subsidies, which lower the price of high-fructose corn syrup, should be ceased. High-fructose corn syrup is used to sweeten a multitude of food products, rendering them more pleasurable, comforting, and addictive.
  • The Code of Food and Beverage Advertising to Children (Code PABI) in Mexico should be emulated in the U.S. and other countries. This code, which currently is self-policed, will soon become government-enforced.
  • Ideally, all food advertising directed at children should be banned. Food advertising directed at children is, in truth, enticement rather than advertising. Only highly pleasurable foods are advertised, which may get children hooked. Food companies are no dopes: an addicted kid is a customer for life. Could that be why apples are not advertised?

Overweight and obese kids are hapless victims of stress, loneliness, and depression in a readily available, addicting, comfort food environment. Food addiction and resulting weight gain devastates their lives. These kids are in real pain. They desperately need for the medical profession, parents, and policy makers to do something about this deplorable problem. If one third of our kids were suffering from asthma due to air pollution, we’d take draconian measures. Why is childhood obesity different?

Your responses and feedback are welcome!

(View Part One of This Post)

Image purchased from iStockPhoto.

13 Responses

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  1. Dear Dr. Pretlow,
    It’s a great pleasure to read your blog. I find your post very interesting. Childhood Obesity is indeed a cause for concern and your valuable insight is helpful in finding ways on how to effectively deal with this problem.
    As a reader, I consider your writing to be a great example of a quality and globally competitive output.
    As a moderator for Physician Nexus (a community for physicians) I would like to share your genuine ideas and knowledge. With this you can gain 1000 physician readers on Nexus.
    We would love for you to visit our community. It’s free, takes seconds, and is designed for physicians only – completely free of industry bias and commercial interests.
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    On behalf of the Physician Nexus Team

  2. I don’t know what to do. My son is not obese, but he is addicted to food. I’m disabled and can’t afford daily life much less to send him to military school or expensive doctors. But I haven’t found any help yet because it’s not just sweets and junk food. He will eat anything. I would have to be with him every second of the day to keep him from eating so much. Everytime I go to cook something, I find at least one of my ingredients is gone because he snuck it away. I found piles of trash from food wrappers he was putting on top of the bookcases in his room. I put a lock on the refrigerator, and he started doing things like eating frozen waffles out of our garage freezer directly, still frozen. It’s out of control, and I don’t know what to do. I’ve taken away all of his priveleges. He’s not starving. He eats just like the rest of the family, but he’s still sneaking things away every chance he gets. And he drinks water constantly. So it’s not dehydration. I don’t know what to do.

    1. Karyn, we discussed this with Dr. Pretlow and don’t have an easy answer for you. Most likely, your son is eating for emotional reasons. Getting to the heart of those reasons may provide a solution. Have you looked into low-cost or free counseling services which many psychologists offer?

  3. Dr. Pretlow,

    I was absolutely amazed when I read your article here concerning the correlation between childhood obesity and emotional issues.

    As someone who has struggled with weight all my life, I have only now started to realize that my weight issues are not only physical, but emotional as well. After recently coming to my own realization that I am a food addict and have been using food as a coping mechanism my whole life to deal with Depression and stress, I have started to tackle my weight problem on both the physical and emotional front. And I can tell you from first-hand experience that it is working. After coming to this realization, I decided to start limiting my intake of foods containing high levels of sugar and starches, and I have seen great results.

    From a Public Policy standpoint, these policies are great ideas, and they are ones which are realistic. Having psychological support available to children who face this problem is key to stopping the cycle, and furthermore helping children to grow into prosperous adults who can accomplish anything they set their minds to. I really wish that there had been help like that for me when I was a child.

    Thank you so much for posting this article. I hope that your enlightened attitude will continue to spread throughout the medical and policy community, and eventually inspire change in how we deal with this issue.


    1. I applaud your compelling story, Emily! Even though the emotional basis of obesity was not realized when you were a child, your story will help solidify this realization for the current generation. Now that we have firm evidence of this psychological/addictive basis, we must take action, both treatment and prevention. Publicizing that childhood obesity is not a simple nutritional ignorance or sedentary activity problem is the first step in curbing this horrific epidemic. Our country must then implement draconian measures such as banning holiday candy for kids, banning food advertising to kids, and restricting sale of junk food to kids. People like you, who have been there, are the catalyst needed to launch this herculean effort.

  4. Hi. I have been searching for help for a year now and this has been the closest thing I have found that addresses the difficulty we are having with my son. I could really use help finding a source of assistance in Michigan. My son clearly has a food addiction but he is not depressed or lonely. He is an active, happy boy who does not seem bothered by his weight yet (he is 11). I would like to find help before he reached the unhealthy point that some of these kids are dealing with. I have not found anyone who is prepared to help beyond ‘teaching him the importance of eating healthier’ which is not helpful. He has an addiction. Can you advise?

    1. Thanks Lisa, for your compelling post. Unfortunately, there’s no one we are aware of in your state, or close by, to whom we could refer you for an addiction-based overweight intervention for your son, but only typical diet and exercise programs, which do not have lasting results.

      Even though your son seems not depressed or lonely, it may not be obvious that he is and is using food as a coping mechanism, as this can be unconscious or mindless. In our three studies involving 143 overweight/obese young people, we’ve observed a striking disconnect between their anonymous voices and their face-to-face voices, in terms of what they say about their lives and their struggles with their weight. Anonymously, they write heart-wrenching stories. Face-to-face, or even on the phone, none (zero!) in our three studies admitted to being unhappy about being overweight or that they struggle to resist overeating.

      Here are some suggestions, based on an addiction treatment approach:

      1) Don’t nag or make food a power struggle. Be loving and understanding to your son, no matter what. Your distress about his weight gain will be counterproductive – it has to come from him. Your concern must be about his health.
      2) Educate him on the dangers of weight gain and the health effects of using food as a means of relaxation, easing tension, or relief from boredom, which again typically is mindless.
      3) Yet, realize that education on the effects of smoking doesn’t have much effect on kids either and education on the dangers of weight gain may not as well. Kids, particularly teenagers, tend to feel invincible. Motivations, such as being able to run faster, not being teased, being able to wear cool clothes, and for older teens attracting the opposite sex, have much more effect.
      4) Help your son to develop other means of relaxing, relieving tension and boredom, and finding comfort besides food, like writing down whatever worries him and then writing a plan to deal with each worry. Pets can be a source of comfort.
      5) Seventy percent of the kids in our three studies were able to totally eliminate snacking, by simply distracting themselves and avoiding triggers such as boredom and going into the kitchen. Snacking seems to be a cultural custom or psychological need and not nutritionally necessary for kids. Help your son to realize that he may not actually be hungry when wanting a snack. And of course keep snack foods out of your house.
      6) Curbing food amounts at meals is trickier, as kids have to eat. Yet, they can curb excessive amounts. A staged, withdrawal approach of gradually decreasing the amounts of foods eaten at meals seems to work. But of course your son has got to want to do this. The trick is to convince him that he actually can eat less and not miss the food, if he cuts down in small increments.
      7) Practice what you preach and avoid, “Do as I say, not as I do.”

      Hope this helps.

      Good luck,
      Dr. P

  5. Dear Sir

    Hi my name is Kelly from Jakarta Beacon Academy in year 9. I am doing a school project about obesity and wondering if i could do an interview with you. Just answer the questions below as many as you could.

    1.How many of your family members think that being physically healthy is important?
    2.How do you recommend losing weight?
    3.What are the importance of children being fit?
    4.What are your views of obesity in indonesia?
    5.Do you believe that obesity is an important issue?
    6.Do you think that children are getting enough education on eating healthy and fitness?
    7.What is the number one cause of childhood obesity?
    8.Why is it important to tackle the issue of childhood obesity?
    9.How can families teach their children about the importance of eating healthy?
    10.Is school one of the problem that cause obesity as they usually served junk food?
    11.What are the cause and consequences of obesity?
    12.What should we do to tackle the obesity?

    13.Does happiness plays a huge part when exercising ,if so how?

    14)Is it better to create your own program which one would follow or a program created by a professional?
    I really hope that you will answer them to help my project but if you don’t have the time, i understand

    Thank you

  6. Useful piece ! I Appreciate the analysis ! Does anyone know if I could access a fillable a form document to use ?

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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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