The Thing About Food Addiction


The Yale study “Neural Correlates of Food Addiction” has changed the landscape. Medical professionals and even regular people who were previously voices crying in the wilderness have been vindicated to a very great extent. And more of these regular people are coming forward with their stories. “Write what you know” is truer than ever before.

Of course, many adults, except for a brave few early adopters, have not wanted to consider their food issues in the light of addiction before this. They have not wanted to look at their overweight or obese conditions through what Dr. Robert A. Pretlow calls the Psychological Food Dependence-Addiction Lens. However, the pioneers are the thousands of children and teens who have shared their experiences via the Weigh2Rock website. They aren’t afraid to tell it like it is, or to recognize that they are dealing with a force beyond their control, i.e., addiction.

Of course, many journalists reported the Yale findings on food addiction in pretty much the same way. Just to pick one at random, here is William Weir of the Hartford Courant:

What they found was that the brains of subjects who scored higher on the food addiction scale exhibited neural activity similar to that seen in drug addicts, with greater activity in brain regions responsible for cravings and less activity in the regions that curb urges.

In other words, the hyperpalatable, hedonic and “more-ish” foods that are so widely available are not the only culprits. Sure, school lunches need to be looked at. Sure, the ingredients of all that stuff on the supermarket shelves need to be looked at. And most definitely, the current practices in the area of advertising to children need to be scrutinized with the utmost care. But the problem is not just the food, it’s the addictability of the person.

The Yale Food Addiction Scale, originated by Ashley Gearhardt and other team members under the auspices of the Rudd Center for Obesity Research and Policy, is available online as a PDF file. People who score high on the food addiction quiz are, unfortunately, prone to addictions in general. This is why, for instance, bariatric surgery does not have the success rate that its proponents would wish for it — because there is a strong possibility that the patient will either return to the old food-addiction ways or develop a different dependency.

We mentioned this in relation to The Oprah Winfrey Show where several young people who had undergone various kinds of stomach-altering surgery were guests. A 21-year-old woman talked about how she merely changed dependencies, from food to alcohol. Another guest, Dr. Mehmet Oz talked about the phenomenon variously called addiction transfer or addiction transferal or cross addiction. People ensnared by this affliction take it for granted, and refer to it almost casually, as just another fact of life, like the person on the My Fitness Pal message board who says,

I also am a recovering drug addict, and food has taken the place of the drugs…

We have also mentioned Jane Velez-Mitchell, who said in her book, Addict Nation:

Addictions jump! You give up one thing and something else pops up to take its place. The reason for this is obvious. Addicts will use whatever substance is available to escape and self-medicate.

The problem is the individual’s vulnerability to addiction, which is what Dr. Pretlow has been saying all along. Healthy food choices and exercise are wonderful, great, and desirable things — but what a hooked person needs is treatment specifically designed for hooked people, preferably a long and comprehensive residential program.

In a piece about addiction transfer, Meghan Vivo explains that people who have compulsive behavior problems, from smoking to shopping addiction, are dealing with the same brain disease whether the addiction concerns a substance like cocaine or a process like gambling. It shows up in different ways, but all starts in the same place.

People who struggle with compulsive behavior… often find that they overcome one addiction only to develop another months or even years later. Research suggests that the same biochemical processes are at work in multiple types of impulse-control disorders… Each of these behaviors triggers the same reward sites in the brain, resulting in cravings that are difficult to resist.

Is it ever possible to escape? Yes, but it first it is necessary to face the fact that addiction is at work. It takes therapy to address the emotional needs that have caused the person to see their substance (or process) of choice as an answer. With a substance, it also takes periods of discomfort and sometimes extreme distress as the body learns to get along without the substance it wants to consume, whether that be chocolate, alcohol, or heroin. Then, it takes work and commitment to learn new coping skills. It takes, unfortunately, time and money, the investment of which makes it worth doing right the first time. Vivo says,

In order to break an addiction without transferring to another addiction, experts say intensive therapy and treatment are required… The best addiction treatment programs will help put a relapse prevention plan in place so that the patient knows what to do when temptation strikes or life gets overwhelming… Individuals in recovery need to realize that addiction is a lifelong battle, and their recovery is something that must be guarded and nurtured long term.

Your responses and feedback are welcome!

Source: “Food Addiction And Drug Addiction,” The Hartford Courant, 04/04/11
Source: “Yale Food Addiction Scale (PDF),” Rudd Center for Obesity Research and Policy
Source: “Drug addict turned food addict-anyone else out there?,”
Source: “Featured Articles: Understanding Addiction Transfer and Cross Addiction,” Drug Addiction Center
Image by colros (Sandra Cohen-Rose and Colin Rose), used under its Creative Commons license.

2 Responses

  1. You write: “what a hooked person needs is treatment specifically designed for hooked people, preferably a long and comprehensive residential program.”

    I agree with the first part (need treatment for hooked people) but disagree with the second (needs to be long and comprehensive). Long/comprehensive may work, but is it scalable? Me, I think a good deal of the problem (80-90%) can be dealt with via nutrition — and I’ve just finished up 50 sessions of neurofeedback (google NF & alpha-theta protocol) to deal with the remaining 10-20%.

    Getting the brain happy with solid nutrition can take as little as a week. Neurofeedback will take a few months, but it doesn’t need to be done in an expensive residential program. Alas, it’s not yet covered by insurance to treat food issues, but then again, neither are residential programs (for food addicts).

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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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