Stigmatizing Words and What Works

Junk Food Addiction
As Childhhood Obesity News has been saying all along, it would be a good idea to recognize that there is such a thing as food addiction, and take it from there.

The downside is, following the logical sequence of events would lead to a mixed outcome. Not all the consequences would be positive. Or would be negative for some, but not all, people. Or would only be negative for a short time, until people could adjust to a new way of thinking that includes viewing the obesity epidemic through the psychological food dependence-addiction lens.

So there’s all the practical stuff: the bureaucratic problems of reconciling health insurance practices with the reality of food addiction, editing the Diagnostic and Statistical Manual of Mental Disorders, a massive redesign of childhood obesity treatment paradigms, and many other things.

Another aspect is the effect of such a cultural shift on the individual, the psychology of it all. A lot of it has to do with words, descriptions, definitions. Who makes the definitions? Who gets to pick the words that are used and the ones that are punishable? What is the effect of words on obese people? How many different ways are there to approach the childhood obesity dilemma? And can they work for a common cause despite some differences in outlook?

For instance, one school of thought holds that food addiction is all biochemically hard-wired. They’re not into the idea of emotional eating or any psychological explanation. One reason for this might be that finding the basis of addiction in the psyche seems uncomfortably close to “blaming the victim.”

But not everyone thinks of psychological illness that way. It’s, well… illness. Yes, a large amount of personal responsibility has to be in place, for an addict to seek help and to benefit from programs. The accountability rests squarely on the individual. That’s not blaming the victim, it’s acknowledging reality.

And here’s the main thing: This is no different from physical illness. Germs are all over the place, and people are often exposed to them through no fault of their own. That much of it is biological. But there is a behavioral part. People who take the trouble to maintain good general health and who stay away from avoidable germs are less likely to get sick. Personal responsibility and accountability are very important and desirable things, and to say that people do have some control over their health, both physical and psychological, is not to “blame the victim,” but to state the obvious.

Then there’s the whole debate about compulsion and where it originates. The word “compel” means to “drive” or “force,” but where does the driving force come from? In compulsive overeating, does the body or the mind do the compelling? Is the capacity for addiction latent in everyone, for physiological, hard-wired reasons? If so, then why does it only affect some but not all people? For those who are affected, is the activating trigger psychological?

As Dr. Pretlow puts it,

Where is the puppeteer that makes everything else dance????

A big question. But even if we don’t know the answer, can we proceed on the basis of empirical evidence and do what works?

Dr. Pretlow sees food addiction as a learned behavior that can be unlearned. The mind learns to ease emotional distress with pleasure eating, and it can learn better ways. That’s not theory. Although there is no universal agreement on why 12-step programs work for many addicts, the fact is, they do. Not for all, but they seem to work better than any other known program method.

Thousands of recovering addicts bear witness to the fact that the program works — if you work the program. Do we really need to know every detail about the root cause or causes of addiction, in order to reach a sensible conclusion like, “Hey, if these programs work, let’s get some more of them”? It doesn’t really matter at this point why. The important thing is to make sure those programs are available to people.

It’s great to find out the basis, because prevention is better, but meanwhile, there are a large number of people for whom prevention is too late. What if we just accept that people act under compulsion, and take it from there? Locate the ones who have successfully sustained the healthful lifestyle congruent with sustained weight loss, and find out how they do it. And help other people to try it, no matter if the scientific foundations can’t yet be known or proven to everyone’s satisfaction.

Your responses and feedback are welcome!

Image by colros (Sandra Cohen-Rose and Colin Rose), used under its Creative Commons license.

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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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