Obesity and Food Addiction: Caught Between Two Stigmas

Me with Moustache Fry

Deepak Chopra told The Huffington Post readers that, aside from the relatively few cases of hormonal imbalance, obesity comes from bad lifestyle habits that children can’t be expected to break unaided, so the responsibility lies with parents and schools. As some of the causes of the overeating that throw the body’s energy system out of balance, he names the usual suspects — sedentary lifestyle, large portions, etc., and there are only a couple of hints at the emotional roots shared by obesity and addiction.

He says,

Using food as a fix.
Covering up unwanted feelings through eating.

That’s fine as far as it goes, but something needs to be done about the hyperpalatable, over-designed foodlike substances that can be addictive. And obesity needs to be looked at through the psychological food dependence-addiction lens. Some people are prone to addiction and can get addicted to certain foods.

“Addicted,” “obese” — nobody wants either of these labels, and nobody knows which one is worse. There are all kinds of stereotyped ideas about both. Addiction to hard drugs and even alcohol both have a certain amount of cultural glamour attached, while there is nothing glamorous about obesity.

One of the objections to the food addiction paradigm is that so many kids would be stigmatized by the addict label. To many minds, it’s similar to having a criminal record. The information is easily findable and can put their futures even more at risk.

The paradox of psychology is that psychologists know how harmful labeling is, yet they are compelled to invent ever more explicit labels so that patients can maybe use their insurance coverage, and for the government statistics, and so the prescribing of certain medications can be defended if necessary, and for many other reasons.

There is a whole movement against adding more conditions to the Diagnostic and Statistical Manual of Mental Disorders. There is a belief that large areas of normal human life are being pathologized, and a conviction that a lot of over-diagnosis goes on. These will be some of the hardest people to convince that food addiction is as real as cocaine addiction.

At the 2010 Obesity Society scientific meeting, Dr. Pretlow did a poster presentation, and noted,

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.

At the same conference, a colleague who also believes food addiction is a major cause of obesity, asked Dr. Pretlow,

How are we going to deal with this? We can’t call obese people ‘addicts.’ That would stigmatize them even more!

Dr. Pretlow says,

Obese people are victims, hapless for the most part, of stress and depression in an addictive, cheap, comfort food environment.

It is a difficult situation. While efforts are being made to de-stigmatize obesity, at the same time, we need to recognize food addiction, which throws people into a different and even more stigmatized category.

Via the website Addictions Unplugged, Signe Dewar & Dr. Vera Tarman acknowledge that although fats, sugars, and carbohydrates have only recently been recognized as potentially addictive, the medical community is beginning to understand about food addiction.

We’ve suggested that if there is such a thing as a “gateway drug,” it is sugar. These authors agree, and remark on something that recovering alcoholics and recovering drug addicts have in common:

Ask an addict who is abstinent from their drug if they have resorted to their initial ‘drug of choice’ — sugar.

The authors point out that when obesity is seen as caused by individual weakness, that is damaging and shaming to the obese person. A vicious cycle can kick in, where the lack of control, self-esteem, and willpower causes even more harmful overeating. (For a complete exploration of vicious cycles, see chapter 13 of Overweight: What Kids Say.)

Dewar and Tarman want to move ahead by accepting the obvious:

Telling a person they eat too much implies blame and shame of the individual; telling a person that they are eating a highly addictive substance which surpasses self control implies a societal, as well as an individual, solution. Avoid (rather than limit) the addictive substance. By recognizing food as an addiction, we can start treating it.

Your responses and feedback are welcome!

Source: “No More Laughing at Fat Kids,” The Huffington Post, 10/ 26/11
Source: “Ending Childhood Obesity Through Healthy Eating & Exercise?,” Childhood Obesity News, 04/27/11
Source: “Where does food fit on the hierarchy of addiction?,” Addictions Unplugged, 07/21/11
Image by Marshall Astor, 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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