Chasing the Dragon

Dragon Fire

According to the Diagnostic and Statistical Manual, or DSM-IV, there are six substance-abuse criteria, and if a patient has three out of six, he or she has an addiction. Childhood Obesity News has previously enumerated the “top six reasons why food addiction falls within the already established criteria for addiction,” and today we take another look at #5, tolerance.*

This characteristic of addiction has been known for centuries, and given the name “chasing the dragon.” In the Urban Dictionary, a contributor known as “jpc1” defines it as, “Doing everything you can to obtain that same ‘high’ you got from the first time you tried a drug, but never quite getting there due to the body developing a natural tolerance.”

Contributor “Woody” expands on that:

It starts when you have your first high, the world is peaceful, everything is perfect, you’re numb, but in the best way possible. But, soon, it starts wearing off. Fast. Your mind races, you’re pulled out of your dream world. You crave the drug more and more, wanting to feel the same way as you did on your first high… Still feels good, but not as good as first time… Your life becomes a living hell, all in search of a repeat of the first high. That’s chasing the dragon.

A sage once said, “You can never get enough of what you don’t really want.” What people really want from a substance — and that may vary according to the individual — is some kind of feeling. It’s not the opiate or the food, really, that a hooked person wants, but the elusive sensation of peace of mind, comfort, and safety. That’s why one brand of pathological response to food is called “comfort eating.”

In the novel titled On Green Dolphin Street, Sebastian Faulks describes the experience of a visitor to Southeast Asia who tries opium for the first time:

There was no fear, no doubt, no death; the idea of calamity or grief was absurd. He could perhaps imagine unhappiness, but only as an hypothesis that had no real existence. The truth of bliss, meanwhile, was everlasting…

That’s what compulsive eating is all about. The character in the novel may go back to the opium den, but he will never again rediscover quite the same all-encompassing sensation of bliss. And neither will the children who communicate with Dr. Pretlow’s Weigh2Rock website and describe their eating as “out of control” as they consume larger amounts of ridiculously engineered pseudo-foods, trying for the same degree of satisfaction they first got hooked on.

Dr. Pretlow refers to one of the Weigh2Rock polls, where the kids admit they eat more now that when they first became overweight, and 16% indicate that food satisfies less, which is consistent with tolerance. In a typical comment, a teen girl says she has “become immune to the foods that used to comfort me.”

In Overweight, What Kids Say, Dr. Pretlow writes:

The assertion that a substantial component of the child obesity epidemic is due to an addiction to the pleasure of eating is corroborated by neuroimaging positron emission tomography (PET) studies. These studies reveal that the brains of obese individuals are strikingly similar to the brains of drug-addicted individuals… Dopamine receptor levels are much lower in both drug addicted and obese people, as compared to the PET brain scans of healthy weight people (control subjects). Similar to drug addicts, the brains of obese individuals also have been ‘rewired’ by dopamine changes.

One change is, the substance can’t meet previous standards of either pleasure or effectiveness. At best, it’s a only a palliative, a temporary measure to dull the pain, and after a while it doesn’t even successfully accomplish that anymore. Food as an addictive substance does nothing toward mending the inner malaise, and indeed only makes it worse. As Dr. Pretlow notes, when the time comes to get unaddicted, “the higher the BMI, the greater the struggle.”

A child or teenager involved in this struggle needs at least three things. One is, a way to get physically unaddicted (PDF), which is difficult but not impossible, and takes a relatively short time. Another, which will take longer, is psychological healing. A third is training and practice in coping skills to use for the rest of life, so that the pressures and stresses of everyday existence are not allowed to undo the good that is done.

*The other criteria for addiction are, according to the American Psychiatric Association: 1) large amounts of substance consumed over a long period, 2) unsuccessful efforts to cut down, 3) continued use despite adverse consequences, 4) withdrawal, and 6) neglecting aspects of life in pursuit of the substance.

Your responses and feedback are welcome!

Source: “Problem Foods and Childhood Obesity,”, 11/11
Source: “Chasing the Dragon,” Urban Dictionary
Source: “On Green Dolphin Street,”, 01/22/11
Image by archer10 (Dennis) OFF (Dennis Jarvis), 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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