More Emotions, Eating, and Obesity


There were years when Dr. Pretlow didn’t talk with other medics about the psychological basis of obesity, or even mention the “a” word, addiction, in relation to food. Professional resistance to the idea was very frustrating, and he was told at one conference, “You are obsessed with emotional eating!”

And why not? Why should a conscientious doctor not be obsessed with such a dangerous and basic problem? There are so many things to say about the connection between emotional health and the danger of food addiction, and people often say them to Dr. Pretlow. The fact that he specializes in childhood obesity inspires others to share their life experiences, whether Dr. Pretlow is at his desk or traveling.

For instance, he heard from a pediatrician of about 40, who had been overweight ever since the McDonald’s fast food chain came to town when she was a little girl of 9. It was the start of a lifetime of overeating. Dr. Pretlow relates the story:

She said she was in her clinic, and nurses had brought in some dark chocolate brownies, and this pediatrician said she kept trying to stay away from them until finally she just overdosed on the whole 12 brownies on the tray. She said afterwards she was sweaty and had palpitations and turned gray, and the nurses even worried that she was having a heart attack. At that point, she said, she realized that she was just like an alcoholic, an addict in the gutter. It was a stark realization to her, what was going on.

As journalist Elizabeth Hartney reminds us, an occasional binge is normal for many people, who soon return to sensible eating patterns and balance out the damage done by temporary irresponsibility. Hartney also draws parallels, as we quoted previously, between food addiction and drug addiction, and notes that as of its latest edition, the Diagnostic and Statistical Manual of Mental Disorders did not view food as an addictive substance, although excessive eating was included as a characteristic of some clinically defined eating disorders.

Critics who do not want to acknowledge the reality of food addiction say that “true addictions are limited to psychoactive substances which produces symptoms such as physical tolerance and withdrawal.” But to be psychoactive means it does something to the mind, via the brain, and Hartney also reminds readers that sugar and fat have indeed both been demonstrated to be psychoactive.

In laboratories full of expensive equipment, experiments have been shown that both substances produce opiates in the body, which the brain welcomes just as it does any other opiates. Plus, sugar and fat both make people fat. Hartney concludes that:

Similarities between food addiction and other addictions suggest a universal process underlying food and other addictions. Some experts go further, theorizing that overlaps, similarities, and co-occurrences of mental health problems, including addictions, depression, obsessive-compulsive disorder and eating disorders, and the phenomenon of a new addiction or mental health problem developing when an old addiction is treated, indicate that they are expressions of related underlying pathologies. It has been argued that viewing these conditions separately hinders the development of a comprehensive view of addictions.

In other words, addiction is addiction, and patients are suffering from the effects of substances whose power they can’t escape from without help.

These include children who suffer from isolation and discrimination because they are too big. The emotional effects of childhood obesity include, but are not limited to, low self-esteem, problems in school, unfavorable treatment by children and adults, and the lure of comfort eating. Comfort eating, of course, leads to nothing but more obesity. Eventually, another middle-aged grownup looks back and wonders what happened to her life, and tells her story to a doctor she has never met but who seems to understand.

Your responses and feedback are welcome!

Source: “Food Addiction: When You Use Food to Cope Emotionally,”, 11/30/11
Source: “Emotional Effects of Childhood Obesity ,”, 01/14/11
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Profiles: Kids Struggling with Weight

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The Book

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.

Food & Health Resources