Strands of the Childhood Obesity Tangle


Both the human psyche and the meat vehicle that carries it around are fully prepared to acknowledge chocolate fudge as a reward equal to cocaine. The same lights flash and, metaphorically speaking, the same bells ring. Any substance that sets off the fireworks could, in extreme cases, lead to anti-social behavior that harms others. That’s why addiction is categorized as a problem.

But wait. Are people all hardwired the same way? Then, why do some become addicts, while others are immune to the charms of nicotine or tequila? One of the answers, or a partial answer, seems to be that emotional stability is a huge decider, when it comes to the question of whether any particular person goes off the rails and develops a destructive relationship with a substance. Emotional health is one of the strands.

Another strand is, of course, the availability of food-like substances that have been deliberately engineered to lure consumers into eating ever-increasing amounts of them. America can’t do much about that, aside from abolishing civil liberties in a last desperate bid to control every mouthful that every person eats. Jurisdictions can pass as many laws as they think necessary, but in everyday life, trying to enforce the rules in such a personal area of behavior is very difficult.

Still, the task of making citizens behave sensibly is minor, compared to the job of making corporations behave ethically. Once it has decided what to sell and how to make that product, a corporation is pretty well unstoppable. They tend to get their way.


The obesity epidemic is so intractable because several different things are going on. On any population, any age group, any gender, and indeed on any individual, anywhere, multiple forces exert influence. The forces are different, depending on circumstances, but they are all tangled up and knotted together. To separate and classify the strands is exhausting, labor-intensive work.

Many researchers have learned the hard way the importance of taking all the strands into consideration. It’s no fun to complete a project, only to realize that an important variable was not accounted for, and the whole experiment is worthless.

When the concept of synergy enters the picture, things get even more complicated. Synergy happens when more than one agent influences a situation, and the total effect is not merely mathematical.

The different forces acting together can add up to more than the sum of their parts. For instance, certain combinations of medications can’t be prescribed for a patient, because their synergistic effect brings a result quite disproportionate and damaging.

The fewer strands that are woven into the problem, the better. If any one of them are to be picked loose and dealt with, its neutralization must have an impact on the big picture.

(To be continued…)

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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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