Obesity and Various Therapies

[animated image of thin boy on diving board expanding to obese proportions]

Attention modification training (AMT) has been employed with children before, to treat anxiety and a number of other mental health issues. One of its most important uses is the treatment of substance abuse problems. Since food is a widely abused substance, AMT offers hope in the effort to end childhood obesity. Perhaps the most startling thing about a recent study is the implication that a single session of attention modification can make a significant difference in behavior.

The AMT study was carried out by the UC San Diego School of Medicine. Lead author Kerri Boutelle, PhD, believes that AMT training, based on classic Pavlovian conditioning, could be provided in the form of a computer game. The subjects in the exploratory study were 24 kids between 8 and 12 years of age, all overweight or obese, divided into two groups. PsychCentral’s senior news editor, Rick Nauert, describes how the study worked:

One group underwent an attention modification program (AMP) in which they watched pairs of words quickly flash upon a computer screen. One was a food word, such as “cake;” the other was a non-food word, such as “desk.” After the words had flashed and disappeared, a letter appeared on-screen in the place of either the food word or the non-food word.

The viewing child was asked to immediately press the right or left button associated with the letter’s location…. The AMP trained attention away from food words because the letter always appeared in the spot of the non-food word while in the other group, the condition trained attention was split with the letter appearing half of the time in the food word location and half in the non-food word location.

Although obesity obviously has multiple contributing factors, the theory behind AMT says that a major factor is “an abnormal neurocognitive or behavioral response to food cues.” Some people are inherently oversensitive to food cues, but they can be turned around. These researchers believe that the victim can be trained to ignore or disregard specific cues so their problematic nature is neutralized.

Two-way street

Mental health disorders can lead to obesity, just as obesity can cause mental health disorders. It is also apparent that the longer a person has been obese, the more difficult reversal is. This is one reason why so much emphasis is placed on early intervention. When people get older, behavioral therapy still has a chance, although as Dr. Pretlow says, “Overeating needs to be addressed much deeper.” To get to the root causes of obesity in an individual is obviously vital. But the world simply doesn’t have the resources to provide years of talk therapy for every morbidly obese person.

There is definitely a place for “interventions that break maladaptive behavior patterns before they become ingrained.” Adolescents with eating disorders who participate in cognitive behavioral therapy have higher recovery rates than adults, says the National Institutes for Health. When symptoms have existed for a shorter time, with less severity, treatment has a better chance of success.

One of the first things any behavioral therapy has to do is identify what behavior is modifiable. For most people, it is totally possible to increase their physical activity, to drink more water, to limit their sedentary time interacting with computers, and to consume more vegetables and fruits. Dr. Bryan P. Walsh wrote:

We become what we think about all day long. If you want to be skinny or more fit, you need to act lean, feel lean and do the things a fit person does. The more you feel, experience, and act as if you have already achieved your goals, the more likely the goals will become your reality. True, this can be very difficult to do, but if you do not have the right attitude for fat loss, you won’t achieve fat loss.

In ending addiction, 12-step programs have a well-deserved reputation for efficacy if, as the saying goes, the person works the program. Still, they are not the only way out. There have always been people who managed somehow to do it on their own with a “fake it till you make it” strategy. It isn’t easy, but it’s like an acting job. You act like a person who doesn’t eat sugar, until you become a person who doesn’t eat sugar.

Acknowledging rules takes strength and so does following them by rote. Sometimes people never get to the root causes of their addictions, but succeed in escaping from them anyway. Success is much more likely when basic problems are discovered and addressed.

Your responses and feedback are welcome!

Source: “Attention Training Helps Kids Avoid Obesity,” PsychCentral.com, 02/17/14
Source: “Cognitive Behavioral Therapy for Weight Management and Eating Disorders in Children and Adolescents,” NIH.gov, 04/01/12
Source: “The Missing Fat Loss Manscript,” FatIsNotYourFault.com, 2010
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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