Mysterious Motivation

Bad Attitude (clown)

Research projects like the Millennium Cohort Study have found that for obese children, both emotional and behavioral problems start early. Especially for boys, life is an endless round of physical and psychological discomforts. Quality of life is affected in numerous ways, from the difficulty of finding big enough clothes, to school desks that are too small, to low self-esteem exacerbated by bullying.

According to the National Institutes of Health, obese boys as young as 3 have more behavioral problems than their age-mates of normal weight. The professionals who work with them notice increased problems with hyperactivity and inattention by age 5, as well as difficulty with peer relationships. Many of the problems that start early only become more serious with time. But somehow, the motivation to change is often simply not there, or hidden and smothered by layer upon layer of other issues.

In working with overweight children and adolescents, Dr. Pretlow has noticed repeatedly that motivation is problematic. This observation is so counterintuitive as to be almost mysterious. Because no one wants to be uncomfortable, unhealthy, or ostracized, it seems to outsiders (i.e., health care providers, professional therapists, teachers, parents, etc.) that the motivation to slim down ought to be built in. But one school of thought proposes the opposite.

Even when help is available and freely offered, kids sometimes find themselves incapable of taking advantage of opportunities to change course. Adults stand by, confused and helpless. One hint comes from Deborah Cohen, M.D., of the RAND Corporation, who wrote A Big Fat Crisis: The Hidden Forces Behind the Obesity Epidemic — and How We Can End It. She discusses self-limiting, or the ability to say no to oneself.

Since so many people lack the ability to say no to themselves, with such devastating personal and societal results, Cohen would like to see the government take a firmer stand in the regulation and taxing of junk food. But why advocate such drastic and unpopular measures? Because, Cohen believes, humans are “biologically designed to overeat.” Says Susannah Cahalan in a review of Cohen’s book:

The tug-of-war between gluttony and self-discipline takes place in the brain between the higher cognitive processing systems, responsible for planning and long-term problem solving, and the base, more instinctual, non-cognitive processing system, which might as well have a “Feed Me” sign.

Seen in this light, the obstacle is that the ability to self-limit varies from one person to the next, and appears to be innate to such an extent, Cohen suggests, that it cannot be taught. As she puts it,

An individual can improve to a degree, but someone who has been born with genes associated with low self-control will never be able to develop the capacity for self-control of someone who was endowed with more favorable genes.

If indeed the ability to say no to oneself is genetically determined, then it would follow that the question of motivation is moot, because it can neither be intrinsically cultivated nor extrinsically instilled. Can this be? Or is it actually possible to help young people find the inspiration to change? As Dr. Pretlow states, further research on this question is essential.

Your responses and feedback are welcome!

Source: “Health risks of childhood obesity,”
Source: “Is obesity associated with emotional and behavioural problems in children?”, June 2011
Source: “Why gov’t should regulate food like tobacco & alcohol,”, 12/28/13
Image by Fotofever


Leave a Reply

Your email address will not be published.

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

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