The European Childhood Obesity Group (ECOG) brings together professionals from all over the world, including but not limited to “paediatricians [sic], psychologists, nutritionists, geneticists, physical activity experts, [and] economists….” Founded more than two decades ago, it maintains headquarters in Belgium. This year’s mid-November gathering was convened in Salzburg, Austria, in the state-of-the-art auditorium of Paracelsus Medical University. The schedule was divided into five sessions:
Critical window: Pregnancy
Critical window: Infancy
Critical window: Early childhood
Novel ideas and perspectives
Session 4 included Dr. Pretlow’s invited keynote talk, “Treatment of Child/Adolescent Obesity Using the Addiction Model.” The presentation begins with the shocking statement that not a single country has curbed its obesity rate over the last 30 years. Here is the one of the most interesting parts, from Slide #17:
With a few exceptions, withdrawal from problem foods and snacking was associated with minimal withdrawal symptoms. However, withdrawal from excessive food amounts was associated with significant withdrawal symptoms consisting of nagging urges, agitation, even anger, but rarely real hunger. Nevertheless, the participants interpreted food withdrawal symptoms as “hunger.”
The kids even admitted to sneaking food because of what they termed hunger. But if they ignored it, the feeling went away – which real hunger does not tend to do. The bottom line is, in many ways, “We are failing our young people.” The principles are elaborated on in text and graphic form in the poster, “A Smartphone App/Server Platform for Investigation of the Addiction Treatment Approach for Child/Adolescent Obesity,” which attracted a lot of attention.
The long-awaited new edition of the Diagnostic and Statistical Manual of Mental Disorders is strangely unhelpful on the topic. It lists plenty of things a clinician should look for when diagnosing a disorder. And millions of people’s relationship with food meets those criteria. Yet the authors of DSM-5 stopped short of including food along with alcohol, opiates, and stimulants as substances capable of inducing such a disorder. For this and other reasons, and although in general medical opinion has shifted somewhat, it is still difficult to convince doctors to view the obesity epidemic through the addiction lens.
Not the First
This was only the most recent of many trans-oceanic trips. The reader will enjoy Dr. Pretlow’s account of his experiences at the 2009 ECOG scientific meeting, where he conducted a plenary session and introduced the idea that the childhood obesity epidemic is caused by emotionally driven comfort eating which often results in addiction. This idea is based, he says, “on the anonymous posts of thousands of overweight and obese kids on my open-access website over the past 10 years.”
Other European appearances included Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal, and another at the 2012 European Congress on Obesity, and yet another at the 2013 European Congress on Obesity in Liverpool, UK.
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Source: “European Childhood Obesity Group,” undated
Source: “24th ECOG, October 2014
Image by Serge Bystro