Childhood Obesity News has already discussed some aspects of the 24th Congress of the European Childhood Obesity Group, or ECOG 2014, at which Dr. Pretlow presented the address “Treatment of Child/Adolescent Obesity Using the Addiction Model.”
Everyone acknowledges that obesity treatment must begin with prevention, which must begin with identifying the underlying cause or causes. This is where agreement starts to fall apart. What are the underlying causes? Many people take it for granted that one answer is “poor lifestyle choices.”
Dr. Pretlow asks if it were that simple, wouldn’t obese people make the choice that feels better – the choice to weigh less and experience improved health? The cause and effect relationship between obesity and, for instance, sugar-sweetened beverages, is blatantly, almost insultingly clear. So, why don’t people make the choice to expunge SSBs from their lives? As Dr. Pretlow says, “Obviously something else is going on.”
What’s in a Name?
That elusive something is what we have been calling “food addiction,” a term that Dr. Pretlow now suggests may not be the most accurate. Even “eating addiction” does not seem quite apropos, since obesity is 99% a psychological problem. “Overeating addiction” seems more descriptive, and the addiction seems to be behavioral.
While the “feelgood” foods that inspire insatiable cravings are pretty much junk, and many natural ingredients and additives seem able to “hook” consumers, there is still something else going on. Many people snack just to be doing something, and might as well be twirling their hair or biting their nails – except that food brings in more calories.
In Salzburg, various speakers told the assembled health professionals about the available treatment options. Even weight-loss surgery does not produce impressive long-term results. With all due respect to fellow physicians, Dr. Pretlow would prefer that kids not experience surgery.
Residential immersion programs mainly involve forced food withdrawal and cognitive behavioral therapy, and are fairly successful. But of course, such institutional programs are prohibitively expensive and beyond the realm of possibility for the large majority of obese children or adults. And even the people who can afford them can’t stay forever. Going back into the real world must always imply a certain degree of challenge.
In the case of an obese child, part of the challenge, always, is getting the family on board. Parents need to be convinced of the importance of keeping snack foods out of the home, and of avoiding outside meals. Determined parents can always provide a much more healthful diet – and it is rather socially awkward to weigh servings of foods in a restaurant.
Regarding the most recent study of the W8Loss2Go approach, it is possible that some listeners were surprised to know how readily most of the participants took to weighing the servings they ate at home. This good and useful habit is hard to maintain in public, but it is one of the techniques that led to improvements in self-esteem and control over food. As Dr. Pretlow told his colleagues, the smartphone app helped this group of youngsters to decrease their use of eating as a stress-alleviating coping mechanism.
Dr. Pretlow’s paper “Treatment of child/adolescent obesity using the addiction model: A smartphone app pilot study” was accepted for publication by the journal Childhood Obesity.
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Source: 24th ECOG, October 2014
Image by Douglas Iuri Medeiros Cabral