Food and Gambling

All In

In a Rudyard Kipling poem so infamous we won’t even link to it, the poet concludes that “the Colonel’s Lady an’ Judy O’Grady/ Are sisters under their skins!” In other words, despite appearances, a respectable high-society wife and the wife of a lowly enlisted man are more alike than they are different. Could this be true of, for instance, food and gambling?

Childhood Obesity News has been looking at some of the odd, contradictory, and confusing aspects of substance-use disorder as described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A puzzling question remains: How is food addiction not recognized when other, similar disorders are included?

Of course, not all foods are addictive to all people. That would be absurd. It only happens often enough to be a giant contributing factor to the obesity epidemic, that’s all.

Different Strokes for Different Folks

Obviously, diverse individuals are unhealthfully attached to various problem foods. Dr. Pretlow has polled the thousands of children and teenagers who find a safe haven at his Weigh2Rock website, and among them sweetness definitely rules. As we see, chocolate and other kinds of candy are the clear winners in the problem food arena. Hamburgers, chips, and pasta also come into play, as well as very specific sweet treats such as “swiss roll cakes.”

As people age, their tastes often become more sophisticated, and the problem food may be cheese, or even something as seemingly benign as organic Medjool dates. Just for ease of communication, “food” is used here as a generic term, standing in for one or more of many different potential problem foods. (BTW, Dr. Pretlow’s W8Loss2Go smartphone app offers ways to defeat them all.)

Yes, Food Can be Addictive

To recap: according to the Weigh2Rock kids who respond to polls and questionnaires, or write extemporaneously about their personal experiences, and also according to a great many experts whose work has been mentioned by Childhood Obesity News, food is capable of performing in the role of addictive substance. Like any addictive substance, it is capable of being abused.

It is generally understood in our society that a substance is being abused when it interferes with the normal physical and social processes of life. It is generally agreed that when this happens, the person has a disease or disorder. So, why isn’t food addiction a disease like alcoholism? Why isn’t uncontrollable use of food included in DSM-5 like, for instance, uncontrollable gambling?

What About Gambling?

Let’s look at what staff members of the National Center for Responsible Gaming say about gambling, and the attitude the DSM takes toward that habit. In the previous edition of the Diagnostic and Statistical Manual, pathological gambling (PG) appeared in the book section called “Impulse Control Disorders Not Elsewhere Classified.” During the long and arduous preparation of the new edition, DSM-5, the work group suggested moving PG into “Substance-Related and Addictive Disorders” for these reasons:

The rationale for this change is that the growing scientific literature on PG reveals common elements with substance use disorders. Many scientists and clinicians have long believed that problem gamblers closely resemble alcoholics and drug addicts, not only from the external consequences of problem finances and destruction of relationships, but, increasingly, on the inside as well.

Everything that paragraph says about gambling could be said with equal accuracy about compulsive overeating, the kind that usually leads to obesity and a constellation of consequences even more serious than financial and relationship problems.

Sure, gambling can kill indirectly, as when debts are not paid and violent retribution is dealt out. But food addiction quite literally kills – not immediately, but over time, and the patient ends up just as dead as when the cessation of life is caused by, for instance, a heroin overdose. That is why the term “morbid obesity” exists. We will look more extensively at the similarities between various disorders, quite soon.
Your responses and feedback are welcome!

Source: “The Evolving Definition of Pathological Gambling in the DSM-5,”, 05/19/13
Image by Darren Johnson

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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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