When the Food Addiction Concept Caught On

DSC_0188Recently, Childhood Obesity News looked at a fascinating study in which alternative high school students – with at least one behavioral “strike” against them – were interviewed three years after going through a drug abuse prevention project. The researchers were curious about multiple addictions in the young. One reason why this phenomenon has not been studied more extensively is that when a researcher gets a chance to question a teenager, it’s usually only for the length of a 50-minute academic class. Quite often, such an investigation is carried out with a paper questionnaire, a rather limiting tool.

When teenagers talk about their addictions, they are not using definitions from any edition of the Diagnostic and Statistical Manual; even the experts disagree about these definitions. In this case, the researchers readily concede that what they are trying to measure might more usefully be called “self-perceived addictions.” While some scholars applaud this effort, self-reporting is not exactly the most accurate method of collecting data. It incorporates far too much subjectivity for many scientists to be comfortable with. Also, say the researchers:

There is a great deal of redundancy in the measurement of various addictions, which may share in common such features as involving appetitive motives (e.g., pleasure, arousal or sedation, and nurturance), brief periods of satiation, preoccupation, loss of control, and accumulation of a variety of negative life consequences….Such redundancy is burdensome to measure.

At the end of the day, the researchers admitted that the study suffered from at least five limitations. Still, they were excited by the methodology, explaining it like this:

While an addiction matrix measure does not extensively measure any addiction, and validation studies of such measures have not been conducted, this approach is practical, economical, and may actually tap different addictive behaviors….

Apparently David R. Cook, back in 1987, was the pioneer in using a matrix measure with addictive behaviors. Below is a sample of what the American Psychological Association says about Cook’s “Self-identified addictions and emotional disturbances in a sample of college students.” (In this context, of course, the capital S means “subject.”)

Data are presented bearing on the incidence of various addictions and the extent to which Ss identifying themselves as addicted to one experience also reported addiction to one or more other experiences. Results support S. Peele’s (1985) assertion of the validity of self-reports of addictions and also indicate the co-occurrence of addictions that include alcohol, drugs, anorexia, physical violence, gambling, and sex.

The only popular addicting experience that Cook did not include was the internet, because it didn’t exist in any kind of available, user-friendly form at the time. When Cook did his research among college students, the self-reported addiction with the highest prevalence was relationships/love, which affected one fourth of the subjects. The next most prevalent was caffeine, then work, sex, shopping, alcohol, and cigarettes (which, surprisingly, did not even score as high as 10 percent).

A similar study of college students by other researchers in 1999 found that exercise addiction had the highest prevalence, followed by caffeine, television, alcohol, cigarettes, and chocolate, which equaled cigarettes at 23 percent. This probably does not mean that a greater number of young adults were actually hooked on chocolate, but that in the interim of more than a decade, the popular imagination had adjusted to thinking of edible substances as potentially addictive.

Your responses and feedback are welcome!

Source: “Prevalence and co-occurrence of addictive behaviors among former alternative high school youth,” NIH.gov, 03/03/14
Source: “Display Record,” APA.org, 2012
Image by Saiko Weiss

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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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