Obesity and the World of Addiction Studies

Cleaning up the mess

Many health professionals believe that all addictions are one addiction. Furthermore, some believe that all addictions are symptoms. The addiction is not the problem, but the outward and visible sign of the problem. And unless the problem is eliminated, it will manifest by showing up as a different addiction, then another and another.

Childhood Obesity News recently mentioned the theory that a person addicted to a substance might make the switch to a less destructive and more socially acceptable addictogen, such as exercise or housecleaning, while still remaining an addict forever. A therapist with a pragmatic worldview understands that a complete cure is rare, and while substitution might not be the most desirable outcome, it can be acceptable.

The sufferer could change from a compulsive eater to an equally compulsive calorie-counter, and although a form of behavioral addiction is still in place, on the whole it’s a net gain. For starters, conversion to a less physically harmful compulsion leaves the person alive with the potential to grow and improve; and perhaps one day to abandon the obsessive calorie counting.

At the influential 1st International Conference on Behavioral Addictions, Marc N. Potenza asked the question, “How might food addiction relate to drug and behavioral addictions?” He learned that individuals have different neural responses, including diminished activation of the brain’s reward mechanism in obese people with binge-eating disorder. About the fMRI study he worked on, Potenza said:

Certain obese individuals, for example those with binge-eating disorder (BED), appear to share more features of addictions (diminished self-control, elevated impulsivity) than do obese individuals without obesity…

Obese individuals with BED and those without showed divergent findings, with the binge-eating group showing similarities to findings observed in pathological gambling and nicotine and alcohol dependence…

Rarely does one scientific paper hold as many provocative ideas as “Prevalence and co-occurrence of addictive behaviors among former alternative high school youth,” by Steve Sussman, et al. For one thing, there is a suggestion that while treatment programs for alcohol, overeating, and gambling addictions are all well and good, “perhaps a ‘generic’ perspective of addiction might be applied across large populations.” The idea that all addictions are one thing is treated like a well-established and universally-accepted truism in Sussman’s paper. Instead of concentrating on a subset of potentially problematic substances called “drugs,” why don’t schools sponsor inclusive addiction-prevention programs that embrace all possible addictogens?

Even more astonishing, the authors inject a mild-mannered sentence that needs a repetition or two before it sinks in and reveals itself as nothing less than a call for the complete restructuring of the world as we know it:

Finally, it is possible that societal-level changes are needed to reduce modern lifestyle predictors of addictions…

What a terrific prescription! Simply put an end to family strife, poverty, injustice, success-obsession, highway traffic, and a few other obstacles. Reduce the number of irritants that cause so much trouble by driving people into addiction, and all will be well. Who could disagree?

Your responses and feedback are welcome!

Source: “1st International Conference on Behavioral Addictions,” mat.org, 2013
Source: “Prevalence and co-occurrence of addictive behaviors among former alternative high school youth,” NIH.gov, 03/03/14
Image by Toms Baugis


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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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