Obesity and Food Addiction Terminology Roundup


In the effort to stop obesity from taking such a tremendous toll in resources, both human and financial, one obstacle is the uncertainty over vocabulary. A marvelous array of possibilities are open. Sure, there is an obesity epidemic — that is obvious — and there is nothing wrong with calling it that.

But consider, for instance, malaria. An important step was to recognize that malaria is spread by mosquitoes, which then led people to take mosquito abatement measures. Knowing the vector is important. To mistake malaria for an airborne contagion would be counter-productive. Language matters. This is a roll call of the many Childhood Obesity News posts that have considered the language of obesity.

Addiction is a top concept. Some say it is impossible for a person to be addicted to a specific food. Others say it is all too possible, because that’s the kind of addict they are. Some say yes, a lot of people appear to be hooked on cheese, but really it’s just the casein, because there is a lot of it in cheese.

Then maybe casein is addictive, or rather the casomorphin within it that might affect the body and brain like an opioid. But casein is in a lot of other dairy products too. Admitting that a dairy product could be an addictor would open, excuse the expression, a large can of worms.

Biomarkers are another problem. There is a blood test for malaria. The parasites are either in a person, or they are not. However, for an eating disorder called overeating, there no blood test. Diabetes can be a comorbidity with obesity, and there are biomarkers for diabetes, but not for the compulsive overeating itself. A lab technician can say yes, there is heroin in someone’s blood, but not whether the person is a heroin addict.

Why it is so important to define and delineate? The Diagnostic and Statistical Manual of Mental Disorders is…

[…] the basis of psychiatrists’ authority to pronounce upon our mental health, to command health care dollars from insurance companies for treatment and from government agencies for research.

In other words, the position that a condition occupies in this book can decide what kind of treatment a patient gets, and even whether they will receive care at all. In extreme cases, when lawyers and judges become involved, words can matter very much. A diagnosis from the book of mental disorders, once assigned to an inmate, can make the difference between life and death.

Back in 2011, when the long-awaited 5th Edition, or DSM-5, was still being compiled, Dr. Pretlow thought it would be useful to recognize food addiction as a true addiction, although many professionals in the field disagreed. Another post featured the “Top 6 Reasons Why Food Addiction Falls Within the Already-Established Criteria for Addiction as Set Forth in the Current Edition, DSM-IV.”

The role of tolerance in addiction is important, and an understanding of it can help to figure out what food addiction is or is not. How does this fit with “comfort eating”? There can be little comfort in trying to feed an ever-increasing need, yet that seems to be what a compulsive comfort eater attempts to do, just like any other addict.

A certain number of people must eventually realize that comfort is not what they really want, after all. They might come to regard comfort-seeking as no longer an appropriate response. Maybe they want to be the kind of person who seeks results and redress, rather than consolation.

Maybe they want to be an activist in the world, instead of a reactor. Maybe they want to be the person who can comfort others. These are all possible reasons why comfort is not enough, no matter how much of it a person can get hold of.

REMINDER: Are you ready for Halloween? This page lists several useful seasonal posts for parents.

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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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