Dr. Pretlow’s WPA World Congress Symposium


At the World Congress of Psychiatry earlier this month, one of the four main themes was “Comorbidity of mental and physical diseases.” If ever there was a human state that almost universally combines the realms of physical and mental disorder, morbid obesity is that state. It is no use to protest that some very wide and heavy people seem quite well-adjusted.

A woman might wear an armor of fat because of intimacy fears that result from early abuse. As long as she feels safe, protected by all the extra pounds, she could feel happy. But is it the same as being mentally healthy?

People compulsively overeat to fill the emptiness inside — that idea is so familiar, it has become a cliche. But a truth is staring us in the face: If we really paid attention to that well-worn trope, helping people who have emotional difficulties would be a more urgently-felt societal need.

The big call to action

Dr. Pretlow would like to see more psychiatrists and psychologists regard disordered overeating and the consequent obesity as a psychological problem. Obesity should be classified, by the official classifiers, as an eating disorder. Eating disorders are properly treated by psychiatrists and psychologists.

Another important point is that addiction-model methods seem to be effective in treating obesity — and if something works there should be more of it. Yes, surgery and inpatient rehab facilities show good results, but are out of most people’s financial reach.

More importantly, neither of those options is something a kid should be put through if it can possibly be avoided. One thing is for certain, childhood obesity is not going away any time soon, so we had better figure it out.

At the World Congress

Dr. Pretlow chaired a symposium he describes as exciting, with stellar talks by each speaker. The topic: “The applicability of addiction-model methods for disordered-overeating and obesity intervention.”

In his opening remarks, Dr. Pretlow expressed appreciation for Dr. John Foreyt, who initially made clear the concept that the roots of obesity are 99% psychological. As time went on, Dr. Pretlow became more and more persuaded by evidence, to the point where he now says:

Candid accounts from thousands of obese individuals have confirmed to me that obesity is primarily a psychological problem.

The symposium, known familiarly as S-123, has a page of its own describing details and providing links to the individual abstracts. It was co-chaired by Caroline Davis, and the other participants were Nicole Avena and Fernando Fernandez-Aranda.

A very thought-provoking question inevitably arises, concerning how things have been sorted out by the most important book in the field. The Diagnostic and Statistical Manual of Mental Disorders extends recognition to under-eating as a bona fide eating disorder, but leaves overeating out in the cold, deprived of its rightful status.

There is still time for Halloween topics

Allergies, Addiction, Childhood Obesity, and Halloween: All Scary
Rethinking Halloween With SAAD
Halloween Proximity Alert: It’s a Childhood Obesity Issue
Will Childhood Obesity Kill Halloween?
Last-Minute Halloween Hints

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The Book

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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