An Obesity Treatment Paradigm Shift?


Childhood Obesity News has discussed the mental/emotional condition known as Fear of Missing Out (FOMO) and its very close association with obesity. Another recent topic is the scarcity of psychiatrists who do therapy, and the resulting proliferation of other categories of mental health professionals. Many of these healers are able to treat eating disorders, including compulsive overeating that leads to obesity.

How do these subjects come together? FOMO makes people fat, and FOMO is a treatable problem that can be approached in a number of ways by allied healthcare providers who are neither MDs nor psychiatrists.

Natural health proponent Chris Kresser praises a system where doctors are supported by physician assistants and nurse practitioners. Their nutrition and lifestyle information might be more up to date, and they might have had specialized training in behavioral change. For instance, there is “coaching to strength,” in which the therapist helps the person understand how to use existing personality traits to pursue goals.

The need for a collaborative practice model is one of what Kresser sees as the three greatest challenges faced by western medicine at the moment. Another major problem is that our medical paradigm is a mismatch with the alarming preponderance of chronic disease —
which half of all Americans now have. For instance, about 100 million Americans are either diabetic or pre-diabetic.

The possibilities that could open up with a new approach to obesity treatment are illustrated in the closely related example of a healthcare organization whose record with diabetes management is better than the national average — and the patients are seen by health coaches. Journal editor and personal trainer Tony Federico explains further:

If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But… there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach.

Kresser adds that people without an extensive science background can be trained in 12 to 24 months, to be very effective in working with patients toward behavioral change. He says a thing that most people do not want to acknowledge, and that could get a person criticized for not being politically correct.

It is reminiscent of the “personal responsibility” party line laid down by the food and beverage industries and their lobbyists — and that is perilously close to blaming the victim. Kresser says:

If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making.

Your responses and feedback are welcome!

Source: “Reinventing Healthcare with Chris Kresser — Dr. Michael Rusci,”, undated
Source: “RHR: A Three-Step Plan to Fix Conventional Healthcare,”, 11/07/17
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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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