Figuring Out Food Addiction Is Not Easy

Rather than repeat here the gist of several earlier posts, we proceed with the understanding that food addiction may be a substance addiction or a behavioral addiction, or some combination of the two. To avoid cumbersome sentences, the phrase “food addiction” encompasses both.

One basic concept to be going on with, is that people are different, and another is that obesity is acknowledged to be multifactorial. Now, why is there so much resistance to accepting the idea of food addiction?

The weight set point concept has been around for years and will not go away. It assumes that a person has a predetermined body size, and the more zealously she or he fights to shed pounds, the more staunchly the body will push back to protect what it has decided is the optimal size.

The theory also posits that the body can’t tell the difference between an intentional reducing diet and a famine. When the incoming calories decrease, it swings into defense mode and tries even harder to extract the most nourishment from them.

Moreover, it is said that the set point tends to recalibrate itself to match the highest weight ever achieved by the individual. Once the body has learned what it’s like to be 180 pounds, it raises its aspirations, and accepts the new set point. That decision having been made, the body does whatever is necessary to fulfill the requirement.

Inside that framework, the whole addiction debate is moot… unless someone wanted to explore the possibility that the body might even manufacture an addiction, in order to obtain the calories it needs to maintain its grasp on the set point weight. Stranger things have happened, and this is one reason why mental and emotional health need to be more urgently considered.

A questionable premise

Dr. Pretlow has been told that food/eating addiction is “not an established construct,” a rebuttal that suffers from a logical flaw. Everything was, at one time, a not-established construct. For it to become established, there was a time when someone had to at least acknowledge the possibility of it, and take a took at it. Many things that were once postulated are now accepted. Others are speculative, and will eventually be settled, and that is where things stand today.

We have mentioned the importance of recognizing the distinction between initial weight loss and weight-loss maintenance. At the most recent ObesityWeek annual meeting, Lori M. Zeltser, Ph.D., explained:

There are some interventions that may not be particularly effective in the weight-loss phase, but they may be effective in weight-loss maintenance. It’s just that people haven’t looked. Those different processes may need different approaches and interventions.

Again, that word “different.” Obesity is multifactorial, and the people involved are definitely factors, and they often refuse to conform to type or fall neatly into categories. Humans manifest a mind-boggling array of variables.

Your responses and feedback are welcome!

Source: “ObesityWeek annual meeting highlights cross-disciplinary approach,”, 11/09/18
Photo credit: Dennis van Zuijlekom on Visualhunt/CC BY-SA

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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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