The Rubber-Meets-Road Test

Here continues the summary of posts that examine the efforts to eliminate smoking, and how they have been borrowed or might be adapted to quell the obesity epidemic.

“Smoking and Overeating — When Society Fights Back With Scorn”

Who feels more stigmatized — smokers, obese people, drug addicts, or alcoholics? What is the justification for applying social disapproval to other people’s problems? Why do the lifestyles of various kinds of addicts elicit different reactions from observers?

“Smoking, Overeating, and Stigmatization — Roots and Effectiveness”

Has the denormalization of smoking been accomplished in the USA? Yes and no.
In the last 50 years, the adult smoking rate has fallen from pretty near half of Americans to a percentage in the mid-teens. That sounds encouraging. But a percentage is a proportionate number; one segment as it relates to the whole. Expressed in raw figures, the change over the preceding half century does not sound nearly so impressive.

The number of Americans using some form of tobacco has gone from around 50 million in 1965 to around 47 million now. Because now, America has a lot more people. In 50-plus years, even though the ratio has shrunk considerably, there are only three million fewer smokers! Very close to the same number of people are exposing themselves to the risks of smoking-related illnesses now, as in 1965. And medical care has gotten a lot more expensive in those five decades.

“Smokers and the Obese — More Similarities and Differences”

Does stigmatization cause people to change? Any threat to a habit is likely to be subjected to defensive processing. Can an intervention attempt cause an equal and opposite reaction, eliciting rebellion from people who smoke or suffer from an eating disorder that results in obesity?

Again, we are reminded of the problems inherent in studies that depend on self-reporting. Other difficulties arise with trying too hard to compare smokers and overeaters. One inescapable difference is that a smoker can become a non-smoker overnight, while an obese person can adopt different habits or even a stringent weight-loss regime, and yet still remain obese for quite some time.

“The Non-Equivalency of Smoking and Overeating”

To put it another way, expecting someone to stop doing something is quite different from asking a person to stop being something. A person who focuses on smoking cessation can give himself or herself a leg up by avoiding smokers and environments where bumming a cigarette is a temptation. An overeater, unless she or he becomes a total hermit, cannot stay away from people who eat, or scenarios where food consumption is normal and expected.

Your responses and feedback are welcome!

Source: “Number of current adult smokers in the United States from 1965 to 2016 (in millions),”, 2019
Photo credit: Bill Abbott (wbaiv) on Visualhunt/CC BY-SA

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

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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