The Fine Art of Fiddling

Various thinkers have qualified the possible categories of displacement behavior in several ways, and some of them are more arguable than others. The ones we have enumerated are: fight, flee, freeze, feed, fornicate, fool around (or fiddle), fidget, faint, and fun (actually laughter, but it doesn’t start with an F.) They all serve the same purpose, which is to avoid impending pain and/or soothe existing pain.

On the most elemental level, an amoeba’s sense of nociception warns of a nearby noxious stimulus, for instance, a chemical. Technically, an amoeba cannot even feel pain, but it can writhe in what very much appears to be a negative reaction. Preferring to escape rather than experience this, the amoeba can change direction. In the palette of displacement behaviors, the only available one is flight.

At a different place along the spectrum, there is a human being. The main difference is that a human has a brain capable of rationalizing a displacement activity, while a rabbit simply performs the displacement activity. It freezes or flees, and never gives the incident another thought.

The higher primates

The college student, facing exams and terrified of flunking, studies with a huge bowl of snacks within reach. This is not only feeding, but fooling around/fidgeting/fiddling. The jaws moves perpetually, chewing mouthfuls of chips. The hands are occupied, going back and forth to the chips bowl. The fingers are exercised, removing the wrappers from miniature Tootsie Rolls.

The body is given something to do that burns off nervous energy and holds panic at bay. The organism is temporarily placated by a body-focused repetitive behavior, or BFRB. It is a displacement activity that in this instance carries a heavy penalty, namely, obesity.

Speaking of fiddling…

BFRB authority Dr. Fred Penzel offers a mind-bendingly comprehensive collection of
58 Stimulation Substitutes and Behavioral Blockers for BFRBs Or “The Great Big List of Favorite Fiddles.” His suggestions range from the familiar and mundane “Learn how to knit, crochet, quilt, embroider, cross-stitch, needlepoint, or sew” to the original “Apply Elmer’s Glue to your hand and pick it off” to the counterintuitive.

By that, we mean a fiddling option like gaming, which in the context of obesity prevention is usually proscribed, because it involves sitting around rather than burning calories by moving. But this therapist boldly advises, “Play a very engaging video game with a controller that requires both hands.” Because it is better than snacking.

Dr. Pretlow’s work

Transcribed below are the final sections from the poster that Dr. Pretlow presented at ObesityWeek 2018 in Nashville, TN, a year ago — where he met a doctor from the Sultanate of Oman, which (historic note) led to this year’s presentations at the World Obesity Federation Regional Conference in that country.


From our Study 2 results the development of an “Overeating Addiction Scale” that encompasses both the sensory and motor addiction components of overeating may be useful, in contrast to the Yale Food Addiction Scale, which seems to assess only the sensory addiction component.

Binge eating episodes decreased using staged food withdrawal/restriction in the intervention of this study, in contrast to the belief of the eating disorders field that food restriction increases binge eating.


The present study provides preliminary evidence that the addition of BFRB therapies increases the effectiveness of staged food withdrawal for treatment of obesity in young people.

Your responses and feedback are welcome!

Source: “58 Stimulation Substitutes and Behavioral Blockers for BFRBs — Or “The Great Big List of Favorite Fiddles,”, undated
Image by Star Athena/Attribution 2.0 Generic (CC BY 2.0)

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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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