Roaring Into the Twenties

The journal Eating and Weight Disorders — Studies on Anorexia, Bulimia and Obesity has a long title, and with good reason. Obesity alone is a huge area to cover, and figuring out what is going on there becomes more crucial with every passing year.

Childhood obesity is at crisis level almost everywhere on earth, and every day the importance of stopping it early becomes more and more apparent. The urgency cannot be ignored, because with each year of age that a child adds the difficulty of treating the obesity seems to increase exponentially.

Some children apparently never have a chance, and seem to have been born doomed, because their antenatal environment irreparably impaired their ability to ever maintain a reasonable weight. This is why some researchers desperately seek answers in the womb.

Others have no choice but to try to mend the damage later. This journal comes at the problem from every direction: “anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.”

The most recent issue contains an article whose title is also lengthy, “Treatment of the sensory and motor components of urges to eat (eating addiction?): a mobile-health pilot study for obesity in young people.” The authors are Dr. Pretlow and team members Carol M. Stock, Leigh Roeger, Stephen Allison.

A very hard nut to crack

Despite overwhelming suspicion and massive anecdotal reports from patients it has been very difficult to establish that any type of edible substance is addictive in the same way that, for example, nicotine and cocaine are addictive. While overeating as a substance addiction looks deceptively obvious, proof is elusive. Part of the confusion comes from the fact that individuals undeniably have “problem foods,” and subjugation to the power of certain particular problem foods is shared by huge numbers of people.

This paper examines the idea of eating addiction as a combination of sensory addiction and motor addiction. Dr. Pretlow has shown that staged food withdrawal can tame the sensory component. The motor addiction component concerns body-focused repetitive behaviors (BFRB), similar to nail biting, skin picking, and hair plucking.

Some people become dependent on the comfort afforded by the motions of biting, chewing, licking, crunching, sucking, swallowing, and hand-to-mouth motion. The team is optimistic about the idea that these “nervous” activities that people employ for the purpose of self-soothing can be treated with strategies based on cognitive behavioral therapy (CBT), which is successful in quelling other motor addictions.

Here is what happened:

Using staged withdrawal, participants withdrew from specific, self-identified, “problem” foods until cravings resolved; then from non-specific snacking; and lastly from excessive mealtime amounts. BFRB therapies utilized concurrently included: distractions, competing behaviors, triggers avoidance, relaxation methods, aversion techniques, and distress tolerance.

The results were better than those obtained from a previous study that only used staged withdrawal, and the participants maintained overall weight loss as documented by the five-month followup.

For children and teens, what we see here is increasing evidence for the acceptability and viability of an addiction model treatment of obesity. It begins to look as if CBT has the potential to not only improve motivation, but to boost emotional regulation, strengthen coping strategies, and stave off the likelihood of relapse.

Your responses and feedback are welcome!

Source: “Eating and Weight Disorders,”, undated
Source: “Treatment of the sensory and motor components of urges to eat (eating addiction?): a mobile-health pilot study for obesity in young people,”, 01/14/20
Image by Roderick Eime/Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)

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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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