Unraveling the Mysteries of Addiction

The big difference between overeating and the overuse of heroin, or even caffeine, is that a person can live without heroin and caffeine, but not without food. This is one of the main stumbling blocks in many discussions of the whole concept of food addiction, or FA, as some fondly call it. Dr. Pretlow has said,

A central barrier to the success of treatment for obesity that is distinct from drug addiction is the fact that food consumption is essential for survival; thus, abstinence is not a feasible or appropriate treatment goal.

Zoe Harcombe is a polymath with a Ph.D. in public health nutrition and a very substantial reputation. When she reviewed Dr. Pretlow’s book, Overweight — What Kids Say, the piece included these words:

We need to start treating food addiction for what it is — a serious addiction with serious consequences. People cannot be addicts in moderation.

And yet, they must — if they are food addicts. Because abstinence is not an option, moderation appears to be the only road out of the swamp. This paradox is quite a problem, making it obvious that what moderation means, in terms of food addiction, needs more exploration.

According to the Food Addiction Institute, 87 million Americans are afflicted by obesity, and perhaps half that number are actually addicted. Their take on FA is that it is “a physical and emotional reaction to certain food substances, similar to drug and alcohol addiction.” In food addiction, certain foods trigger cravings that dieting and willpower can’t touch.

In the same way that alcoholics and drug addicts must abstain from their addictive behaviors and substances, food addicts need to discover and abstain from the foods that cause a biochemical reaction in their brains.

Here is a viewpoint from Dr. Martin Lerner of SelfGrowth.com, who teaches that FA “always involves a need to identify and abstain from offending food substances much like an alcoholic must abstain from alcohol and related substances” which act as biological triggers. He wrote,

[T]rying to teach someone with food addiction to eat their trigger foods moderately is almost always unsuccessful. Moderation is not the appropriate treatment for food addiction. When moderation is prescribed to the food addict, it can cause harm and needless suffering.

As if matters were not complicated enough already, he also issues a warning about something important to acknowledge: that eating disorders and FA can both exist in the same person, at the same time.

Your responses and feedback are welcome!

Source: “Overweight — What kids say — by Robert Pretlow,” ZoeHarcombe.com, 01/14/11
Source: “Food Addiction Institute,” FoodAddictionInstitute.org, undated
Source: “Food Addiction and Eating Disorders,” SelfGrowth.com, undated
Image modified from ZoeHarcombe.com, 01/14/11

One Response

  1. In response to this quote, below, Dr. Pretlow said:

    “In the same way that alcoholics and drug addicts must abstain from their addictive behaviors and substances, food addicts need to discover and abstain from the foods that cause a biochemical reaction in their brains.”

    It’s not been shown that so-called addictive foods cause a biochemical reaction in the brain. Otherwise, addicts would shoot up on IV glucose and saline.

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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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