More History of a Concept

Professionals in various fields say all sorts of things about the idea of addiction in relation to food and eating. An uncredited author commenting on an obesity conference wrote,

Faced with clients who insist that they’re “addicted” to junk food, dietitians tell us they roll with it. Rather than putting energy into arguing with someone’s convictions, they wisely move on to behavioral strategies for helping with healthier eating behaviors.

At the same conference, presenter Lorenzo Leggio spoke about research into the craving for alcohol and for potentially addictive foods, and mentioned preliminary data about the role of the hormone ghrelin in promoting both alcohol and food cravings.

The power of words

How much does it matter whether or not the client is invested in the addiction paradigm? Is it more helpful or less helpful if the people fighting obesity have a mental picture of themselves as being in the same category of trouble as, for instance, a heroin addict? Many people have been set on a better path by the kind of intensive intervention offered by a multi-disciplinary weight management clinic. Yet it is possible to get significant results, as in Dr. Pretlow’s pilot study with teens, of an addiction-model-based mobile health weight loss intervention. He says,

It has been theorized that overeating may have addictive qualities and a sizable number of adolescents with obesity endorse addictive eating habits. However few weight loss interventions have utilized an addiction approach to target adolescent weight loss.

Cost, of course, is also a factor. In these times when healthcare is more and more difficult to finance, a workable alternative to expensive inpatient treatment is important.

In 2009, Michael R. Lowe was one of the numerous authors of a report on the Power of Food Scale (PFS), a tool to assess the “psychological impact of living in food-abundant environments.” Hedonic hunger is defined as the “preoccupation with and desire to consume foods for the purposes of pleasure and in the absence of physical hunger,” and the PFS was designed to help study hedonic eating behaviors, or eating driven by cravings that look like addiction.

It measures appetite for, rather than consumption of, palatable foods, at three levels of food proximity (food available, food present, and food tasted)… The PFS may be useful as a measure of the hedonic impact of food environments replete with highly palatable foods.

Nine years later, Lowe was one of three authors of “A narrative review of the construct of hedonic hunger and its measurement by the Power of Food Scale,” a paper that set out to examine “whether preoccupation with palatable foods translates to adverse psychological and behavioral outcomes.” It had a lot to do with the tendency of people to eat even in the absence of physical need. The authors delineated four different domains of research: “motivation to consume palatable foods; level of actual consumption of such foods; body mass; and subjective loss of control over one’s eating behavior.”

Loss of control is a major topic here. Does hedonic hunger cause it? The evidence seems to indicate that foods “meticulously engineered to be craveable” are more likely to cause a loss of control, which is also a hallmark of addiction. The first thing a recovering addict has to acknowledge is that loss of control, or powerlessness.

Your responses and feedback are welcome!

Source: “Food Addiction: Science and Storytelling at OW2018,”, 11/13/18
Source: “The Power of Food Scale. A new measure of the psychological influence of the food environment,”, August 2009
Source: “A narrative review of the construct of hedonic hunger and its measurement by the Power of Food Scale,”, 02/09/18
Image by Randy Fath on Unsplash

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Profiles: Kids Struggling with Weight

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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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