If It Isn’t Addiction, What Is It?

In the light of how much attention has been paid to addiction over the last few decades, the amount of mystery that still surrounds the subject is considerable. As a small example, take Dr. Vera Tarman’s words about weighing and measuring portions:

A food addiction treatment plan may also include ample amounts of food so that the person does not over/under eat. To this end, it may even be necessary to weigh and measure foods. This is not about calorie counting or food restriction, it is about keeping the food addict safe by controlling the amount and type of food choices.

But if you can put a leash on it, is it really an addiction? Or just a bad habit? And, is the problem in the substance, or the person? Prof. Bruce Alexander, of Rat Park fame, says research has confirmed that “the great majority of individuals in reasonably healthy social environments who use the so-called ‘addictive drugs’ do not become addicted.”

Is addiction forever?

Even long-term users, like surgical patients, Vietnam veterans, and others, have shown that the inescapable addiction trope is not accurate. So, if drugs with proven addictive potential don’t necessarily hook everybody who tries them, isn’t it overly dramatic and even silly to talk about being addicted to potato chips or cookies?

A phrase that lurks in many minds is, “Once a junkie always a junkie.” In other words, even if someone is not currently using, and has not used for years, they are still just as much an addict as the on the long-ago day when an ambulance picked them up from the gutter and took them to a hospital. Another way of expressing the notion is, “Never recovered, always recovering.” Even within Alcoholics Anonymous, the granddaddy of all programs, the controversy continues, as shown by a lengthy collection of opinions from AA members.

The BED conundrum

We have been talking about the concepts of food addiction (FA) and eating addiction (EA), and also about what a person’s own body and/or psyche might contribute to the likelihood that they will become addicted, obese, neither, or both. In “Is food addiction a valid and useful concept?,” H. Ziauddeen and P. C. Fletcher discussed “the possible validity of a FA model in the context of a subgroup of individuals in whom obesity is prevalent: specifically those who suffer from binge eating disorder (BED).” They wrote,

In BED, we have a phenotype that goes beyond obesity with a behavioral profile of disordered and compulsive eating, and this is critical to begin an evaluation of the underlying processes and neural circuitry.

The NeuroFAST research organization has made an interesting statement about obesity: that in most types of it, food addiction is “unlikely to be relevant.” While FA may exist, most weight accumulation results from “marginal overconsumption of calories over long periods of time,” a slow process that is unlikely to be noticed in the short term, somewhat like facial wrinkles. Instead, they see the FA concept as more likely to apply to regular and significant overeating “within the context of a clinical eating disorder resembling an addiction.”

According to the research brief,

Patients with drug addiction or eating disorders that mimic food addiction (such as BED) do share some character-traits, such as impulsivity. In particular, it will be important to establish how comparable the behavioral and neurobiological processes in chemical and food addiction really are, and whether similarities and differences can be exploited to benefit.

Your responses and feedback are welcome!

Source: “Guest Post: Food Abstinence for Food Addicts: Deprivation or a New Freedom?,” DrSharma.ca, February 2015
Source: “Addiction: The View from Rat Park,” BruceKAlexander.com, 2010
Source: “Recovered versus Recovering — What’s your position?,” BigBookSponsorship.org, undated
Source: “Is food addiction a valid and useful concept?,” NIH.gov, January 2013
Source: “The Biology Behind ‘Food Addiction,” Europa.eu, undated
Image by Fabio Venni/CC BY-SA 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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