Shame and Guilt, Guilt and Shame

Of the two emotions, shame is deeper and more generalized, and has the capacity to be triggering and cause relapse. This emotion is not limited to grownups. In Dr. Pretlow’s book Overweight: What Kids Say, there is a whole chapter on secrecy and shame. In responding to his Weigh2Rock website, over the years, many children and teens have mentioned it:

— I was a compulsive overeater, and very ashamed of the way I looked.
— i weigh close to 265 pounds i am so ashamed
— i hate that my bf broke up with me beacuasw he said i was too fat, i hate that i broke up with my other bf when he liked me fat , because i was too ashamed of my bodysize,
— I have been on this site before but have used various names to cover up my shame from other people I may know
— I’m ashamed. I am a compulsive overeater. I need help. I’m suicidal. I just want to be normal. I’m a prisoner.
— I have a set of scales in my room but most of the time I’m too ashamed to even stand on them. ..
— I want to look and feel better about myself, and not be ashamed of my body any longer.
— im to ashamed to let anyone see me run because i feel so big.
— when i go [to the doctor] and i’ve gained weight i feel so ashamed

On the most basic level, guilt is more objective. In a courtroom, guilt can be shown by items that are entered into evidence, by the sworn testimony of witnesses, and so on, and ultimately be decreed by a judge or jury. Shame is amorphous and diffuse. Guilt is an arrow; shame is a thick obscuring fog. Guilt is objective and can be disproven; shame is subjective and can only be dispelled.

Another source, Makana Path, carves out even more distinctions:

Generally, guilt causes addiction and addiction causes shame… Violence, aggression as well as eating disorders are common causes of shame. Depending on how bad the levels of shame are, one may suffer mental problems, such as depression or substance abuse.

This organization also points out that according to some therapists, guilt is good, and is in fact “a recovering addict’s greatest weapon.” Another program, Caron, endorses this view with “In Addiction and Recovery, Guilt Heals While Shame Poisons.”

Guilt, including regret and remorse, is a necessary tool with which to evaluate our behavior. How does guilt heal? Because it is connected to specific deeds and behaviors, there is a clear path: Do not perform those actions, and do what is necessary to repair the damage caused by performing them in the past.

As we have seen, when it comes to experiencing guilt and feeling overwhelmed by shame, kids can do those things just as readily as adults. But even a young person can wrestle guilt into becoming an asset rather than a liability. A 17-year-old young lady wrote to Dr. Pretlow’s website,

I’ll occasionally have a cookie or a little bit of ice cream, but usually the guilt I feel afterwards makes it not even worth it. ..right now I weigh 130 pounds, for a total weight loss of 140 pounds!

Effective therapy teaches coping strategies to defang destructive emotions. Ideally, these techniques lead to asking for forgiveness from others we have harmed, and ultimately, to forgiving oneself. The most useful therapy also recognizes that, while the addict is the designated patient, actually the whole family is the patient.

Your responses and feedback are welcome!

Source: “Understanding Guilt and Shame in Addiction Recovery,”, 11/13/19
Source: “In Addiction and Recovery, Guilt Heals While Shame Poisons,”, undated
Image by a200/a77Wells/CC BY 2.0

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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.

Food & Health Resources