Dr. Pretlow’s Obesity Week Presentation

The two references for this post are Dr. Pretlow’s recent talk at the Obesity Week conference in San Diego (audio recording) and the visual aspect, the poster illustrating and describing the basic concepts behind the question, “Should Obesity and Eating Addiction Be Reconceptualized as Displacement Behavior?”.

Why is the apparent food addiction that leads to obesity, like other addictions, so difficult to control? Because no matter what the problem, chances are that ingesting more substances, including food, will be inappropriate to the situation, and will go exactly 0% of the way toward alleviating it.

In the animal kingdom, if a bird is threatened with some kind of hostile situation and pauses to tidy its feathers, this displacement behavior might simply delay the necessity to choose between fight or flight. Or maybe the enemy will become bored or distracted, and move on. In either case, the decision to take a preening break might not do permanent harm.

On the other hand, if a student is unable to decide whether to show up for an exam or skip school, eating an entire pizza offers no possible benefit. Whether the choice ends up being fight or flight, or even staying up and studying all night, the person will likely still be heavier at their next weigh-in. Pizza consumption is, in other words, a maladaptive displacement behavior.

No surprise

It comes as no surprise that the conclusion drawn from the trials done so far by eHealth International of Seattle, Washington, and UCLA’s Integrated Substance Abuse Program is,

Reconceptualization of obesity and eating addiction as displacement behavior may be warranted and treated accordingly.

In some cases, displacement behavior can be adaptive, though in many other cases, the opposite is true. As the poster says, “Sheep threatened by a predator will graze despite the danger.” People threatened by an unfaceable situation will eat, both the wrong stuff and a lot of it.

When such a conflict is underway, the conflicting impulses to follow two competing drives can build up “an overflow of mental energy that expresses itself in a third drive, in this case, feeding.” Once the brain has generated a lot of energy that has to go somewhere, then what?


Maybe, what comes along next is a sensory cue — the smell of baking pizza, or the sight of a bag of chips on the kitchen counter, or the voice of a TV huckster whose job is to convince the viewer that she or he cannot survive for another minute without a raft of peanut butter cups. “The displacement mechanism is triggered by sensory cues,” say Dr. Pretlow and coauthor Suzette Glasner, Ph.D.

And contemporary life is full of those cues. We can barely turn around without being confronted by the sight of food. In fact, we don’t even have to move. A perfectly stationary person can be beleaguered by cues that demand, “Think about eating!” Social media platforms are full of not only advertising, but the favorite recipes of our online friends, and photos of their brunch plates.

Broadcast media need advertising to pay their bills, and will bombard a person nonstop with reminders to chow down. We are constantly being cajoled. “Got a problem? Eat. Is somebody mad at you? Buy them something to eat. Do you want to be popular and beloved? Bring food. Are you sad because bringing food didn’t make you popular after all? Eat more.”

In some quarters, the idea of intermittent fasting has caught on. If only we could have intermittent advertising, like maybe a 12-hour truce each day without any reminders of food. But the world doesn’t work like that.

(To be continued…)

Your responses and feedback are welcome!

Source: Robert Pretlow, M.D., Suzette Glasner, eHealth International of Seattle, WA, and UCLA Integrated Substance Abuse Program

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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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