Personality, Behavior, and the New Weight-loss Drugs, Part 3

Extremely disturbed people do not care how full they feel; they will carry on eating anyway. Which may be a clue as to how much compulsive eating is accounted for by behavioral addiction. Some folks who eat are not looking to experience satiation; they are looking to shove things into their mouths, and chew.

The thrill is in the endless indulgence of a deviant behavior where the satisfaction is in the process, gained through repetitive actions, to which they are apparently addicted. Among other rewards, there is the sensual enjoyment of swallowing. There are all kinds of peripheral rewards that have nothing to do with nutrition, or even with food quality or flavor. It’s more about the mouth feel and gullet feel.

Would one stick oneself weekly with a needle and then sabotage that effort in such a way? More than likely, yes. After all, there are people who go through the huge ordeal of bariatric surgery, and then keep eating until their stomachs stretch back out. Likewise, just as a certain number of patients make it impossible for their bariatric surgery to work, some percentage will intentionally circumvent any benefit provided by the drug, and get themselves in real trouble. That is a danger inherent in approving weight-loss drugs.

Not training wheels

Originally, there was some hope that these meds could allow a patient to experience a grace period during which old behaviors could be abandoned and new ones learned. Then, according to this attractive myth, the patient could quit taking the stuff, and sail forth into life retrained and refurbished, and equipped to cling staunchly to a new set of behaviors throughout a new, slimmer life.

But no. Journalist Tara Haelle consulted Canadian weight management physician Ali Zentner, and wrote:

These obesity medications “are still viewed as a ‘training camp’ for teaching you how to eat, which is not how they work,” Zentner said. Just as people with chronic conditions, such as depression or diabetes, need to keep taking a medication to keep their symptoms at bay, so do people who have obesity.

[T]hese “medications are a compensation for what the body’s not doing in the first place, not an education for the body. If it’s not a behavior, then there’s nothing to learn.”

This discussion calls forth echoes reminiscent of the set-point theory. It’s as if a -tide drug is capable of overcoming the set point as long as it is used, but once it is discontinued, the body will spring with agility right back to its inescapable set point.

Speaking of behavior, in relation to these drugs, in the U.K., a medical regulatory agency is looking into the prevalence of suicidal thoughts among users. Elsewhere “The European Medicines Agency is now evaluating about 150 reports of possible cases of self-injury and suicidal thoughts…” What behavior could be more definitive than ending one’s own life?

Your responses and feedback are welcome!

Source: “Is Mounjaro the weight-loss drug we’ve been waiting for?,”, 05/02/23
Source: “European regulator expands investigation into risks of suicidal thoughts in users of popular weight-loss medications,”, 07/12/23
Image by Nikk/CC BY 2.0

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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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