To Build Consensus

Readers will recall hearing about this virtual event, “Consensus Building Workshops on addiction-like symptoms related to consumption of certain foods.” It was created to persuade the World Health Organization “to include symptoms of addiction related to food, as a disease, in the International Classification of Disease, ICD-11.”

Childhood Obesity News also continued with a second post on the then-upcoming event. The purpose, as outlined in an internal preparatory document, “Introduction from the Facilitation Team,” was to define…

– what we know and can agree on about addiction symptoms as they relate to certain foods
– what we feel we know but can’t agree on, and
– where we need further research

The organizers outlined their concerns and observations about standard care, as currently understood and implemented. It appears that some vital elements are missing or ignored, and also that, in the area of food consumption, moderation therapy is ineffective.

This would seem to imply that some foodstuffs actually are literally addictive substances, a matter that is still rife with controversy. What happens if behavior is changed, but the psychological distress that caused it is still present? What if the person changes their eating habits but does not lose any weight? Also, there is a possibility that, without looking any further, doctors might tend to regard difficulties with the treatment as willful non-compliance.

Dr. Pretlow’s part

Dr. Pretlow’s 26-minute presentation is available online. In it, two fundamental questions are, “What should the disease be called?” and “Is the food the problem?”

The research organization NEUROfast seems not to care for the term “food addiction” because apparently, it implies that “food contains chemical substances that lead to development of Substance Use Disorder.” Well, is that proven to be not the case? It is hard to see this point of view, with all the evidence against, for instance, sugar. At any rate, one school of thought holds that “Eating Addiction” or “Addictive Eating Disorder” would be a more accurately descriptive name.

Others point out that not all foods are associated with addictive-like eating. (For some reason, many people particularly identify broccoli as characteristically non-addictive.) Dr. Pretlow mentions that the only behavioral addiction recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is gambling disorder. (Some observers have remarked that, of all the addictions, gambling is probably the most unlike eating.)

Dr. Pretlow points out that while almost all binge eaters will go to town on whatever consumables are available, a relatively small number are more discerning. By this criterion, it sounds like the problem is the eating, and not so much the food. So it’s a sliding scale.

The presentation includes segments of interviews with, for instance, a young 400-pound fellow who admitted to having mistakenly believed that he was in control of his eating; that he was making the decisions. He eventually realized, “It was like an addiction almost. I had to.” This same patient poetically described his illness as being “consumed by consuming.”

(To be continued…)

Your responses and feedback are welcome!

Source: “Introduction from the Facilitation Team,” by Dr. Pretlow
Image by Pat Hartman

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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.

Food & Health Resources