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Medical Science and Food Addiction – Part 2

July 20, 2010

The "Fuel Up To Play 60" Campaign is sponsored by Domino's Pizza, among others.

(Part Two of a Two-Part Post)(View Part One)

by Robert A. Pretlow, M.D.

My last post had to do with the difficulty of medical science in accepting food addiction as a cause of the obesity epidemic. This post presents how the evidence for food addiction is being downplayed.

Anecdotal Data

I recently talked with Robert Lustig, a pediatric endocrinologist and eminent childhood obesity researcher at the University of California, San Francisco, about my paper on “Food Addiction in Children,” which was rejected by the Childhood Obesity journal. Dr. Lustig declared, “The kids’ posts in your study are merely anecdotal and not acceptable for a peer reviewed journal.” Nevertheless, the medical definition of anecdotal is, “a single case report not yet substantiated by studies using large numbers of people.”

There are 134,000 posts on our site, written by 29,000 kids — that’s not anecdotal data. How many kids are in university studies? Typically, a hundred to a couple thousand. Furthermore, the type of data on our website is not obtainable by conventional face-to-face research. A certain degree of anonymity is necessary for kids to open up, which is possible only on the Internet. We used important safeguards to improve the value of the research: The boards were monitored by health care professionals, who removed any blatantly misleading or outlandish posts. This is vetted research, not just unfiltered spam.

Dr. Lustig also claims that, as I’m not a university-based researcher, getting the information accepted by a scientific medical journal would be difficult. Even so, university research committees, legal departments, and human-subjects review boards likely would not allow “World Wide Web” research on kids, particularly without identity validation and parental permission. The kids want to remain anonymous. Only an “outsider” is able to conduct such research.

Scientific Evidence

There are human-brain scan studies, as well as animal model studies, that provide the “scientific” evidence to support the user-generated research. Neuroimaging studies (PDF) reveal that low dopamine D2 receptor levels in the striatum of the brain are strikingly similar in obese and drug-addicted individuals.

Further, a recent study in rats found that fatty, sugary foods such as bacon and frosting can cause cocaine-like addiction. Once rats became obese from eating those foods, they would endure even an electric shock to get to the foods, whereas normal rats would not. The obese rats’ brains showed the same low dopamine receptor changes as in the human studies, and the same changes as in the brains of rats allowed unlimited access to cocaine or heroin. Additional brain-imaging studies demonstrate that obese people react much more hedonistically to sweet, fat-laden food in the pleasure and reward circuits of the brain than healthy-weight people do, which overrides their normal hunger and fullness eating-control mechanisms.

Food Industry Trying to Downplay Overeating Problem in Kids

The food industry is trying to promote the idea that kids can eat as much and whatever they want, and simply work it off with exercise. An example is the “Fuel Up To Play 60” campaign, sponsored by the National Dairy Council in conjunction with the National Football League, and other food companies, including Domino’s Pizza. This campaign overlooks the fact that kids really can’t exercise enough to work off the massive numbers of calories consumed by many kids. Kids simply are not professional athletes. And, the ultimate irony, even the NFL now has obesity problems. Plus, a new study suggests that physical activity has little if any role to play in the obesity epidemic among children: “The focus has to be on what — and how much — children consume.”

Medical Science Slow to Adopt New Approaches

Historically, medical science has been highly conservative and extremely slow to change. Take handwashing, for example. It is something we take for granted when it comes to healthcare personnel, but such was not always the case. In the first half of the 19th century, seven percent of women died in childbirth in hospitals because doctors did not wash their hands and spread infection from one patient to another. Even though there was very compelling evidence of the benefits, handwashing by doctors took years to be adopted.

Another example of slow adoption of new approaches in medicine is what The London Times said about the stethoscope in 1834: “That it will ever come into general use, notwithstanding its value, is extremely doubtful; because its beneficial application requires much time and gives a good bit of trouble both to the patient and the practitioner; because its hue and character are foreign and opposed to all our habits and associations.”

True to its conservative nature, mainstream medicine has not yet accepted the Internet as a means of care or research. Only a small percentage of physicians use email with their patients, and even fewer utilize home monitoring. There were only two Internet research papers presented at the 2010 American Telemedicine Association meeting, one of those mine.

In view of what tens of thousands of overweight and obese kids post anonymously on the Internet, and not merely on our site (e.g. SparkTeens), there seems to be little doubt that comfort eating and resulting addiction to highly pleasurable foods plays a significant role in the childhood obesity epidemic. It’s tragic for kids that medical science won’t look at this. Obese kids are not invited to speak at scientific conferences. If researchers and reviewers would simply listen to the kids, they would figure it out.

Source: “Similarity Between Obesity and Drug Addiction as Assessed by Neurofunctional Imaging: A Concept Review” (PDF), Haworth Press
Source: “Junk food turns rats into addicts,” Science News, 11/01/09
Source: “Eating to Live or Living to Eat?,” The Wall Street Journal, 07/13/10
Source: “Obesity Rampant in NFL, Study Says,” Fox News, 03/01/05
Source: “Inactivity ‘No Contributor’ to Childhood Obesity Epidemic, New Report Suggests,” Science Daily, 06/08/10
Source: “Ignaz Semmelweis,” Wikipedia
Image: “Fuel Up To Play 60” campaign screen pic, used under Fair Use: Reporting.

Robert Pretlow is a pediatrician and founder/director of, an online weight loss system for teens and tweens, used by clinics, hospitals, schools, private practitioners, community centers and health clubs worldwide. He lectures frequently on childhood obesity, both nationally and internationally, and is author of the new book, “OVERWEIGHT: What Kids Say: What’s Really Causing the Childhood Obesity Epidemic?”


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