Is the Failure to Lose Weight among the Obese Partly Because Obesity is an Addictive Disease?

Abstract

Obesity is a worldwide health issue that shows no signs of abating despite concerted efforts in the past decade to understand the determinants of this growing problem, as well as efforts to prevent or reduce the problem. Associated with high rates of morbidity, and lower than anticipated life quality and years of life, 1 as well as significant impacts in middle life on working ability, 2 the costs to the individual and society are increasingly exorbitant, with no respite in sight. So why do individuals become obese and why do the obese often fail to lose weight and maintain this, and why are rates of this problem increasing across the globe-within such a limited time frame? Does some form of addiction contribute to the onset, manifestation and inability to successfully change compulsive eating patterns without relapse in today's society where processed foods are engineered to enhance the desire for fat and sugar? If an addiction is a behavior repeated in face of contradictory evidence-in this case behaviors involving the overconsumption of specific food, 3 the chronic use of certain foods and lack of engagement in physical activity-does this tend to result in weight gain, rather than weight loss or maintenance, followed by high levels of body dissatisfaction, poor self-concept, and reduced emotional wellbeing, plus other health, family, social, and quality of life problems as in the case of substance dependence? Similarly is the fact that the changes needed to reverse this situation are not always forthcoming or sustained when adopted 4 due to similar neurological changes in certain brain pathways or structures. While addiction has a genetic basis, is it possible that the rise in obesity that prevails globally, is not due solely to changes in the gene pool, or lack of physical activity, but because some foods are engineered to provide comfort, or stimuli that are deemed satisfying to the brain, and that potentially tend to rewire the brain as with chemical substances, thus making them highly sought after, as proposed by Mogul et al. 5 According to the American Society of Addiction Medicine, an addiction refers to a continual pursuit of a behavior that is increasingly harmful. 6 In addition, accompanying alterations in the brain's reward system, motivation, and related pathways, can conceivably impact how an individual thinks, feels, and makes judgments. This situation can presumably affect their ability to engage in healthful activities, and to make careful decisions. According to Gearhardt et al., 7 previous research has consequently supported the need for further examination of the apparent association between features of addiction to psychoactive substances and excess food intake. While not as obvious as mainstream chemicals, certain foods that have addictive properties and that are highly marketed and part of the social norm may increase the struggle to lose weight, even if one or more of these food addictions results in a variety of irreversible health challenges, and social problems. Alternately, Topcu et a...