01/26/2015 12:41 EST | Updated 03/28/2015 05:59 EDT

There Is More to Obesity Than 'Calories In, Calories Out'

I've written a couple of times about the complex causes of obesity. One prominent factor is too much food (especially junk) and too little exercise: excessive calories taken in and too few of them burned up. Sitting around watching television or the computer screen and eating too many munchies and folks get big. The risk can arise early. A major study in the U.S., published this year, established that a third of children who are overweight in kindergarten are obese by grade eight. And almost every child who is obese stays that way into adulthood.

At the same time there is more to obesity than "calories in/calories out". A recent study has tied body mass index (BMI) to pollutants. That investigation suggests that exposure to second hand smoke and roadway traffic may be linked to increased BMI in children and adolescents. Several other studies and reports also raise fears about pollutants and other chemicals and their links to obesity. Endocrine disrupting chemicals (EDCs) to which individuals may be exposed raise grave concerns. They may be connected to obesity in several ways. For example, these substances may increase the number of fat cells, alter the amount of calories utilized while an individual is at rest, and modify the body's mechanisms for appetite and satiety. The White House Task Force on Childhood Obesity underscored the possible effects of EDCs and urged more investigation.

Enter Food Junkies: The Truth About Food Addiction . a new book by Dr. Vera Tarman (with Philip Werdell). As the subtitle indicates Dr. Tarman focusses on how food, particularly of the junk variety, can be addictive for some individuals resulting in several negative consequences, including obesity. The book is full of stories about individuals' struggles with food as it comes to dominate them and wreak havoc in their lives. Tarman is touchingly open about her own battles with food addiction: she's been there.

For Tarman there is a big difference between addiction to food and eating disorders. If someone is addicted to certain foods, most prominently sugar, the response must be the same as with other addictions -- tobacco, alcohol, recreational drugs: total abstinence. No more -- ever. She maintains the first couple of weeks are heavy going but thereafter feelings of elation take over as the cravings recede and the prisoner of junk is freed from bondage.

An interesting book. But what are we to make of it? It's hard to say because Food Junkies is largely comprised of compelling vignettes of individuals and their challenges. We are never told what percentage of the population, generally, and obese people, in particular, is so addicted. Nor are we told just how many individuals are able to permanently "kick the habit".

Part of the problem is, by Tarman's own admission, that food as a source of addiction "...has never received a place in the medical cannon" (p.19) (She argues in some detail that this decision is wrong). And, again as acknowledged by her to her credit, "..the science that supports [food addiction] is still in its infancy.." (p.59). She says little about the need to battle Big Food and the way it entices us to (over)indulge in so many products laced with three demons: sugar, fat, and salt. I'm interested in using law to do that. She seems indifferent, at best, to challenging that industry and its questionable practices.

Back to the beginning of this post. The causes of obesity are many and complex. Food addiction for some people may be among them. Food Junkies is a good read. But it would have been a lot more convincing with fewer stories and more hard evidence.


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