Treating Obesity as the Result of an Addiction
by Francis P. Koster, Ed.D.
When many of us see a child with Down Syndrome or other visible birth defects, we feel pity and a desire to help. But that is often not the reaction when we see a seriously overweight person. We leap to blame or condemnation.
We get a lot of chances to behave this way. Three out of every four applicants to join the United States military are rejected — mostly for obesityand related poor physical fitness. One in five American kids 12-19 are now obese. 
The public attitude has been that all these kids simply ate too much, and exercised too little, and that it was entirely their own fault that they were fat.
Science now understands this is not true.
Although slow moving, obesity is one of the most significant epidemics of modern times. As one prominent researcher told me: “We would not go from 100 million to 2 billion overweight and obese in 20 years globally on pure sloth and gluttony.” Something is going on.
Recent research points to a number of important causes.
The Journal Pediatrics just reported that if kids were repeatedly given broad spectrum antibiotics before the age of 2, they were up to 20 percent more likely to become obese.  This appears to be caused by the antibiotic making changes in the tummy and how food is digested.
Other studies have shown that food habits of parents and grandparents cause changes in the babies’ genes that impact how and what the child eats.Starting more than two generations ago, more and different foods started impacting everything.
Modern science now understands how genes “express themselves.” Called epigenetics, this field of study found that some genes are under the control of cells that work like dimmer light switches. Buried in our DNA, these switches can take a gene and make it “brighter” or “dimmer” based on what the switch “was taught” during conception and while in the mother’s womb. In other words, what Grandma and Grandpa and Mom and Dad eat changes how the next generations feel hunger and a sense of fullness, and actually change what the baby’s body does with the food. The evidence points to an increasing number of cases of hand-me-down “eating addiction” that is hard-wired in.
The fundamental way our bodies are processing food is changing without our knowing it. We are consuming more and processing it differently. (A lot of the important research in this area is being done at the North Carolina Research Campus in Kannapolis).
This is a game changer for the entire human race.
Our ability to learn more about causes and effects in this area of science has been badly hurt by cuts in both the federal and various states health science research budgets, now roughly 20 percent less than they were in 2003.
This is not to say that we are powerless. In 1964, The United States Surgeon General issued the first national report about the dangers of smoking. Our society made changes that help people control their smoking behavior. These include education of the public, limiting sales to minors, making public buildings off limits for smoking, and raising the price of cigarettes through high taxation. These actions cut the segment of our citizens who smoke down from 45 out of every 100 in 1964 to 20 out of a 100 today.
Today we can boast that only half a million of our citizens will die from smoking annually. (That was sarcasm - even today the tobacco companies spend more than $23 million dollars a day in the USA trying to sell cigarettes, while the doctor and hospital costs from smoking total $364 million dollars a day.) 
The same social response exists in the fight against alcoholism. We do not excuse alcoholics who abuse, but we help support them as we ration sale of alcohol to minors, limit the percent of alcohol in beverages, have some (limited) medicines to help the addicted, and have a range of public and private support services to help those struggling with the issue.
Because both tobacco and alcohol addicts have genetic and other biological triggers that run in families, the emerging picture suggests that eating addiction is in the same arena.
As we all struggle to cope with the enormous and costly impact of our food system, it will in large part remain the job of the patient to overcome these handicaps. Our society will have to support the victims by removing as many of the underlying causes as we can.
There are many programs and techniques that can be used to help support the obese. You can find some elsewhere on this website, or by googling “evidence based obesity programs.”
3 Personal communication Professor Barry Popkin, University of North Carolina September 29 2014