Treatment of the sensory and motor components of urges to eat (eating addiction?): a mobile-health pilot study for obesity in young people

Robert A. Pretlow, Carol M. Stock, Leigh Roeger, Stephen Allison

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)
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Purpose: Compelling evidence indicates that an addictive process might contribute to overeating/obesity. We hypothesize that this process consists of two components: (a) a sensory addiction to the taste, texture, and temperature of food, and (b) a motor addiction to the actions of eating (e.g., biting, chewing, crunching, sucking, swallowing). Previously, we reported a mobile health application (mHealth app) obesity intervention addressing the sensory addiction component, based on staged food withdrawal. We propose that the motor addiction component can be treated using cognitive behavioral therapy (CBT)-based strategies for body-focused repetitive behaviors (BRFB), e.g., nail biting, skin picking, and hair pulling. Methods: The present study tested the effectiveness of CBT-based, BFRB therapies added to the staged withdrawal app. Thirty-five participants, ages 8–20, 51.4% females, mean zBMI 2.17, participated in a 4-month study using the app, followed by a 5-month extension without the app. Using staged withdrawal, participants withdrew from specific, self-identified, “problem” foods until cravings resolved; then from non-specific snacking; and lastly from excessive mealtime amounts. BFRB therapies utilized concurrently included: distractions, competing behaviors, triggers avoidance, relaxation methods, aversion techniques, and distress tolerance. Results: Latent growth curve analysis determined that mean body weight and zBMI decreased significantly more than in a previous study that used only staged withdrawal (p < 0.01). In the 5-month follow-up, participants maintained overall weight loss. Conclusions: This study provides further preliminary evidence for the acceptability of an addiction model treatment of obesity in youth, and that the addition of CBT-based, BFRB therapies increased the effectiveness of staged food withdrawal. Level of evidence: Level IV, Evidence obtained from multiple time series analysis with the intervention.

Original languageEnglish
Pages (from-to)1779-1787
Number of pages9
JournalEating and Weight Disorders
Issue number6
Early online date14 Jan 2020
Publication statusPublished - Dec 2020

Bibliographical note

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit


  • Behavioral addiction
  • Body-focused repetitive behavior
  • Eating addiction
  • Food addiction
  • Motor addiction
  • Sensory addiction


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