America is a nation of self-disclosers, amiably acceptant of our weaknesses. Celebrities, family members, coworkers and friends think nothing of admitting their compulsions and dependencies on alcohol, street drugs, prescription medications. We enter rehab programs, clean up, dry out, and go on with our lives: beating our problem or entering a long series of relapses and treatment episodes. Except, perhaps, for politicians or ministers, there is little social stigma attached to such mistakes unless there are criminal overtones that may lead to incarceration.

Television and films have educated us on the dangers and side effects of dependence upon alcohol, heroin, cocaine, amphetamines, designer drugs, steroids, pain pills, cannabis and opium. We had to coin the term chemical dependency (CD) to completely cover the broad and ever-growing field. We approach individuals ensnared in their abuse as victims of a disease, to be educated and helped as long as they have a willingness to change and are prepared for the painful journey that owning responsibility for one’s own self-destructive behavior demands.  

But the most widespread, self-destructive, dangerous addiction afflicting America is never discussed: FOOD.

The treatment of overeating is extensive: diet clinics, fitness programs, fat farms, plastic surgery. We collectively spend billions of dollars on weight loss aids and fitness equipment. We decry the epidemic of obesity that is overtaking our population to an enormous (literally) degree. We investigate metabolism and hormonal effects. We debate the comparative merits and flaws of protein, fats, carbohydrates, and roughage. We develop new vitamin and mineral formulae. Diet books, support groups, internet clubs, and television shows trumpet tips, techniques, special aids and hundreds of weight control regimes that promise inevitable weight loss with the right combination of “tasty” and “delicious” foods, guaranteed to ensure that our comfort levels remain high and our self-discipline minimally challenged. 

We fail to confront the irrefutable fact that obesity is caused by food addiction. Excuses and metabolic rationales aside (No, Virginia, no one ever walked out of a Nazi concentration camp or a Japanese prisoner-of-war camp fat – macabre but true) our out-of-control overweight is a direct result of our obsession with, and dependency on, too much food.

You may disagree. After all, the other CD addictions are for substances we can totally banish from our lives whereas we have to eat to live.  

Consider the problem from a slightly different perspective. In the United States, an “all or nothing” society, the goal of the typical CD treatment program is total abstention. The alcoholic is taught that one sip of liquor is never acceptable and constitutes a full relapse from which recovery must start over. In Europe, and many other parts of the world, moderation is considered more realistic than abstention. The goal is to lower the level of usage to the point where it has no deleterious effects on the user’s life and the problems – work, relationships, mood, productivity – are resolved. 

Such a model can more easily be applied to food. Our bodies require a certain level of sustenance to thrive. It is when the intake becomes excessive that problems arise: appearance, the inability to be active, fatigue, depressed mood, and strains on the internal organs. If we can temper that level of intake, we can avert the consequences that follow overindulgence in anything.  

Such is indeed the focus of many weight control programs. However, they are missing one vital ingredient: acceptance of personal responsibility. At a 12-Step meeting, members repetitively admit to the group: “My name is B and I’m an alcoholic.” Imagine, if you will, the different atmosphere that would be engendered if a member were to state: “My name is B. I drink a lot because I inherited the genes from my drunken parents and I can’t drink, like all my friends can, without overdoing it. It’s so unfair that everyone else can enjoy a drink and I can’t.” 

Such a statement sounds ridiculous coming from an admitted problem drinker yet that is exactly what we allow from our problem eaters. It is far more likely that we will tell a close friend: “M, I think you have a problem with alcohol and I want you to get help,” than we will tell an equally close friend: “G, I think you have a problem with too much eating and I want you to get help.” 

We remain silent about overweight because we don’t want to hurt anyone’s feelings. We use euphemisms like “heavy” and “queen-sized” to avoid the word “fat.” When a very overweight friend asks plaintively, “Don’t you think this dress makes me look slimmer?” we quietly agree, refusing to give the honest answer that nothing in the world will make her look slimmer except losing 60 pounds of avoirdupois! 

One lesson learned over decades of CD research and treatment is that the problem must be acknowledged before it can be addressed and beaten. CD clients are notorious for making excuses, playing mind games with those around them, and shirking self-responsibility whenever they can. If we can bring ourselves to acknowledge that we are addicted to food, it allows for eventual movement into a process of change, bypassing the excuses and rationalizations at which overeaters excel -- to an extent that their CD counterparts would admire.

Confrontation of the problem requires that we drop the façade of politeness and euphemistic phrasing. As a society, we need to look at others and ourselves and call it as we see it. If I’m fat, I’m fat, and it’s my responsibility to not only admit that honestly, but to also admit to myself and the world that it is my fault: I am the one who made myself fat. No one else forced food into my mouth. Like the recovering alcoholic at the bar, I can always say no or drink a plain club soda. Like the recovering cocaine addict who learns to stay away from certain street corners or drug houses, I can stay away from bakeries, fast food outlets, and pizza parlors.

Weight control can be simple – eat only what you need to survive – but never easy. The fallacy of many diets is that we can lose weight without suffering. Stopping or minimizing CD abuse is always painful and a craving for chocolate, ice cream, or the urge for sugar (no one seems to crave vegetables) can be as overwhelming to the dieter as the addict’s emotional need for his drug of choice. 

Naming our national weight problem for what it really is, a plain old addiction to food, releases us to start the process of rehab and recovery that has been so completely developed in the CD field. Honesty, and the willingness to work through pain to reach our goal, allows us to not only accept our responsibility for our problem but also to relish the triumph of our eventual success.