Josh Peck, renowned for his role in Nickelodeon's "Drake & Josh," has openly discussed the challenges he faced growing up in the spotlight as a "morbidly obese" teenager. His weight loss journey, far from being a simple success story, reveals the intricate connections between body image, addiction, and mental health. Peck's experiences shed light on the phenomenon of addiction transfer and the importance of addressing underlying issues rather than solely focusing on the number on the scale.
The Pressure of Fame and the Illusion of a Quick Fix
Peck described the immense pressure he felt during his teenage years, leading him to believe that losing weight would solve all his problems. He recounted on an Oct. 20 episode of "Cancelled with Tana Mongeau" that at 17, after losing a significant amount of weight, he thought he had reached the finish line and no longer had to worry about anything. However, he soon realized that he was still "plagued with the same thoughts and things that had always messed with me my whole life." This realization marked the beginning of a four-year journey of "being a total cliché," as he tried to make up for the partying he felt he had missed out on due to his career.
Addiction Transfer: A Common Phenomenon After Significant Weight Loss
Peck's story highlights a phenomenon known as "cross addiction" or "addiction transfer," where one addiction, often food, is replaced by another, such as drugs and alcohol, after weight loss. Listeners of Peck's podcast episode pointed out that his experience detailed this phenomenon shared by many people that occurs after significant weight loss. At 21, Peck sought treatment and became sober. Research has found that people can develop addictions after significant weight loss to other things too, such as gambling, shopping, exercise, skin picking and the internet - all of which serve as an emotional escape from the overwhelming lifestyle changes tied to weight loss.
The Underlying Causes of Addiction Transfer
Addiction transfer is mostly associated with people who undergo weight loss surgery, such as gastric bypass or sleeve gastrectomy because the procedures lead to a dramatically reduced food intake and body weight over a relatively short time. However, experts say it can happen after natural weight loss too, and potentially after weight loss via medications like Ozempic, although that remains to be seen. Alexis Conason, a licensed psychologist and certified eating disorder specialist who has studied addiction transfer, explained that "anytime people endure a major change in their body, there's a psychological change that corresponds to that and it's not always the positive one that people imagine it's going to be." She added that "when we lose a lot of weight, it sometimes happens very quickly and often in a way that feels outside of people's control."
Similar to Peck's experience, many people assume that a slimmer body is the answer to their problems. But without treating the underlying cause behind an existing addiction, some run the risk of replacing it with another potentially more dangerous one.
Read also: CrossFit Legend: Josh Bridges
Conason noted that people often "put all their eggs in that basket and feel hopeful while having unrealistic expectations of what life is going to be like afterward." The consequences of a person's perception suddenly changing can be jarring, trickling into personal relationships. Oftentimes, people’s bodies change faster than their body image can adjust, which can lead to body dysmorphia. Peck described his experience as having "the same head, a different body," a sentiment he also shared in his memoir "Happy People Are Annoying" which was released in 2022.
Conason said that "it can be a disconcerting experience to see yourself one way and then have the world respond to you in a different way." In some cases, people don’t lose the weight they wanted to or regain the weight they lost over time, which can be difficult to cope with, especially for people who undergo surgery and feel like it’s their final opportunity to lose weight. Conason said that "when surgery doesn’t help, people can be more prone to depression and hopelessness," and "are oftentimes given very little support on how to deal with it." The result can be substituting food with a different coping mechanism to soften the blow of these challenges.
Drugs and alcohol, for example, have been shown to trigger similar reward responses in the brain as food, which helps explain why some people become addicted to substances when they can no longer receive satisfaction from their diet. Research also shows that intoxication happens more quickly and with less alcohol following weight loss surgery, increasing risks of alcohol addiction, said Dr. Julio Teixeira, a bariatric surgeon with Northwell Health who has published research on addiction transfer. Because tolerance is reduced, people may experience the rewarding aspects of alcohol use sooner and more frequently, which could lead to a greater desire for more.
Addiction Transfer Can Happen to Anyone
Addiction transfer after significant weight loss can happen even to those with no prior history of addiction, whether it’s to food, drugs, alcohol, or another substance or behavior. In a small 2022 study of 97 patients who had a sleeve gastrectomy, researchers found that 1 in 5 "non-high-risk drinkers" (a total of 84 people) developed an alcohol problem one year after their procedure. That said, a history of addiction is generally associated with increased risks of addiction transfer after weight loss.
The Role of Medications Like Ozempic
The increasing popularity of medications like Ozempic for weight loss has sparked debate about the "right" way to lose weight. While some celebrate the use of these tools to achieve a healthier lifestyle, others express concern about the normalization of dieting and the potential for weight discrimination.
Read also: From "Morbidly Obese" to Healthy
Many people aren’t able to lose weight with changes to their diet and exercise habits alone, Takkouche said, often because of underlying issues such as insulin resistance (Type 2 diabetes) and fatty liver disease, many of which have strong genetic components. Genetics may account for up to 70% of people’s predisposition to be overweight or develop obesity, Takkouche said. “Nobody is cheating by using Ozempic. They're using some of today's modern tools to help them achieve a healthier lifestyle, which doesn't mean quote unquote low weight,” Takkouche said. “It means less fat around your body that increases your risk of heart disease, diabetes and other problems. A lot of people today fixate on the number on the scale, but that doesn't always represent the truth.”
Injectable medications like Ozempic and Mounjaro (approved to treat diabetes), as well as Wegovy and Zepbound (approved for weight loss), work by sending signals to the appetite center of the brain to reduce hunger and increase fullness - simultaneously correcting some of the metabolic problems that people with various conditions face. Weight loss with these medications isn't possible, however, without a healthy diet and consistent exercise regime, Takkouche said. Failing to maintain these healthy habits can explain why many people regain some or most of the weight they lost within a year after stopping the use of the drug. “You need to have a proper diet and exercise in addition to taking these medications. They do not replace one another,” she said. “Some people just require additional help with injectable medications.”
Studies have also found that the longer people are overweight or have obesity, the harder it becomes for them to lose weight and the greater their need to pursue more extreme measures like surgery and medications, Takkouche added. While weight loss drugs are known to cause side effects like nausea, vomiting and diarrhea, they have also been found to reduce risks for heart attack and stroke among people who are overweight or obese.
The Body Positivity Movement and the Dangers of Weight Discrimination
The assumption that using weight loss drugs is the "easy" way to shed pounds has, according to fat liberation activists, fueled weight discrimination and reversed much of the progress made in the body positivity (or body neutrality) movement. Victoria Abraham, 23, has been on and off Ozempic for two years to regulate her blood sugar levels. She has been rationing a single box of medication she received three months ago because of a nationwide shortage as more people who don’t need the drug use it for weight loss - a reality she feels has normalized conversations about dieting again as we see more people undergo drastic body transformations.
Abraham said that “we had exited that era of constantly monitoring others' bodies and always consuming weight loss content." Abraham added that “as a fat person who talks about these issues, I've been noticing more and more hate comments, cruelty and just overall nasty behavior from others.” As a self-proclaimed fat liberation activist, Abraham is trying to change attitudes around what it means to be fat: “My goal is for people to stop defining their worth with their size. There's always going to be someone thinner, prettier.
Read also: Weight Loss Journey