In his Belltown home office, Robert Pretlow, M.D., has just showed me what he calls “food porn”: a TV commercial showing thick chocolate poured sensuously over a curvaceous cookie and the word “comforting” materializing on the screen.

It’s to illustrate the temptations that plague the kids quoted in “Overweight: What Kids Say” (self-published through Amazon.com’s CreateSpace publishing division). The new book features messages kids posted anonymously on Pretlow’s website, http://www.weigh2rock.com. Although it’s not a scientific study, Pretlow argues that the anonymity elicited information kids don’t reveal elsewhere, and he drew conclusions from it about their struggles with obesity.

Q: A new study shows that obesity is a national-security threat because so many kids are unfit to join the military. Which is only good news if there’s a draft.

A: I think that’s absolutely true. I think it really is a security issue. If our soldiers are not able to move on the battlefield, they’re not going to be able to fight. That’s a no-brainer.

Q: Anonymity allowed kids to open up more than they would otherwise. What new things did you learn from that?

A: What these kids say contradicts the prevailing beliefs of mainstream medicine and also the lay public as to what’s causing the childhood as well as the adult obesity epidemic. The prevailing belief is that kids as well as adults, parents and so forth do not have knowledge of how to make healthy choices — in terms of healthy eating, in terms of healthy activity. These kids say that they’re OD’d on healthy-choice information.

Q: Gorged on it.

A: They get it nonstop, in school, in health classes. What they say they need is ways to resist their cravings for this highly pleasurable junk food, fast food, restaurant food that’s available to them, that’s always around.

Q: Kids hating themselves, avoiding photos, saying that looking in the mirror in the morning is the worst part of their day, having nobody show up to their birthday parties ... some of their posts are heartbreaking.

A: I read them every day. They are heartbreaking, heart-wrenching. I feel for these kids so much. The travesty is that no one seems to believe them. Their docs don’t seem to believe them, their parents don’t seem to believe them, so they band together on the Web, where they can talk to other kids that will believe them.

Q: Some kids choose home-schooling to avoid ridicule — and ironically, you say that just makes them gain more weight.

A: When they’re home-schooled, they don’t get activity at all. They just basically sit at home on the couch. They also don’t have social contact. Which is a vicious cycle because the more isolated they become, the more lonely they become, and they eat to counteract this loneliness, to comfort this loneliness.

Q: When I see overweight kids I think some parents could be guilty of a form of child abuse.

A: I think that’s true in terms of why parents allow their kids to become overweight. There’s all types of arguments as to why parents allow this. One is the parents are too busy to cook healthy, so they must purchase fast food. It’s counterintuitive that a parent would allow their child to become obese, which would impact so negatively on their social standing, their self-esteem as well as their health. It’s counterintuitive that a parent would allow that just so they could save time and not have to cook.

Q: Parents play the biggest role?

A: Yes. Parents play the biggest role. And the second reason the kid’s overweight is the parents themselves may be overweight. Two- thirds of our population is that way, physically. And they give the kids the same kinds of foods that they use themselves for whatever reason, that they use for coping. Or even if they don’t do that, the food is available to the kids because the parents have it all over the house.

The third reason parents contribute to obesity in their kids is that the parent doesn’t happen to be overweight, and the child starts inclining in that direction because they’re getting the food wherever, and they’re starting to put on the pounds, and that will tend to upset a parent that is fastidious. The kid will then sense that the parent’s upset. The parent tends to be a little less loving, withdraws a little bit, more critical of the kid. And that’s a vicious cycle because the kid then turns to food for comfort.

Q: You dismiss a number of theories such as sedentary lifestyle, a food-rich environment and the Oscar nomination of that girl for the “Precious” movie. All right, not the last one. What do you think’s responsible for the childhood obesity epidemic?

A: The reason I would say is not what people want to hear. It’s that these kids are using food to cope. And most of them do it unconsciously.

Q: What can be done about it?

A: Number one is to recognize first of all what food is being used for by kids, that it’s being used for much more than just nutrition, what we need to run our bodies on. Particularly how the pleasurable food — junk food and fast food — was designed to entice taste. It’s highly pleasurable, and almost everything that’s highly pleasurable can become a dependent entity or an addiction.

Q: If they had to retire Joe Camel the cigarette mascot, isn’t Ronald McDonald another pied piper of death who should be banned from influencing children as well?

A: I got a great quote from a kid that says exactly that. “He’s a skinny clown that has no business advertising food that makes these poor kids fat.”

Q: You want to treat obesity like substance-abuse addictions. Isn’t it true that companies engineer some foods to be addictive and make us hungrier?

A: Absolutely. They don’t acknowledge that, but it certainly appears that that’s what they’re doing.

Q: What should people watch out for in that respect?

A: Anything that’s got sweet in it, whether it’s got high-fructose corn syrup, sucrose, fructose, whatever that makes things really sweet. Salt ...

Q: (Pulling out a bag of Chili Cheese Fritos.) I’m dying for some of these. Want some?

A: No, thanks.

Q: Just one?

A: I’ll try it. Sure, thanks.

Mark Rahner: 206-464-8259 or .(JavaScript must be enabled to view this email address)