Helpless Heavyweights
Obesity is one of the most common medical complaints in the U.S. today.Depending on the choice of surveys, anywhere from one-tenth toone-quarter of the population is overweight to some extent, andmillions of people unhappy about their girth and concerned about theirhealth spend more than $400 million a year on reducing drugs andtreatments. Physicians interested in the subject have even formed theAmerican Society of Bariatrics to study the problem collectively. The field has nowhere to go but up;medical science has so far failed miserably to help the heavyweights inany important way.
This was the admission of bariatricians and other physicians meeting inWashington last week. The average family doctor treats ten or morepatients a month for overweight. A relatively small number have obviousmetabolic disorders that can be checked. For most of the rest, theproblem is simply excessive eating, and doctors have not found a way tocontrol that for very long. A 250-lb. man who should weigh 165, say,would have to cut his caloric intake by more than half. By his eatingstandards, that would be close to starvation. It is easier to dry outdrunks than to starve down heavy eaters.
Fad diets, the experts feel, have only temporary effect, and some can bemedically unsafe. Drugs that dull the appetite, like amphetamines, helpcertain people for a while, and some doctors prescribe drugs inconjunction with diets. But no one considers pills a long-term answerbecause of side effects and the chance of addiction. Many extremelyobese people eat heavily because of emotional problems. For thesepatients, psychotherapy can provide clues about the basic causes of thetrouble and sometimes helps ease the anguish of kicking gluttony. Thekey element is usually motivation. Group sessions on the style ofAlcoholics Anonymous benefit some people more than orthodox medicalapproaches do.
Regardless of method, the quest for permanent slimness is rarelyrewarding. According to Dr. Alvan Feinstein of Yale medical school, thesuccess rate of weight-loss programs is "terrible, much worse than incancer." Out of every 100 obese patients, some doctors have found, onlya dozen can be expected to lose significant amounts of weight in ayearlong treatment program. Of that happy dozen, ten can be expected togain back their excess poundage during the following year.
Prev:Kudos for CliniciansNext:A Stockholm Notebook
If you enjoyed this post, please consider to leave a comment or subscribe to the feed and get future articles delivered to your feed reader.
