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EDITOR'S CHOICE: Trish Groves New ideas please BMJ 2006; 333: 0-f [Full text]

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The whale paradox

Augusto Pimazoni   (9 December 2006)

The whale paradox 9 December 2006
Augusto Pimazoni, Medical Marketing Consultant MED MARK Medical Marketing Consultants,Brazil Send response to journal: Re: The whale paradox	Dear Dr. Groves: Well said: lifestyle changes remain, for now, the potentially most effective and most difficult intervention to control diabetes. And yes, we do need new ideas to make it happen. But how to make this miracle come true? It might not be a proven scientific fact, but it seems as if obesity, rejection to physical activity and to healthy vegetarian foods come all together in a malicious gene as a trick from nature to castigate "those who indulge and bulge"! As we all know, whales strictly follow all the recomendations for a healthy lifestyle: a very healthy diet (mostly fish), full time physical activity, swiming auround the clock and no stress. And in spite of all these favourable conditions, the whale is the most explicit example of obesity... If all theories on dietetic strategies to control overweight were correct, then the Whale Padarox would not be such an impressive reality. This very same rationale holds true for the elephant, characterizing the Elephant Paradox, i.e., the "dried version" of the Whale Paradox. How would you explain this? As a physician and a metabolic syndrome patient I agree that lifestyle changes can be efficacious in controlled conditions for a short period of time, but it will never be effective in daily clinical practice. AUGUSTO PIMAZONI, MD pimazoni@uol.com.br Competing interests: None declared