Drugs are not best for obesity

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7312.576 (Published 08 September 2001) Cite this as: BMJ 2001;323:576
  1. Elliot M Berry, senior physician (Berry{at}md.huji.ac.il)
  1. Department of Human Nutrition and Metabolism, and Internal Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel, 91120

    EDITOR—Després in his editorial recommends more studies that test drug treatment for obesity.1 Most doctors and patients would agree that the medical management of obesity is a failure. The modern epidemic of obesity implies that there is an environmental rather than a metabolic cause promoting prolonged positive energy balance. Treatment should therefore move more into the field of behavioural psychology,2 using paradigms taken from treatment of addictive behaviours to promote a healthier lifestyle. 2 3 Doctors still have an important role in encouraging exercise and eating habits, rather than prescribing potentially dangerous “magic bullets.”4

    In this light, the editorial by Després, in which he advocates long term drug treatment for obesity (and when should you stop?), makes poor sense both medically and economically. It is counterproductive and uneducational, deceiving patients into thinking that they have a disease that can be treated with a drug so that they need not make any effort to change the poor lifestyle that is at the root of obesity. The behavioural approach to obesity is as successful as that of drugs2 and has minimal side effects, but it is obviously less attractive for research support from industry. It is, however, surely the direction in which professionals must go to try to lessen the tremendous health burden of obesity.5


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