Health promotion helps no one

EDITOR—Narayan et al suggest that we use clinical and community based strategies to prevent type 2 diabetes.1 Over three years our small practice in Glasgow worked very hard to encourage healthy eating and exercise among our 2000 patients. We referred many patients to an exercise scheme, had a dietitian working in the practice, and organised health groups who met on a weekly basis where dietitian and doctor would weigh, encourage, motivate, and educate patients. Within a year almost half of my personal workload became this health promoting clinical input. In the end almost all of these patients required a continuous personal input to maintain their weight loss, regular exercise, or healthy eating, and it simply became unsustainable. Our energies were removed, and soon they all returned to their normal states.

I learnt a lot …