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Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: Lighten Up randomised controlled trial

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6500 (Published 03 November 2011) Cite this as: BMJ 2011;343:d6500

Re: Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: Lighten Up randomised controlled trial

Prevention of Obesity is now the Priority

The results of treatment of obesity by Jolly and colleages(1)were poor. Only 11% of overweight patients accepted the invitation of their family doctors to attend a slimming clinic and only 21% of those who attended the NHS Size Down clinics and only 15.7% of those who attended GP obesity clinics had a 5% sustained weight loss over a year. Would oncologists accept similar results for their patients? Perhaps different approaches to prevention should be explored.

About the age of 10 months most babies refuse to eat foods which previously they had taken eagerly. This normally coincides with a sharp fall in the BMI and a change from the chubby cherub to the leaner adult shape. Parents, especially those with a first child, become anxious. Initially they think that the infant is acutely ill and later that she will become ill if she continues to become thinner. In desperation they give foods that are more tasty, but contain more sugar, salt or fat. The extra food, which is not needed for normal growth, may cause a permanent addiction to foods with a strong taste and obesity.

The scope of the last NICE report on obesity(2) began at the age of two years. Another report covering the period of birth to two years may reveal more effective approaches to the management of the present epidemic of obesity.

(1) BMJ 2011; 343: d6500
(2) National Institute for Health and Clinical Excellence. Obesity. Guidance on the prevention, identification, and management of overweight and obesity in adults and children. NICE, 2006(Clinical Guidelines 43)

Competing interests: No competing interests

01 December 2011
Bernard Valman
Emeritus Consultant Paediatrician
nil
Northwick Park Hospital
105 Bridge Lane London NW11 OEU