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We have been successful in changing not only weight but other parameters such as glucose, blood pressure, and lipid levels. A simple suggestion to refer to those professionals would have been a much better recommendation than to spend 30 seconds discussing something in which one lacks expertise (possibly driving a patient to more self-blame, dangerous supplements, and fad diets) and to suggest that patients sit while eating and not eat from the refrigerator. (See Alternative Medicine Alert, February 2001, pp. 23-24.)
Millicent Lasslo-Meeks, MS, RD, CEDS, CDE
VA Medical Center, Memphis, TN
Christ United Methodist Counseling Center, Memphis
1. Sachs GS, Guille C. Weight gain associated with use of psychotropic medications. J Clin Psychiatry 1999; 60(suppl 21):16-19.
2. Nestler, JE. Obesity, insulin, sex steroids and ovulation. Int J Obes Relat Metab Disord 2000;24(Suppl 2):S71-S73.
3. Polivy J, Herman CP. Distress and eating: Why do dieters overeat? Int J Eat Disord 1999;26:153-164.
Response: Ms. Lasslo-Meeks has misread and misunderstood the evidence-based support to physicians to regard obesity as a disease, and to offer patients ways to create behavioral change as a first step in treating obesity.
Study after study has demonstrated that if physicians simply encourage patients who want to lose weight, patients are far more successful than if they had never been to the office. Sensible behavioral steps are an easy way to start.
Treating obesity is difficult, and each obese person is ill in his or her own way. But in just the title, Geneen Roth’s When You Eat At The Refrigerator, Pull Up a Chair captures the need for recognizing portion size and improving self-esteem—too often a shared problem, especially for women. Teams of clinicians, including dietitians, exercise physiologists, clinical psychologists and physicians, can learn from each other while offering the time and expertise that so many patients need.
John La Puma, MD, FACP
Professor of Nutrition, Kendall College
Director, CHEF Clinic
Alexian Brothers Medical Center, Elk Grove Village, IL