Exercise is good for you. Eat more fruits and vegetables. Stop smoking. Drink less alcohol. Such messages abound in public health campaigns and there is a firm belief that they will ultimately change behavior. This is based on the assumption that individuals are motivated to change behaviors to reduce their individual health risks. While healthy individuals may understandably ignore such messages, one would certainly assume that people who already have conditions ...

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Charging passengers by the pound is unfair Recently the wires have been active with suggestions that people with obesity pay more for airline travel. This discussion was prompted by a Samoan airline announcing that they would begin charging passengers by the pound. It was also stimulated by Bharat Bhatta, an economist from Norway suggesting that heavier passengers pay a surcharge while lighter passengers are offered discounts. The logical argument ...

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And issue of Newsweek quotes me as saying, “A lot of our weight-loss recommendations are unethical because we shouldn’t be saying lose weight when there is no chance people will keep it off.“ This quote appears in the context of a lengthy article by Daniel Heimpel that examines whether or not the obesity epidemic is being oversold. While I personally do not think that the obesity epidemic is being oversold, I do ...

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On the first day of the 1st Caribbean Obesity Forum, I presented various talks on obesity - its economic implications, its assessment and the need for firmly anchoring obesity treatment in primary care. Interestingly, several family doctors in the audience raised the interesting issue that here on Barbados (as probably on other islands) many patients are actually quite happy with their weights. One family physician noted in his presentation the case of ...

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Given the staggering prevalence of overweight and obesity in most developed countries, there is no other hope than to have general practitioners (and their allied health colleagues) take on the considerable burden of managing obesity in their practices. In fact, a recent example of a successful weight management program run in primary care just found considerable media attention in local newspapers. But research shows that most general practitioners (GPs) neither feel confident ...

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In my interactions with patients, I always ask them to tell me when their weight problems began and what they believe contributed to their weight gain. Broadly speaking, there are two categories: people, who were big (or were considered big by others) as long as they can remember and those, who can often clearly pinpoint when their weight ...

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Recently, I attended a scientific symposium on addictions. One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA. While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book. The definition reads as follows:

Alcoholism is a primary chronic disease ...

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Obesity is now increasingly recognized as the "natural" consequence of societal changes that have occurred over the past decades to foster an increasingly obesogenic environment. Yet, rather than focus on the root causes of these societal drivers of obesity, governments apparently prefer to make obesity prevention a personal matter, with a strong emphasis on trying to get individuals to change their lifestyles. It is clearly far easier to simply tell people to ...

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One commonly heard propositions to combat the obesity epidemic is to tax soft drinks. No doubt, sugary soft drinks are a common and important source of “empty” calories, but will taxing soft drinks really reduce obesity rates? This assumption was now examined by Yale University’s Jason Fletcher and colleagues, in a paper just published in Contemporary Economic Policy. The researchers collected information on taxation of soft drinks with respect to specific excise ...

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One of the topics that I have often thought about (especially in light of our seeming inability to develop zero-risk obesity drugs) is the problem of averages. Our entire medical philosophy of “evidence-based” medicine seems built on the “Gaussian” assumption that averages can reflect the true benefit (or risk) of a drug, when in real life (or medical practice) there is no such thing as the truly average patient. Clearly, a ...

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