Abstract
THE TREATMENT of obesity remains a puzzling challenge, says Bernard Guy-Grand, MD, of the Hotel-Dieu de Paris (hospital), France. Furthermore, physicians must expect failure when they administer treatments without understanding the [specific defect in] physiology underlying the problem. Guy-Grand's comments reflect some of the frustration felt by clinicians who try to help their patients lose weight, only to see anywhere from 75% to 95% of them regain the lost pounds (see Bray GA (ed):Obesity in America. US Dept of Health, Education and Welfare, 1979.) They also suggest a feeling among obesity specialists that perhaps some new approaches to treatment are in order. William Bennett, MD, editor of theHarvard Medical School Health Letter, Boston, thinks that we ought to abandon a cure model for obesity in favor of a rehabilitation model. [This would focus] not on improving weight, but on the composition of the diet, changing lipid levels, etc.
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