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April 28, 1993

Futility and AvoidanceMedical Professionals in the Treatment of Obesity

Author Affiliations

From the George Washington University Obesity Management Program, The George Washington University Medical Center, Washington, DC.

JAMA. 1993;269(16):2132-2133. doi:10.1001/jama.1993.03500160102041

TWENTY years ago, I changed course in my internal medicine practice and decided, rather deliberately, to work on the problem of obesity. My friends, my colleagues, and my family thought I was crazy. The warnings were clear. "Don't risk your credibility and your career." "Don't venture into a part of medicine that no one takes seriously." "Don't move into the world of quacks and charlatans." My brother, a thoughtful, professorial cardiologist, assessed the situation in most negative terms. "The guys who deal with obesity are the sleaziest guys in medicine. Pills and shots!" he shouted. Another friend, also comfortably cloistered in academia, could not imagine how I could possibly want to spend my time working with fat, middle-aged ladies: "What on earth is there to talk about?"

Taking the Plunge  Even in my naive youth I was not oblivious to the risks involved in dealing with obesity. Although my credentials