Management of obesity
Authors: Ray C McHenry, Richard W Gilhome and Chris Hensman
Published online: 18 October 2004
Ray C McHenry,* Richard W Gilhome,* Chris Hensman*
* General Surgeon, Eastern Surgical, Suite 7529, Police Road, Mulgrave, VIC 3170.
To the Editor: We take issue with the recommendations on treatment of morbid obesity in the otherwise excellent article on obesity management by Proietto and Baur.1
Like most non-surgical clinicians involved in the management of obesity, they fail to differentiate between the treatment of obesity (body mass index [BMI], 30–35 kg/m2) and morbid obesity (BMI > 35 kg/m2). The literature is crystal clear — non-surgical treatments are unsuccessful in achieving and maintaining weight loss in morbid obesity.2,3 We are unaware of any branch of medicine, other than morbid obesity management, where respected clinicians routinely recommend treatments (drugs, diet and lifestyle modification) which have been proven not to be effective.
We challenge all clinicians to accept what the evidence clearly shows, that:
References
- Proietto J, Baur AL. Management of obesity. Med J Aust 2004; 180: 474-480. <eMJA full text>
- Perri MG, Fuller PR. Success and failure in the treatment of obesity: where do we go from here? Med Exerc Nutr Health 1995; 4: 255-272. CHDGFGJF
- National Task Force on the Prevention and Treatment of Obesity, National Institutes of Health. Very low-calorie diets. JAMA 1993; 270: 967-974. CHDCJDFG
- Chapman A, Game P, O’Brien P, et al. Systematic review of laparoscopic adjustable gastric banding for the treatment of obesity: update and re-appraisal. Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S) report no. 31. 2nd ed. Adelaide: ASERNIP-S, The Royal Australasian College of Surgeons, 2002. Available at: www.surgeons.org/asernip-s/systematic_review/LAGBreviewUp0602.pdf (accessed Aug 2004).
When ‘Liver Enzymes’ Are Not Hepatic: Late-Onset Pompe Disease
Shauna Madigan, Georgina England, Wayne Rankin
Primary Hyperparathyroidism in Adults: Recent Developments in Diagnosis and Management
Elizabeth Wootton, Sunita M. C. De Sousa, Richard L. Prince, Donald S. A. McLeod, David A. Pattison, Mathis Grossmann
Severe Hypoglycaemia Secondary to Chronic Opioid-Induced Hypothalamic–Pituitary–Adrenal Axis Suppression: An Under-Recognised Phenomenon
Michael Do, Annabelle Hayes, Malgorzata Brzozowska
Rethinking diabetes care for Indigenous Australians: the need for Indigenous‐codesigned and led diabetes models of care
Natalie Nanayakkara, Sharon Atkinson‐Briggs, Alicia J Jenkins, Neale D Cohen
The first Australian evidence‐based guidelines on male infertility
Darren J Katz, Liza O’Donnell, Robert I McLachlan, Tim J Moss, Clare V Boothroyd, Veena Jayadev, Sarah R Catford