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14 Med. Sci. & L. 1 (1974)

handle is hein.journals/mdsclw14 and id is 1 raw text is: MEDICINE SCIENCE Vol. 14 No.1 and the IAW The Official Journal of the January, 1974 British Academy of Forensic Sciences Editorial ONE of the commonest conditions from which we suffer today is that of obesity. The choice of medical treatment is influenced by certain general principles, namely: - I. Patients only lose weight if motivated to do so. 2. They must have a realistic assessment of the anticipated rate of weight loss or they become disheartened and stop, particularly when normally there is a large initial decrease in weight followed by the indefinite period of no weight loss at all until regular small decreases in weight become established. 3. Temporary weight loss is only of little value. 4. Medical management cannot be separated from the psychological Support that many obese patients require. Successful treatment requires the detection and correction of the initial weight gain, whether this be psychological or due to an inappropriate dietary habit. 5. Prevention of the initial weight gain is easier than the correction or the control of established obesity. The medical management of obesity must take account of the problems, requirements, and expectations of the individual person. Males tend to be able to take to diets better than females. It is sometimes unreasonable to attempt anything except prevention of further weight gain. If, however, one is genuine in wishing to lose weight and finds that progress is unsatis- factory one must check the dietary history for it may reveal inadvertent cheating. For example, some patients really believe that stout and ale are good for them, thinking that they do not have a high calorific value, and, in addition, believe it is not necessary to control general fluid intake. In the management of the obese patient more emphasis should be put on the pre- vention of weight gain as one would prefer not to proceed with the possibility of drugs, starvation, or even ' by-pass ' surgery.