How important are diet drugs in ending the obesity epidemic?

Dr. David L. Katz, MD, MPH
Preventive Medicine
Very little about genes, metabolism, or human nature has changed in the past five decades. We have epidemic childhood obesity now; we did not have it then. The ambient level of personal responsibility in 8-year-olds has not changed over that span. A dramatic change in the epidemiology of obesity is directly related to profound changes in our environments, food supply, activity levels, and social norms. We have caused the obesity epidemic, by looking the other way as a staggering array of "advances" made ever more calories ever more temptingly available, and made physical activity ever more elusive.

The root cause and cure of all but rare cases of obesity resides with how we use our feet and forks. Pharmacotherapy is no substitute.

There is, indeed, a role for pharmacotherapy in obesity -- as there is a role for surgery. But it should be a small role. I protest any indulgence in the idea that a diet drug is a meaningful solution to the problem of epidemic obesity. I protest the attention and resources that get diverted from making the modern environment more salutary, more conducive to healthful use of feet and forks. As a society, we should be doing all we can -- and we are not! -- to make sure very few of us ever need the options of surgery or drugs.

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