Losing weight requires less calories

04 Jan 2020

Hargreaves, R.

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In their debate article addressing the classification of obesity as a disease (VR, 14 December 2019, vol 185, p 735) Alexander German, Ian Ramsey and Philip Lhermette state that there is a wealth of evidence that obesity is not a normal physiological response to excess calorie intake. I do not question their expert understanding of fat metabolism, but how do they explain my lifetime’s experience that the successful management of chronic weight gain and obesity always requires a reduction in calorie intake?

With regard to the way we approach weight management in the consultation room, stigmatisation is not dependent on whether obesity is classified as a disease. Indeed, the risk of stigmatisation may even be greater if we begin to tell clients: ‘If you don’t follow my advice you cause a disease, and will be making your animal ill.’

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