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

handle is hein.journals/mdsclw14 and id is 1 raw text is: 



Vol. 14 No.1                           and the IAW
                                       The Official Journal of the
January, 1974                          British Academy of Forensic Sciences


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.

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