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To the Editor: In their Commentary, Drs Alonso-Alonso and Pascual-Leone¹ discussed the right brain hypothesis for obesity. We agree that there is a great deal of basic science research needed to understand the complex etiology of obesity and to untangle the biological, cognitive, psychological, and environmental issues that may contribute. However, we feel the authors are premature in linking right prefrontal cortex abnormalities and obesity. There are simpler and more practical reasons for the behaviors observed among obese persons than those the authors cite.

It is unlikely that "deficits in decision making" underlie the difficulty obese patients have in committing to long-term weight loss strategies. More likely explanations of high attrition rates during behavioral treatment include program fatigue, discordance between treatment goals and treatment success, and the time needed for frequent group attendance.² Poor adherence with breast cancer screening programs reflect barriers and stigmatization of obese persons that are common . . . [Full Text of this Article]

Keith H. Bachman, MD
keith.h.bachman@kp.org
Kaiser Permanente
Portland, Oregon

Trina M. Histon, PhD
Kaiser Permanente
Oakland, California

RELATED LETTER

Obesity and the Right Brain—Reply
Alvaro Pascual-Leone and Miguel Alonso-Alonso
JAMA. 2007;298(7):738-739.
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RELATED ARTICLE

The Right Brain Hypothesis for Obesity
Miguel Alonso-Alonso and Alvaro Pascual-Leone
JAMA. 2007;297(16):1819-1822.
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