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Susan Yanovski, MD
National Institute of Diabetes and Digestive and Kidney Diseases Bethesda, Md

JAMA. 1997;277(15):1202.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—We appreciate the reminders from Dr Tiedt that long-term changes in diet and exercise, whether or not assisted by medication, are required for long-term maintenance of weight loss. We wish to reiterate that anorexiant medications should not be used in isolation, but only in conjunction with programs designed to enable patients to make and sustain those changes. Overall, the effects of currently available anorexiant medications are modest; however, many patients do sustain sufficient weight loss to improve obesity-related risk factors.

While the secular trends toward decreased physical activity and increased dietary intake noted by Tiedt undoubtedly have contributed to the alarming increase in obesity in the United States, there is mounting evidence that genetic and metabolic factors play an important role in predisposing certain individuals to the development of obesity.^1,2 In addition, physicians must not ignore the enormous public health and personal burdens obesity places on society and individuals. . . . [Full Text PDF of this Article]

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