OBESITY AND CALORIC BOOKKEEPING

To the Editor:— The prevailing dominance of psychiatry and psychology over the whole field of medicine is bound to create certain one-sided attitudes. Thus the view is held that obesity is merely a question of overeating, emotionally conditioned and medicinally controlled only with negligible success. According to the recent editorial inThe Journal, July 9, page 1141, only 2% of treated patients "maintain a significant weight loss for as long as two years." Moreover, on page 1131, Dr. Modell's article estimates that in only 10% of all cases of obesity do genetic, glandular, or other causes play a role. The same paper calls the use of salt restriction or diuretics meaningless and senseless. These statements are in stark contrast to my experience with successfully treated patients during the past 30 years. It is a commonly ignored fact that not all obese people are hyperphagic; quite a few are euphagic or