Obesity is a worldwide epidemic and will be followed by a worldwide
epidemic of diabetes.1 While diet, lifestyle,
and exercise are the cornerstones of current approaches to treat obesity,
they have been ineffective in stemming the current epidemic. In this issue
of THE JOURNAL, the article by Bravata et al2 systematically
reviews and synthesizes the literature on the use of low-carbohydrate diets
for treatment of obesity. Their findings add to the review of popular diets
published by Freedman et al.3 Among the principal
findings in the analysis by Bravata et al are that lower-carbohydrate (≤60
g/d of carbohydrate) diets were associated with reduced calorie intake and
that weight loss was predicted by calorie intake, diet duration, and baseline
body weight, but not by carbohydrate content. At the end of their analysis,
Bravata et al note several gaps in the current literature on low-carbohydrate
diets, including the need for better follow-up and for use of intent-to-treat
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The Rational Clinical Examination
1. Weight Loss in the 6 Months Before the Examination, Expressed as a Proportionate Loss From Previous Weight
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