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Commentary |

Asymmetric Paternalism to Improve Health Behaviors

George Loewenstein, PhD; Troyen Brennan, MD, JD, MPH; Kevin G. Volpp, MD, PhD
JAMA. 2007;298(20):2415-2417. doi:10.1001/jama.298.20.2415.
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Individual behavior plays a central role in the disease burden faced by society. Many major health problems in the United States and other developed nations, such as lung cancer, hypertension, and diabetes, are exacerbated by unhealthy behaviors. Modifiable behaviors such as tobacco use, overeating, and alcohol abuse account for nearly one-third of all deaths in the United States.1,2 Moreover, realizing the potential benefit of some of the most promising advances in medicine, such as medications to control blood pressure, lower cholesterol levels, and prevent stroke, has been stymied by poor adherence rates among patients.3 For example, by 1 year after having a myocardial infarction, nearly half of patients prescribed cholesterol-lowering medications have stopped taking them.4 Reducing morbidity and mortality may depend as much on motivating changes in behavior as on developing new treatments.5

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