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 in health care settings,3 or the low specificity of mammography in this population.4 “Lack of embarrassment” from prefrontal cortex impairment seems an unlikely contributor to obesity because weight loss attempts correlate with increasing body mass index.5
Before adding the stigma of “brain damaged” to the high physical and social burden obese persons already bear, we would like to see more compelling data to support this conclusion.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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