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Dump the sugar and simple carb laden foods, no soda, alcohol, added sugar, etc and then add some exercise. Do all that first if you have not already done that. I made all those significant small changes first, then went harder. The week I attended the seminar I ditched the diet coke, done. Then let go of pasta, rice, any bread except rye and then only one piece toasted once a day, etc. These changes are pretty much permanent. To go hardcore to get to your most important goal - which is surgery scheduled - you may need to go lean protein and vegetables sooner - which is the lifestyle we all have after surgery anyway. You don't need the shake routine until your doc says do the shake routine, unless for you that seems easier. Me - I would rather have tuna or chicken than a shake. Good luck.

The entire process was relatively 20 1/2 weeks, but only 10 1/2 weeks from my first consultation: February 13- started required 3 month supervised weight loss program April 24-consultation May7- psych eval, met with Nutritionist, lab work, swallowing study May 22- finished month 3 of program and submitted all required documents to Surgeon's office *this was a Thursday and Monday was a Holiday May 27-insurance company requests something from Primary Care Physician stating I had not been treated for substance or alcohol abuse within the past year (one of the requirements) June 3-Doctor's office finally has letter prepared and I faxed it in June 4-Insurance Approval!! Today(June 10)- waiting for the hospital to contact me bc they have to confirm that you dont have an outstanding balance, and they require you to pay a deposit. I spoke with the Bariatric Coordinator at my surgeon's office, and as of today the next available date for surgery is July7(they only perform the procedures on Mondays and Tuesdays, and you have to have time to do the pre op diet.

I understand about the exercise. It gets tougher when you are working out a lot and consuming a lot of calories. If you do have a carb max you are shooting for it does become easier to hit it, so from that perspective, assuming you are eating a lot of bars plus other things... then sure I could see wanting to watch them closer. I do still think however that it's not that big of a deal if you are avoiding sugars and taking high Protein bars you are likely ok. Note that 50g of carbs is higher than the pre-surgery diet. The pre-surgery diet is 30 carbs max, 70g protein min, as a general guideline. So you really aren't on the same diet as pre-surgery. My point is you don't need to worry so much about whether or not these bars have as close to zero carbs as possible, even on a 50g carb diet. You referred to the bars people mentioned here with concerns about high carbs. That is why I commented. Most of these bars are not that high in carbs for a post surgery diet, even the "higher carb high protein ones. A bar with 26g of carbs (12g fiber, 2 sugar alcohol and 5 sugars) is effectively 12g. Pretty low for a Meal Replacement with 20-30g of protein. And that bar is on the higher carb end of those discussed. It's easy to get so caught up in this stuff that you laser focus on one thing, like trying to keep carbs to a minimum. Personally I'm primarily focused on high protein, high nutrition and watching calories. The rest follows.

Plenty of sugar in them. It is in sugar alcohol which is half of the carbs. Your majority of carbs when eating should be fiber not sugar alcohols. This is how they make them taste better and a way for them to list them as 0 sugars in big and bold on the front label. Just saying a marketing gimmick.

Danila I'm sorry you have to do all liquid. My surgeon has done over 3000 sleeves and I don't have to do all liquids until after surgery. I'm on low carb (Atkins style - just had an omelet and bacon yumm). I heard from some you tube videos of people that went to this surgeon we actually get a last supper the night before surgery! Anything we want including alcohol. Yea!! Anyone else get a last supper?

Honestly, this is the type of thing I don't like to see here. BUT - I get it, so you wont get any judgement from me but here is what I do have to say on the topic. Most surgeons would not touch you with a ten foot poll if they knew you were drinking alcohol at this stage, because you are setting yourself to have problems. That goes straight to your liver (which you should be reducing at this point) and ultimately if you do poorly, it reflects poorly on them. You should be following your rules ONE HUNDRED PERCENT for at least the first 18 months post op and in the months leading up to your surgery. If you cannot commit to that, I question your candidacy for something like this (from a healthcare standpoint) As a patient - I get it, but I don't really approve, not that it matters.

If you are an American, HIPAA law prevents your employer or future employer from being able to access your medical record. No medical practice would go giving out that information unless they want to get sued. It is against the law. Sent from my Nexus 10 using the BariatricPal App Ummm, Horse S**t. Sorry, HIPPA was wiped out in 2009 when the American Recovery and Reinvestment Act of 2009 was passed. One of the provisions was an automation of doctor and hospital records via federal grants to state hospital associations. The public reason was "well it will make it easier for people's medical records to be shared with other medical providers in case of emergency." And that is a dang lie. If you want more information than you ever want on this, I am very sure I can prove that assertion. For the purposes of this discussion, if you have serious drug/alcohol or psychiatric problems and you think the government, law enforcement or big pharma doesn't know it, you are wrong if you have third party coverage. What this means is even though you think your attempts to get help won't or can't be used to keep you from purchasing a firearm in the future, hurt your job prospects, create difficulty getting insurance and professional licening et. al. YOU ARE FLAT OUT WRONG. That patient privacy/HIPPA form that you sign is not worth the paper it is printed on. I self pay and have to work very hard to keep my information out of that system. NOTE: you might ask, why do I care? I really don't give a rip about being one more data point in a government data base, but my ex-wife is a government employee (and bi-polar) and she has access to the whole dang database. She illegally tracks everything I do on the system and let's my kids know everything about my medical history, with the hope of embarrassing me. I don't want her, or anyone else to know. So I work very hard to keep it private. I switched to a non-ObamaCare insurance plan. My doctor is not on the state electronic record system. Most of my pharmaceuticals are purchased from other countries because its cheaper, and no one has a record. So the assertion that it's ok to get help with drug and alcohol problems because "the government will protect your privacy" is VERY, DANGEROUSLY wrong. Sorry. That's a fact and I will gladly defend my position to anyone who wants more info. But this isn't a political site,so I don't want to get too far afield on this, so please if you disagree or want more info please PM.

Dealing with a parent who died from alcoholism (found dead on the floor with a glass of scotch still frozen in his hand) is hard enough if I have to do this again with a sibling or a child I don't know if I could as it's so painful!!! Good luck to you and your family and get support for yourself. Nancy.:thumbup:

I feel your pain. I have dealt with alcoholism in my own family which made for a very rocky, unhappy childhood. I hope he sees the light at some point. I really hope the parents can start seeking help to understand how to deal with this addiction to stop enabling him.

I don't think ads for any thing should be band, smoking or alcohol or any thing else for that matter. people need to have will power and if they don't, then thats part of life. I for one can say that food advertisement rarely makes me want to go buy something or eat something, I come up with that feeling all on my own. This reminds me of a story my friend told me...he's a heavy smoker and he said he would be sitting at home watching tv not even thinking about smoking, but then one of those adds against smoking would come on (I can't remember what the group is called but they make lots of tv ads with the bad statistics against smoking) and he said as soon as he saw the ad AGAINST smoking, it would make him want to smoke.... McDonald's is a business and their looking to make money. Their primary concern is NOT our health. And who can blame them, business is what makes the world go round. The make tasty food because thats what people buy and because thats what makes them money, and I don't think we should deny them that by cutting of their primary source of advertisement. Its just not fair business practice. (speaking as someone with an MBA in my pocket) Business have a right too, just as well as consumers. The women who won that coffee burn lawsuit was ridiculous (stupid... use cup holders don't put a hot drink in between ur legs), as were the people who sued the tobacco companies. (who cares if smoking use to be thought of as harmless, every day things we think are harmless are being shown to be harmful...are we going to go sue all those companies as well?) WE decide what to do with our bodies and we can't throw the blame on any one else.

Thanks for replies everyone! I'd love to hear more, thanks for all the info and ideas! Papoose, when I said lap band diet, I was referring to the diet a website I found online that said I should try. It was something along the lines of a high protein/low carb diet for the first few weeks, then the liquid diet, then the soft foods, as well as keep the portions down to a few ounces.I didn't know much about it so I thought I'd ask around. As far as the food and alcohol goes, I'd be lying to say there wasn't a part of me that didn't want to go out with their friends once or twice a month, and there's absolutely nothing wrong with that as long as it's in moderation. I'll only be young once. I can deal with the smaller portions and giving up the alcohol the majority of the time, but not many people my age want to sit out on everything for the next few years. Maybe this means I'm truly not ready to commit. From what someone said above though, it does sound like there is some flexability if I do choose to have a lap band done where I could have my fun every once and a while. If this is true, maybe this is something I should look into more.

I think I know what she is saying. She wants to 'try' the pre-op diet we all are on before we get banded as a 'trial' to see if she can lose weight? Am I right? In anycase, we are on the pre-op for a reason: is to 'shrink' our liver before surgery. We will not be eatting like this for the rest of our lives. Once banded we will have what is called 'restriction' and will only be allowed to intake very small amount of foods in at a time. This is what gives ourselves the 'advantage' of loosing the weight and keeping it off. I know you said you are only 21 and still want to hang out and party. Understandably so, I know so many people banded and still continue with their daily lives. Yes, they go out and drink, party, eat, but its relatively in 'smaller' portions and when consuming alcohol you have to be super careful because drinks can easily add up to some pretty hefty calories and are loaded with sugar. Some of those yummy summer drinks can easily be over 800 calories for just one. Lastly, you really need to be ready to do this and have a good head on your shoulder when making this decision. Its not a miracle fix or cure, its a tool to help you lose the weight. My only advise to you because you are very young is to do more research on the lapband. go to youtube and watch the video about lapband surgery. Stay on this site and read read read. As said by Cazzy, I think some of the 'younger' bandsters could be of more help..... Best of luck to you in your decision -Patty

I think it's because the alcohol went down so easily. Carbonation, not a problem. Sugary combination, not a problem. Like I dipped my toe in the water and hoped I'd get bit by a shark. But, nah, the water's fine. Come on in. I didn't want to really know that I'd have zero reaction to a high sugar drink. I'm doing better today. And biked 10 miles at the gym so I'm feeling better about myself for at least getting my butt there and doing it. It reset my head. Today's a new day.

I haven't figured a way to cook for 1.5 people.... And for the past year my daughter and 18 month old granddaughter have been living with us... So i now cook for 3/4 which is most likely what i cooked for before. But I can honestly say my bill stayed about the same. If I was single I would be saving a bundle. What has gone down is eating out. When it just the two of us hubby eats like he did but I get an appetizer or something of the child's menu and no alcohol for me or sodas so our eating out bills have decreased dramatically. Also I used to spend at least $50 a week on lunches and that has dropped dramatically to basically nothing. However once in a while I will go out with coworkers for a treat but my bill is usually under 5$ depending on where we go.

I'm planning on drinking coffee after I have my sleeve (on Tuesday...eeep!). My surgeon said decaf is ok right away, and try to wait 3 months on the caffeinated stuff, along with alcohol and carbonated beverages. I can't wait to have my beloved nonfat cappuccino with breakfast again...got hooked on them in Rome two years back. Being in the Seattle area, I think there would be an uproar if a surgeon suggested we ban coffee from our diet entirely...he'd/she'd probably go out of business! That being said, if it were essential to maintain your sleeve health, I don't think they would hesitate to make coffee restriction mandatory. I think the key is everything moderation, take it easy and listen to your sleeve!

Hi, I'll certainly answer your questions. Hope it helps! 1. How long have you had your band? Since September, 2008, which would be two years, 3 months. 2. How much weight have you lost? 70, then I kind of didn't pay attention because I had other surgery which distracted me, now I've lost an additional 10 3. How many fills and unfills did you get until you found the "sweet spot"? I've had three fills, no unfills. 4. If you stick to a particular diet (ie weight watchers, low carb, atkins, etc) which on works for you? No, just watch calories. 5. How often do you exercise? Need to start up again... 6. Does anyone do Yoga and how long did you wait until you started practicing again? No 7. Do you ever drink alcohol? No 8. What foods give you a problem? More than 1/3 piece of bread, sometimes chicken and turkey, definitely rice 9. Does your port stick out? No 10. How much water do you get in each day? 4 bottles religeously 11. Any tips that will help on the journey? Stick to it, it works if you work it!! Great questions, made me think...

Hope you get some help for your health issues. Even if they are not caused by the alcohol your weightloss will definitely suffer eventually from the alcohol.

I had a drink a few weeks ago for a concert (beyonce).. I was 7 weeks out, had a bottle of wine... I was able to tolerate alcohol just as easy as before, and I'm still standing. People like to Put the fear of God into new bariatric patients to try and get you to live a holy life of Protein and veggies... I'm young, I like to enjoy my life. Drinking is fine, of course in moderation. Glad all went okay! Sent from my iPhone using the BariatricPal App

That's true @@LipstickLady and I know it's silly. Really it is. I have indulged in the past with a few of the couples at various times so I guess it just seemed odd that I wasn't drinking and I didnt want to have to explain so I just pretended to drink. We were supposed to hang out until all the alcohol was gone. Every couple had a bottle... next time I'll probably just say no. It's really silly to go through all that.

That's interesting perspective. I'm not totally sure I agree with you. I cook a lot and 20 minutes is not really realistic. And then there is the shopping and the planning. Yes it is better to cook a huge batch and freeze it and I will do that when I can, but that's not always realistically going to happen, especially when I go back to school (I am a teacher). I didn't get fat primarily from fast food, I got fat because I'm a great cook and could never figure out how to cook for one. That's not going to get any easier with the micro portions I can have now. I think a certain amount of practicality is important. Yes I admit I am an addict. But what makes food addiction the most difficult addiction (IMO) is the fact that you can't just stop eating like you can with drug or alcohol addiction. I feel like I need to have "safe foods" I can get on the go and not just tie myself to my kitchen.

Also suppositories (for nausea) should calm it down so you can eat much more. Eating so little is most likely contributing to it and you are in a vicious cycle. Keep looking for answers. I had nausea & food aversions for a few weeks (my Cpap machine was filling me with air) and I had the nurse and my surgeon on speed dial until we figured it out! It took many phone calls, a barium swallow and 2 weeks but we found the problem. Best wishes! Ps. In the meantime I hope you are doing the usual home remedies. Drinking warm peppermint tea, smelling rubbing alcohol, adding some fresh ginger to your tea etc.

I asked my dr that and he said yes. The contradiction comes in on sweet things. Atkins markets those with net carbs as well but they count sugar alcohols or something similar. Those don't count. It's always carbs minus fiber.

Aaah, Melbourne has been in extreme shut down for ages so they’re not open for dining. Attica was listed as one of the top 50 restaurants in the world until last year & Vue de Monde’s been best restaurant in Aust a few times. Honestly, I can’t justify paying $250 -$300+ for a meal of which I’ll eat 1/3 now even if it’s fabulous. Though, at least I’d save on the alcohol part of the bill these days - lol. Last time we went to V de M, we left >$500 a head poorer. Was worth it though.

@adiosannie300 while this may sound harsh people who truly care about you will be supportive. I have run into people who seem very upset by the fact I will no longer eat sweets, breads or drink alcohol.. it bothered me for a bit but when I thought about it.. they are just upset with themselves that they have not made the changes in their lives and I will not sabotage myself for anyone. True friends will support you on your endeavors and encourage you to do the right thing! I hope we all have more of those types :)

<TABLE width="100%" border=0><TBODY><TR><TD colSpan=2>The social and psychological consequences of obesi </TD></TR><TR><TD>Our society has a very negative view of overweight and obesity. Research evidence of stigma and discrimination agrees with the public values and attitudes commonly expressed by the media. They tell us that being fat is an extremely unattractive and undesirable way to be, indeed, that it is a state to be avoided at all costs. This hostility towards fatness has been compared with other common social prejudices, and the striking conclusion drawn that anti-fat attitudes are at the stage that racism was some 50 years ago; namely, that anti-fat attitudes are overt, expressible and widely held. The perception of obesity This derogatory view of obesity is not new. Some of the earliest research, published in the 1960s, examined children’s attitudes, presumably because they openly reflect prevailing adult opinion. In one of these studies 10- and 11-year old children were presented with six line drawings of a child as physically normal and with each of five physical disabilities, one being overweight. Ranking the figures by asking which they liked best resulted in a robust order of preference, with the normal child at the top, and the overweight child at the bottom, below that of a child with facial disfigurement, in leg brace and crutches, or in a wheelchair. In a second study children were asked to assign 39 adjectives to one of three silhouette drawings depicting a thin, a muscular, and a fat body shape. The obese body shape was least frequently assigned ‘best friend’, most frequently ‘gets teased’, and labelled ‘lazy, dirty, stupid, ugly, liar and cheat’ more often than the other body shapes. Subsequent research has confirmed both this order of preference and these perceived negative character traits, broadly describing the obese stereotype as greedy, lazy, of lower intelligence, and socially isolated. It also suggests that the negative response has increased rather than relaxed as might be expected given the increasing levels and public face of obesity. These two studies are important since they describe two principal features of the stigma of overweight. On one hand is the stigmatisation of bodily appearance; obesity is a highly visible but undesirable state. On the other, is the stigmatization of character; the moral view that holds the obese personally responsible for their own state and so blames them for their fatness. Further research with children has extended this characterisation and shows that even pre-adolescents have incorporated the message of poor health, fitness and eating habits in their attributions of overweight. Likewise, there are social class variations in these negative views, with the least favourable attitudes more likely to be expressed by children from higher social class backgrounds. During adolescence overweight may be an important determinant of social experience. Overweight adolescents, for example, receive fewer friendship nominations than lean peers and are less likely to be named as a friend by people they nominate. In addition, teenagers express discomfort with dating overweight peers, something particularly strongly expressed by boys. This confirmation of overweight as unattractive, unhealthy, and least acceptable in affluent social circles goes some way to explaining the high levels of body shape dissatisfactions and dieting in pre-adolescent and teenage girls. </TD><TD> </TD></TR><TR><TD> Download File </TD><TD> </TD></TR><TR><TD colSpan=2>Obesity and psychological health </TD></TR><TR><TD>Given the above catalogue of stigmatisation, a state of poor psychological health would be expected for all obese individuals. However, this is not the case. The variation in psychological adjustment among the obese is broadly comparable to that in the population at large. And there is certainly no major psychiatric disorder or specific personality disorder associated preferentially with obesity. However, there is an emerging literature linking obesity with depression. In one study, for example, over 40,000 adults were given a structured interview including an assessment of anxiety and depression as part of a National Alcohol Survey. Obesity was associated with a 37% increased risk of major depression in women but a 37% decreased risk of depression in men. There was a similar association between obesity, gender and suicide attempts – obese women at increased risk, obese men at decreased risk. Furthermore, although the association between female obesity and depression was rather modest in epidemiological terms, the researchers had controlled for depression co-occurring with physical illness or bereavement. When these were included the association between obesity and past-year depression further strengthened. In another large scale community survey in the US, obesity was significantly associated with past-month depression in women (odds ratio = 1.82) but not in men. Furthermore, there is longitudinal evidence that in people aged over 50, obesity increases the risk of developing depression. The relationship between obesity and self-esteem is not clear-cut either. In adults, obesity is associated with a modest reduction in self-esteem, sometimes limited only to those with morbid obesity. In pre-adolescent children, obesity has little or no impact on global self-esteem. In teenagers, self-perceived overweight is more closely associated with reduced self-esteem than is actual overweight. Similarly, this relationship is stronger in females than in males. Body esteem, or satisfaction with appearance, is the domain of self-worth most affected by obesity. This is especially true for obese adolescents and young women whose sense of identity is greatly dependent on appearance and in whom some show very high levels of body dissatisfaction. Again, body dissatisfaction may be more strongly associated with perceived overweight and depression, than with actual weight. Therapy aimed at improving body image in obese women has shown some success in relieving negative psychological symptoms but has little impact on body weight. Further studies of large representative samples using established measures of health-related quality of life have helped separate physical functioning from psychological health, while showing their inter-dependence. Age is an important moderator of the relationship between obesity and well-being. Overweight and obese women in their late teens and early twenties score significantly lower in physical functioning, vitality and general health, but show few differences on any of the main psychological health measures. The pattern for middle-aged women (45-49) is different. First, there are proportionately more overweight and obese women in this age group. Second, these older obese women score significantly lower than those of average weight on all the physical and psychological health scales. Most of the available evidence shows the greatest deficits are in the severely or morbidly obese (BMI>40). Scores on the psychological health scales for the moderately obese (BMI 30-40) show similarity to those who are underweight (BMI<20), whereas overweight women show similarity to normal weight individuals. It is also important to take account of the co-occurrence of chronic illness. In one study, people with obesity plus other chronic health conditions (around half the obese) reported particularly poor physical and psychological health. Since this was most apparent in those with 3 or more chronic conditions it identifies an especially vulnerable group. It is also notable that among groups of people with similar levels of chronic illness, the additional presence of obesity was associated with a significant deterioration in physical but not emotional well-being. This means that past assessments of psychological well-being may have been confounded by physical health problems. It also shows that obese individuals with pain or co-occurring chronic illnesses are most at risk of psychological distress. </TD><TD> </TD></TR><TR><TD colSpan=2>Binge-eating disorder </TD></TR><TR><TD>Binge eating is one clinical problem that does appear to be more prevalent in the obese, at least in those entering weight loss programmes. The recently described syndrome of ‘binge eating disorder’ (binge eating without purging by vomiting or other means) has been described in 30% of patients attending US weight loss clinics. The use of strict diagnostic criteria reduces this to well below 20%. In community samples, BED is much less common, apparent in only 1-3% of respondents. Overall, the prevalence of BED in any group increases with increasing obesity. Interestingly, up to half describe their binge eating as preceding their obesity, rather than arising as a consequence of extreme dieting, the pattern most commonly found in bulimia nervosa. Attitudes of health professionals Given what has been written above it should be no surprise that the attitudes and beliefs of health professionals reflect those of the wider community. Thus research shows that doctors and medical students are likely to share the moralistic view that obese people are weak-willed, ugly, less competent and likeable, and less likely to benefit from counselling. Bias has also been observed in nurses and nursing students, nutritionists and psychologists. Even health professionals who specialise in obesity show anti-fat biases. They mask overtly negative responses but measures of implicit attitudes reveal the culturally prevalent stereotyping. One important question is whether professionals’ views of overweight have consequences for the medical process. Some time ago it was noted that doctors were more likely to note a weight problem and recommend a treatment programme for women than men. More recently, obese women were found more likely to be misclassified as having coronary heart disease than non-obese women. In addition, the prescribing of lipid lowering medication by British general practitioners has been found less likely in overweight people, with doctors explicitly stating this as their policy. However, the most apparent consequence is the reluctance of obese individuals to seek medical care. This is not restricted to consultations about weight loss but has been observed in decreased use by obese women of preventive health care services such as breast screening. This reluctance could be because obese individuals are aware of the negative attitudes of medical professionals towards people such as themselves. It also may be the result of body self-consciousness, or past experience of health professionals attributing health problems to the obesity. Additionally, doctors may be disinterested in managing overweight patients, in part based on their perceived futility in bringing about weight loss in a group with little presumed will-power. </TD><TD> </TD></TR><TR><TD colSpan=2>The effects of weight change </TD></TR><TR><TD>The effects of weight loss on improving feelings of well-being and self-esteem have been reported many times. This may be especially marked when some form of physical exercise or activity has been part of the weight loss strategy. Indeed, relatively modest reductions in weight can improve general psychological health. However, the mixture of individuals who enter a weight control programme will experience a mixture of psychological repercussions. These will include, pride in their success and a feeling of mastery, annoyance at the difficulties in adjusting their routine to ensure weight loss, despair at apparent failure, and anger and frustration at the effort that has to be expended. Significant and sustained weight loss is not easy for the great majority to achieve. Weight regain is usually associated with loss of psychological gains, although one study at least has shown the psychological benefits of weight loss to remain with full weight regain. The relationship between weight loss and mood is a complicated one and an issue that is not limited to obesity. Of relevance here though is the observation that greater and faster weight losses are associated with poorer mood outcomes. Specifically, nearly half of the studies with a mean weight loss of greater than 9 kg (20 lb) have reported aversive mood consequences. In contrast, there are none in those with smaller weight losses. A related issue is that of weight cycling, or the phenomenon of repeatedly losing and regaining weight, noted as frequent in both overweight and non-overweight individuals. The very few studies that have examined the psychological consequences are consistent in showing that those with a history of weight cycling have significantly more psychological problems, lower levels of satisfaction with life, and more eating disorder symptoms than those who are weight stable. In addition, obese binge eaters have been found to have more past weight cycling episodes than obese non-binge eaters. However, the research cannot yet distinguish whether it is the weight cycling that causes these psychological problems, whether the problems themselves lead to intensified dieting but weight regain, or that weight cycling and psychological problems are correlated but not causally related. Attempts to identify psychological predictors of weight loss have not met with great success. As the preceding account implies, the presence of depression, anxiety or binge eating is associated with poorer weight loss, although again findings are inconsistent. Similarly, summary measures of readiness to change or motivation to lose weight have generally failed to predict outcome. In contrast, self-efficacy – a person’s evaluation of whether s/he can perform the behaviours required for weight loss – is a modest but consistent predictor of success. The need for change Obesity can have devastating psychosocial consequences. However, the mechanisms to impaired psychological health are different from those to physical illness. Two prominent researchers in the field, Stunkard and Sobal make the point very bluntly: ".... obesity does not create a psychological burden. Obesity is a physical state. People create the psychological burden." Changing people's attitudes and thus those of society will not be easy. But the analogy with racism could be used as a starting point for identifying those strategies that have been most successful in the past, and by learning from their outcome. The combination of education, science, good practice, changes in legislation, and a promotion of tolerance, are all necessary to meet this goal. The inclusion of psychological well-being as an obesity treatment goal, the activities of patient support groups, the development of training packages for health professionals, prosecutions for false weight loss product claims by trading standards officers, and test cases for discrimination under employment law would all be steps in the right direction. </TD></TR></TBODY></TABLE>