[Debbie L.]

Interesting thread, I don't know how I missed it before.

A few things that occurred to me as I read.

First, it's not so simple as fat/estrogen. We don't really know the whole story yet but it's probably at least as much elevated insulin levels in response to too many simple carbs (insulin resistance/type II diabetes).

And second, it's not enough just to say that providers should encourage weight loss, and provide evidence, etc. Sadly, that just doesn't seem to work at all, for most people. In addition, again sadly and frustratingly, diets just don't seem to work longterm for most people. "Rethinking Thin" by Gina Kolata (a health writer for the NYT) is one book that looks at the issue of weight control in our society of plenty. It's an easy and interesting (albeit discouraging) read.

I'm not sure if there ARE answers, but it seems to me instead of just keeping on with telling people they should lose weight (no matter HOW we say that), it's time to reroute all that effort into figuring out what might actually work in getting the result everyone wants (longterm weight control and/or loss).

And my gut preference would be that we find a way that each person has individual control over -- not surgery nor drugs. One way to start that process might be by trying to get society to demand healthier foods -- fewer processed "foods" and fewer simple carbs (which are usually the same thing). This will be a hard task, as the food industry makes most of its money from processed things that our ancestors would not even have recognized as food.

Like I said, no answers from me. But an awareness that this is a complex issue. Obesity, although important to cancer, is a much larger influence on other deadly diseases -- so finding ways to decrease its incidence would benefit us (the big "us", all of society) in so many ways.

Debbie Laxague