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We are pleased to respond to Keith Bachman, MD's comments on our recent description of our extensive experience with treating obesity in the Southern California Permanente Medical Group San Diego area. Dr Bachman's comments represent the usual views about treating obesity, a serious problem that is generally not handled easily or well.
Although we believe we made these points clearly, we also understand that they lie sufficiently outside conventional thinking about obesity that they perhaps need restatement in different ways. To that end, one of us (AR) has extended an offer to Dr Bachman to again visit the San Diego Positive Choice Program to see in action what we are describing.
Any major revision of commonly held ideas is difficult, uncomfortable, and sometimes threatening. The philosopher, Eric Hoffer, explored this problem well in his small monograph, The Ordeal of Change.2 In that regard, The Permanente Journal offers us all in Kaiser Permanente an important sounding board for the introduction of new thinking into an old problem that is obviously getting worse in the face of usual approaches, even though those approaches are supported by august governmental agencies.