Obesity is the toughest behavior/disease/epidemic that our healthcare system will ever have to face. No drug that has a 90% failure rate would ever be cleared by the FDA yet we try to put our patients on diets, all that time knowing that we would be even lucky to get 10% to follow it. We are in for a world of hurt. In the past ten years, the rate of diabetes has doubled and this is all being blamed on our weight gain. I do not have the answers on this one. I have struggled as a doctor to help my patients in the areas of cholesterol and diabetes. Unfortunately, the "First Farrago Rule of Medicine" applies: "there is no amount of oral diabetes meds, insulin or statins that a patient can't out eat". Patients have been eating a certain way for so long that change is hard. Eating less is painful. We want to be comfortable and happy and many of us use food to create these emotions. Losing weight means major change without quick fixes and many patients think that our medicines can substitute for proper diet and exercise. It doesn't work that way and studies are showing the costs of patients not taking their health into their own hands. Until this country reduces this biggest of our carbon footprints (obesity), then there is no possible way of healing our healthcare system.