The Pol-e-Pill Finally Arrives

  1. James A. Levine1 and
  2. Ronald M. Davis2
  1. 1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
  2. 2Center for Health Promotion and Disease Prevention, Henry Ford Health System, Detroit, Michigan
  1. Corresponding author: James A. Levine, levine.james{at}

The global obesity epidemic affects billions of people (1), and, in its wake, a worldwide epidemic of type 2 diabetes has followed (2,3). Obesity is not only associated with diabetes, of course, but also with the other partners in the X-gang: hypertension, hyperlipidemia, and cardiovascular disease (4). As exemplified in an original article in this issue of Diabetes (5), the link between diabetes and obesity continues to be scrutinized in detail. In the wake of this metabolic catastrophe, the ill effects of joint pain, degenerative arthritis, and sleep apnea ensue (6). A ripple of despair similarly washes over the oncology community, who now realize that the global tragedy of obesity claims cancer lives too (7–10). “But how about us?” the immunologists (11) and vascular (4) specialists cry; obesity dulls the body's response to infection, impairs wound healing, and, consequently, diminishes reproductive capacity (12).

All of this is important, but none of it matters to Keith Mitchell, who expresses his frustration to his impotent physician, “Doc, I've tried every diet on earth. Why can't you help me?” (13). Keith returns home bereft of hope to later apologize to his children, with whom he is too tired to play (14), and to his wife, whom he feels …

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