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Obesity, the stepchild of American medicine, may be the only remaining medical condition in which patients are stigmatized and their physicians disparaged. Few members of the medical profession profess to treat obesity, and many of those who do are marginal "diet doctors" or proprietors of pill mills. Treatment has always had limited effectiveness, and for some time it has largely been out of the hands of physicians. Psychologists, for example, developed the first systematic treatment for obesity behavior therapy and commercial weight-loss organizations have used this method to dominate the treatment of obesity in America. Most Americans who
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