The humbling experience of treating obesity: Should we persist or desist?

Obesity has humbled one research group after another. Some of the field's brightest scientists have attempted to subdue obesity by treating it, but now, after decades of work, treatment gains remain small, maintenance is poor, and the field produces effects far below what patients want or expect. This can be explained by strong biological and environmental forces that oppose weight loss and foster regain. Attempts to improve treatment must continue, but with recognition that treatment is a clinical measure and will not affect prevalence (because treatments are too expensive to be used broadly). Policy change and prevention will be necessary to improve public health.