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To the Editor The Viewpoint by Dr Massetti and colleagues emphasized the link between obesity and cancer and called for more robust clinical intervention to prevent and treat obesity. 1 The authors proposed that sustainable weight loss be achieved by comprehensive strategies that support patients’ efforts to make significant lifestyle changes. However, most published studies have shown that the long-term success rate of lifestyle changes is low. Although lifestyle changes may be sufficient to reduce body weight prior to sustained obesity, once obesity is established, body weight seems to become biologically fixed and lifestyle programs become less effective. 2
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