Research by Michael Dansinger and his colleagues at Tufts-New England Medical Center in Boston, published in The Journal of the American Medical Association (JAMA) in January 2005 showed that it is not the diet that determines how much weight you lose, but the rigour with which you adhere to it. They followed 160 overweight or obese adults aged 22-72 who each had high blood pressure, high blood sugars, high cholesterol or other health problems and who were randomly allocated to one of the four diet programmes. No statistical difference was detected between four popular diet plans, including the Atkins diet, Weight Watchers, Ornish and Zone diets. The findings were that, whilst there was no difference between them. To quote: "We found that a variety of popular diets can reduce weight . but only for the minority of individuals who can sustain a high dietary adherence level. The higher discontinuation rates for the Atkins and Ornish diet groups suggest many individuals found these diets to be too extreme." Also to quote, Robert Eckel of the University of Colorado offers a simple answer to those seeking guidance through the plethora of modern diets. "The best way to lose weight is to reduce calories and increase exercise." Whilst this may be the case, there is incontrovertible evidence to show that, in rare cases, individuals have a genetic disorder which affects their appetites and who present as children with morbid obesity. These children do no experience satiety and will eat until they simply cannot physically consume more food. Some of these have been found to have absent Leptin, a protein that can now be delivered by injection. Great success has resulted from this treatment and the children have returned to normal body weight (O’Rahilly et al …). In the worst cases, parents are vilified for maltreating their children by over-feeding them and in one known case a child was removed from her mother, the mother having been accused of Munchausen's Disease by Proxy. Children with this abnormality do not survive into adulthood without treatment. More genes are being discovered which have an association with the feedback loop associated with appetite. Yes, it is true that reduced calorie and increased exercise intake will lead to reduced weight; however, it is undoubtedly the case that many individuals will be found to have some sort of genetic mutation which makes them hungry. Those who are thin and active will be unlikely to experience hunger in the same way. It will be good, when this happens, to see the end of the culture that leads to the obese being labelled as gluttonous and slothful.