Obesity is becoming the biggest threat to health in the developed world, and a practical answer to the obesity epidemic is slow in coming. At the extreme end (“morbid obesity”), surgery is successful, but it cannot be a population-wide solution. A less drastic option for this group is suggested by an Italian trial where 24 morbidly obese people were randomised to receive topical intragastric botulinum toxin or placebo (Int J Obes 2007;31:707–12). There was an average weight loss of 11 kg at 8 weeks in the active drug group, but we will need evidence from bigger and longer trials before setting up endoscopy clinics with a long row of oversize chairs. Obese Japanese women can reduce their weight and cardiovascular risk by drinking green tea with a high catechin content, according to a randomised trial (Obesity 2007;15:1473–83), and similar benefits can be achieved by a low glycaemic index diet, according to a Cochrane review (2007;CD005105). A similar diet may also help to clear acne (Am J Clin Nutr 2007;86:107–15).

Meanwhile, those of us who go about …