This January, there was a small eruption in the television and celebrity gossip world. Simon Cowell, the judge on American Idol we all love to hate, announced he was finally stepping down. Obviously, life without having Paula Abdul to mock was not worth living. So what is it about Cowell that has made him a star? Never underestimate the importance of culture. As a Brit, he’s used to speaking his mind. If someone can’t sing in tune, he tells them straight out. More to the point, he expects those on the receiving end of his words of wisdom to take his constructive comments and advice calmly, and has no patience with those who throw a hissy fit. What America fails to recognize is that, back in Britain, Cowell is in the mainstream. His willingness to talk to and with people openly is normal. Here in the US, we are too wrapped up with the idea of politeness. It’s not socially acceptable to tell people they have no talent. You’re supposed to find good things to say about them — emphasise the positive, eliminate the negative as the old song says. In some ways, this cultural unwillingness to challenge people’s understanding and perceptions can be very dangerous.

Like the majority of countries around the world, the US is facing an epidemic of obesity. For the record this means one of two things. Either people have a body mass index (BMI) of 30 or more, or they have a BMI of 27 or more and are already ill with at least one of the diseases or disorders associated with obesity. Yet the latest survey finds primary care doctors in the US unwilling to talk to their patients about losing weight. Even though they know their patients’ health is at risk, they cannot bring themselves to "accuse" people of being overweight. That’s where Cowell’s attitude becomes so important. People should be told the truth about themselves, particularly if this could help save their lives. Where would we be if doctors failed to tell us when we had cancer or heart disease? This news gives them the chance to have treatment to extend their life expectancy. Doctors give these diagnoses without fear. They should do the same when it comes to obesity and the dramatically increased risks of diabetes, cancers and heart disease.

So what should doctors do? First, they should educate. This is not lecturing and judging, but explaining how excess weight relates to other diseases. Secondly, they should look for ways to motivate their patients, setting realistic goals and praising people when they succeed. Finally, this should be a team effort in which dieticians, physical trainers, nursing practitioners and community outreach staff join together with the community to beat the weight problem. Assuming everyone in the program remains positive and emotionally well-balanced, the research evidence shows acomplia usually helps people lose an average of 10% in their body weight. More importantly, a significant number of people do not immediately put weight back on — the cycle of weight loss, weight gain and weight loss damages your body. Acomplia is one of the appetite suppressants and, if people no longer feel hungry, they stay motivated to eat less. As an aside, it is also a useful drug to help people quit smoking but, like all drugs, there are costs as well as the benefits. You should not use this drug if you are depressed.