On the other side of the equation, "self-disgust" could decrease energy — no matter how much sweat there is little to show for it. Being critical of self could fuel belief that even if the "workout" trims the waist, a person will not be liked or good enough. Being afraid of change and destroying the hiding place of obesity can also slow down any exercise.

So there is a need for some more "self-loving" and less "self-loathing" for the overweight. Loving oneself may be a first for some people. Unpracticed souls need to love every day in multiple for self-acceptance to stick — "Thou shalt love thy overweight self as thy overweight neighbor" may be a modern translation of timeless counsel.

Learning to love fat in order to get rid of it may be counterintuitive, but hopefully learning to love oneself feels as natural as eating fruits and vegetables and walking in the park.

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Joseph Cramer, M.D., is a fellow of the American Academy of Pediatrics, practicing pediatrician for more than 25 years and an adjunct professor of pediatrics at the University of Utah. He can be reached at jgcramermd@yahoo.com.