Obesity drugs grow as fat society's crutch

As Americans get fatter and fatter, a healthy diet and regular exercise are
giving way to an easier - albeit more costly - approach to staving off
obesity-related illnesses: prescription drug therapy.
More and more, overweight Americans are being prescribed drugs to treat the
conditions that can lead to diabetes, heart disease and stroke. These are
not drugs that actually help you drop pounds. Instead, they allow people to
maintain their unhealthy habits and sidestep early death.

Bolstered by studies that show the success of aggressive drug therapy for
elevated blood pressure and abnormal cholesterol levels, some doctors are
pushing for greater reliance on drugs for a younger, much larger
population.

"Many health care professionals have thrown in the towel with lifestyle,
saying we can't get our patients to change their behavior - eating right
and exercising - so we have to go strictly to the medications," said John
Foreyt, a clinical psychologist and director of the Behavioral Medicine
Research Center at Baylor College of Medicine in Houston who works with
diabetics. "We are treating the symptoms, but we are not getting at the
real cause."

On the other side are those who say it's great to tell everybody to lose
weight and live healthy - but not realistic. For most people, these doctors
say, the choice is medication or early death.

"A patient comes in and has coronary artery disease. I can wag my tongue at
them, scold them and tell them they need to change their lifestyle," said
Dr. Steve Nissen, a cardiologist at the Cleveland Clinic in Ohio. "What
percentage actually do? Very few. Until we come up with other solutions,
drugs are a reasonable approach.

"I don't think it's a bad thing. It's a good thing. While it does allow
them to live a bad lifestyle, it partially reduces the harm they do to
themselves."

In fact, say Nissen and others, there is evidence that in some cases drug
treatment works better than exercise and diet alone.

"Primary-care doctors emphasize lifestyle, lifestyle, lifestyle - which is
not bad - but their hesitation to turn to drug therapy is too high," said
Dr. Christopher Cannon, whose recent study found that the risk of a second
heart attack was reduced by 50 percent in people who were given
higher-than-normal doses of the cholesterol-lowering drug Lipitor. "In
fact, they go together."

Cannon is among those who say that while there is no definitive research on
the issue, he foresees a day when people at all levels of risk will take
statins - a class of drug that reduces cholesterol - much as they would a
multivitamin. "It's not a bad idea," he said.

For its part, the pharmaceutical industry is banking on an acceleration of
the nation's obesity epidemic and the American penchant for a quick fix.

The two top-selling drugs in the United States last year were statins,
accounting for 6.4 percent of all drug sales and 3.7 percent of all
prescriptions, according to IMS Health, which tracks pharmaceutical sales.
Calcium blockers, beta blockers and ACE inhibitors for high blood pressure
accounted for 4.3 percent of the market and 9.1 percent of prescriptions.

The conditions that put people at risk for heart disease and type 2
diabetes are so common that, when combined with a big belly, they've been
given a name: "metabolic syndrome." The problem is estimated to affect one
of every four American adults.

Although there are no drugs approved specifically for use against metabolic
syndrome, market researchers recognize a potential gold mine.

In an analysis published in February for D&MD Publications, which does
pharmaceutical industry research, authors Sreten Bogdanovic and Beata
Langlands reported:

"Specific components of the syndrome ... represented a $54 billion
worldwide market in 2003 and are forecast to grow to $98 billion by 2008.
The emergence of the metabolic syndrome ... is predicted to have profound
implications for developers of all drugs."

A big part of the sales increase stems from treatment guidelines adopted in
2001 that lower the threshold at which cholesterol is considered abnormal
enough to warrant drug treatment. Between 2000 and 2003, sales of statins
jumped from about $9 billion in the United States to nearly $14 billion.

Analysts and physicians alike are especially excited about drugs that
tackle more than one obesity-related condition in a single pill.

The Food and Drug Administration in February approved Caduet, made by
Pfizer and the first drug to treat both high cholesterol and high blood
pressure. AstraZeneca's Galida, used to lower blood glucose and cholesterol
in type 2 diabetics, is going through its final tests in patients
worldwide.

The breathless enthusiasm with which many doctors and researchers look to
drugs as the answer troubles some in the medical community.

Art Caplan, a bioethicist at the University of Pennsylvania, said the
emphasis on drugs shifts responsibility from the individual, the food
industry and society at large, to the medical profession.

"People love to find a quick fix. They can say, 'Oh, well; I'm not
indulgent, I'm just sick,' " Caplan said.

"The U.S. is suffering from a severe case of medical addiction. We are in
love with the idea that medicine can bail us out of all kinds of woes,
ailments and problems. And even though we complain the costs are killing
us, we can't stop."

Part of the problem, said Cindy Moore, a registered dietitian and
spokeswoman for the American Dietetic Association, is that physicians are
not trained to help people change their lifestyles.

"Having a physician tell a patient 'you need to lose weight and lower your
cholesterol' isn't going to provide them with the specific tools they
need." She added that most insurance plans allow someone to see a
registered dietitian only if they already suffer from chronic diseases.

Studies show that only 2 percent to 5 percent of people who try to lose
weight on their own are successful at keeping it off long-term. So some of
those pushing to address obesity through lifestyle changes are themselves
using a highly "medicalized" approach.

The Coronary Heart Disease Reversal Program at UC Davis pulls in doctors,
dietitians, therapists, exercise physiologists and high-tech machinery for
a multipronged attack on the underlying factors that lead to illness.
Patients already suffering from obesity-related conditions also are
prescribed drugs, but the goal is to reduce or eliminate reliance on
medication.

For many in the program, it took serious illness to motivate them to make
changes.

Even with a diagnosis of type 2 diabetes, said Davis resident Charlotte
Maggard, 64, it took her eight years to commit to giving up junk food and
getting some exercise.

"When you first learn about it, you are kind of in denial," she said. But
over the years, the diagnoses - and drugs to treat them - mounted: high
blood pressure, high cholesterol, diabetes-related vision deterioration and
heart problems.

Since joining, she has quit eating red meat and lost 10 pounds. Her goal,
she said, "is to get off the medication."

Similarly, Sacramento resident Michael Guzman, 51, said that following his
heart attack in 1999, he tried to get more exercise, but didn't stick with
it. Despite being diagnosed with diabetes, he couldn't quit his barbecued
pork habit and at one point weighed 291 pounds.

Since joining the UC Davis program two months ago, he has sworn off all
forms of meat. On a recent visit to the Sacramento Natural Foods Co-op with
other patients, he filled his cart with products such as tofu ravioli and
fat-free refried beans.

"I'm finding there are a lot of foods that are real tasty," he said.

Dr. Tissa Kappagoda, the cardiologist running the program, said the diet
and exercise regimens are proven to work.

He followed a group of his own patients for 10 years and found that those
who stuck with the program for two years had a significantly lower
incidence of major heart attack or stroke. In addition, he said, 80 percent
of the dropouts were taking medications to lower cholesterol compared with
40 percent of those who remained in the program the full two years.

"We are living in an environment where you think drugs will solve every
medical problem," Kappagoda said. "But these are diseases of lifestyle. ...
Keeping people obese and alive with medication really doesn't, in my view,
address the issue."

-----BEGIN PGP SIGNED MESSAGE-----
Hash: SHA1

On 14 Apr 2004 03:43:29 +0200, Dorsey Griffith
wrote:

Picky, picky, picky... those fat folk can't do anything right. Why are you using
an anon remailer if you really believe in posting this off-charter baloney from
God's eyebrow to the devil's asshole? Is it because you are a liar as well as a
thief? (you are stealing bandwidth) and a coward?

Another idiot has been hatched folks.

I even think we all know who it is too....

LV


Lady Veteran
- -----------------------------------
"I rode a tank and held a general's rank
when the blitzkrieg raged and the bodies stank..."
- -Rolling Stones, Sympathy for the Devil
- ------------------------------------------------
People who hide behind anonymous remailers and
ridicule fat people are cowardly idiots with no
motive but malice.
- ---------------------------------------------
"To Do Is To Be" Socrates
"To Be Is To Do" Plato
"Do Be Do Be Do" Sinatra
- -------------------------------

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Good article.

Too many people want an easy out and doctors are all to happy to oblige. Be
it hyperactivity in children or being fat, people want an instant pill to
cure things. Forget getting to the root of the problem, just give us drugs
so that we can continue not being responsible for ourselves.

Tis a good thing that those of us in this group know that there's a better
way. (:

---
CGV
258/233/180
Since 4/23/04
"Dorsey Griffith" wrote in message
...
As Americans get fatter and fatter, a healthy diet and regular exercise
are
giving way to an easier - albeit more costly - approach to staving off
obesity-related illnesses: prescription drug therapy.
More and more, overweight Americans are being prescribed drugs to treat
the
conditions that can lead to diabetes, heart disease and stroke. These are
not drugs that actually help you drop pounds. Instead, they allow people
to
maintain their unhealthy habits and sidestep early death.

Bolstered by studies that show the success of aggressive drug therapy for
elevated blood pressure and abnormal cholesterol levels, some doctors are
pushing for greater reliance on drugs for a younger, much larger
population.

"Many health care professionals have thrown in the towel with lifestyle,
saying we can't get our patients to change their behavior - eating right
and exercising - so we have to go strictly to the medications," said John
Foreyt, a clinical psychologist and director of the Behavioral Medicine
Research Center at Baylor College of Medicine in Houston who works with
diabetics. "We are treating the symptoms, but we are not getting at the
real cause."

On the other side are those who say it's great to tell everybody to lose
weight and live healthy - but not realistic. For most people, these
doctors
say, the choice is medication or early death.

"A patient comes in and has coronary artery disease. I can wag my tongue
at
them, scold them and tell them they need to change their lifestyle," said
Dr. Steve Nissen, a cardiologist at the Cleveland Clinic in Ohio. "What
percentage actually do? Very few. Until we come up with other solutions,
drugs are a reasonable approach.

"I don't think it's a bad thing. It's a good thing. While it does allow
them to live a bad lifestyle, it partially reduces the harm they do to
themselves."

In fact, say Nissen and others, there is evidence that in some cases drug
treatment works better than exercise and diet alone.

"Primary-care doctors emphasize lifestyle, lifestyle, lifestyle - which is
not bad - but their hesitation to turn to drug therapy is too high," said
Dr. Christopher Cannon, whose recent study found that the risk of a second
heart attack was reduced by 50 percent in people who were given
higher-than-normal doses of the cholesterol-lowering drug Lipitor. "In
fact, they go together."

Cannon is among those who say that while there is no definitive research
on
the issue, he foresees a day when people at all levels of risk will take
statins - a class of drug that reduces cholesterol - much as they would a
multivitamin. "It's not a bad idea," he said.

For its part, the pharmaceutical industry is banking on an acceleration of
the nation's obesity epidemic and the American penchant for a quick fix.

The two top-selling drugs in the United States last year were statins,
accounting for 6.4 percent of all drug sales and 3.7 percent of all
prescriptions, according to IMS Health, which tracks pharmaceutical sales.
Calcium blockers, beta blockers and ACE inhibitors for high blood pressure
accounted for 4.3 percent of the market and 9.1 percent of prescriptions.

The conditions that put people at risk for heart disease and type 2
diabetes are so common that, when combined with a big belly, they've been
given a name: "metabolic syndrome." The problem is estimated to affect one
of every four American adults.

Although there are no drugs approved specifically for use against
metabolic
syndrome, market researchers recognize a potential gold mine.

In an analysis published in February for D&MD Publications, which does
pharmaceutical industry research, authors Sreten Bogdanovic and Beata
Langlands reported:

"Specific components of the syndrome ... represented a $54 billion
worldwide market in 2003 and are forecast to grow to $98 billion by 2008.
The emergence of the metabolic syndrome ... is predicted to have profound
implications for developers of all drugs."

A big part of the sales increase stems from treatment guidelines adopted
in
2001 that lower the threshold at which cholesterol is considered abnormal
enough to warrant drug treatment. Between 2000 and 2003, sales of statins
jumped from about $9 billion in the United States to nearly $14 billion.

Analysts and physicians alike are especially excited about drugs that
tackle more than one obesity-related condition in a single pill.

The Food and Drug Administration in February approved Caduet, made by
Pfizer and the first drug to treat both high cholesterol and high blood
pressure. AstraZeneca's Galida, used to lower blood glucose and
cholesterol
in type 2 diabetics, is going through its final tests in patients
worldwide.

The breathless enthusiasm with which many doctors and researchers look to
drugs as the answer troubles some in the medical community.

Art Caplan, a bioethicist at the University of Pennsylvania, said the
emphasis on drugs shifts responsibility from the individual, the food
industry and society at large, to the medical profession.

"People love to find a quick fix. They can say, 'Oh, well; I'm not
indulgent, I'm just sick,' " Caplan said.

"The U.S. is suffering from a severe case of medical addiction. We are in
love with the idea that medicine can bail us out of all kinds of woes,
ailments and problems. And even though we complain the costs are killing
us, we can't stop."

Part of the problem, said Cindy Moore, a registered dietitian and
spokeswoman for the American Dietetic Association, is that physicians are
not trained to help people change their lifestyles.

"Having a physician tell a patient 'you need to lose weight and lower your
cholesterol' isn't going to provide them with the specific tools they
need." She added that most insurance plans allow someone to see a
registered dietitian only if they already suffer from chronic diseases.

Studies show that only 2 percent to 5 percent of people who try to lose
weight on their own are successful at keeping it off long-term. So some of
those pushing to address obesity through lifestyle changes are themselves
using a highly "medicalized" approach.

The Coronary Heart Disease Reversal Program at UC Davis pulls in doctors,
dietitians, therapists, exercise physiologists and high-tech machinery for
a multipronged attack on the underlying factors that lead to illness.
Patients already suffering from obesity-related conditions also are
prescribed drugs, but the goal is to reduce or eliminate reliance on
medication.

For many in the program, it took serious illness to motivate them to make
changes.

Even with a diagnosis of type 2 diabetes, said Davis resident Charlotte
Maggard, 64, it took her eight years to commit to giving up junk food and
getting some exercise.

"When you first learn about it, you are kind of in denial," she said. But
over the years, the diagnoses - and drugs to treat them - mounted: high
blood pressure, high cholesterol, diabetes-related vision deterioration
and
heart problems.

Since joining, she has quit eating red meat and lost 10 pounds. Her goal,
she said, "is to get off the medication."

Similarly, Sacramento resident Michael Guzman, 51, said that following his
heart attack in 1999, he tried to get more exercise, but didn't stick with
it. Despite being diagnosed with diabetes, he couldn't quit his barbecued
pork habit and at one point weighed 291 pounds.

Since joining the UC Davis program two months ago, he has sworn off all
forms of meat. On a recent visit to the Sacramento Natural Foods Co-op
with
other patients, he filled his cart with products such as tofu ravioli and
fat-free refried beans.

"I'm finding there are a lot of foods that are real tasty," he said.

Dr. Tissa Kappagoda, the cardiologist running the program, said the diet
and exercise regimens are proven to work.

He followed a group of his own patients for 10 years and found that those
who stuck with the program for two years had a significantly lower
incidence of major heart attack or stroke. In addition, he said, 80
percent
of the dropouts were taking medications to lower cholesterol compared with
40 percent of those who remained in the program the full two years.

"We are living in an environment where you think drugs will solve every
medical problem," Kappagoda said. "But these are diseases of lifestyle.
....
Keeping people obese and alive with medication really doesn't, in my view,
address the issue."

On Wed, 14 Apr 2004 19:05:49 +0000 (UTC), Me announced in
front of God and everybody:

In article , Dorsey Griffith wrote:

"A patient comes in and has coronary artery disease. I can wag my tongue at
them, scold them and tell them they need to change their lifestyle," said
Dr. Steve Nissen, a cardiologist at the Cleveland Clinic in Ohio. "What
percentage actually do? Very few. Until we come up with other solutions,
drugs are a reasonable approach.

If they're not willing to change their unhealthy lifestyle
then maybe they should just be left to die. Evolution only
works because the weak die off and the strong multiply. If
someone is so weak and stupid that they eat themselves to
an early death then let them.

Oddly enough, doctors don't usually look at it that way.

If they're not willing to change their unhealthy lifestyle
then maybe they should just be left to die...

curious says...

My mom has the same idea about illegal drug users...let them make a
decision if they want to use them, if the answer is yes, send them to a
place like a reservation and let them kill themselves on overdoses by
giving them as much as they want. Kind of gruesome, huh? Thought
provoking, though.
-curious-