physicians vow to crack down on obesity

BRAND NEW MEDICAL GUIDELINES
FOR TREATING OBESITY

As BMI increases, the risk for cardiovascular disease, diabetes, and cancer all go up.  Donna Ryan, MD, co-chair of the Guideline Committee for Cholesterol and Weight Control by the AHA, ACC, and Obesity Society

Approximately 37% of male doctors reported being overweight, with 5.3% being obese. This was very similar to a 2004 study that found 38% of male physicians to be overweight and 8% obese, suggesting that the situation has not improved much over the past 7 years.  As for women, according to the CDC, 28.6% were overweight in 2008 and 35% were obese. In the Medscape survey the percentage of women physicians who reported being overweight tended to be slightly lower (26%) than the nation’s women.   A 2012 survey from Medscape.  As you might imagine, the numbers are lower on a survey, than the actual findings of physical examinations

But what about doctors?  As it turns out, we tend to be healthier than people on the other end of the stethoscope, but only barely.  Fifty-three percent of physicians in the U.S. are heavy enough to be classified as overweight, a number only slightly lower than the general population (64 percent).  Dr. Eric Van De Graff of the website LivewellNebraska from a 2013 blog post

This study suggests that providers perceived to be overweight or obese may be vulnerable to biased attitudes from patients, and that providers’ excess weight may negatively affect patients’ perceptions of their credibility, level of trust and inclination to follow medical advice.  The conclusions of a study published in the March issue of the International Journal of Obesity

Obesity is running hog wild in this country.  As you can see from the quotes above, not only is the general population overweight, but so are our doctors.  If you count the people who are SKINNY FAT, our government’s own statistics would put nearly 75% of our population into the overweight or OBESE category.  Re-read that last sentence and think about the wide range of implications for a moment.  And, like Dr. Ryan said in her quote from the top of the page, obesity is being tied to almost every class and type of illness under the sun.  I would never argue that weight is not a serious issue that needs to be dealt with in our country.  I would argue that most doctors are simply not trained or equipped for it (HERE, HERE, and HERE).  They’ve had lots of opportunity, and unfortunately, it has not panned out.
Dr. Ryan mentions BMI (Body Mass Index) as being the best and most cost-effective way to evaluate whether or not a person is overweight.  Although far from perfect, I would have to agree.  It is a simple chart that shows you whether or not you fall into a “normal” weight, overweight, and if overweight, just how overweight you really are.   Most adults (unless you are a well-trained strength athlete) that have a BMI of 30 or more are obese.  Extreme obesity, also called “severe”, “morbid”, or “gross” obesity, occurs when you have a BMI of 40 or more.   Although definitions will be somewhat different for different organizations, if you are 30% over your ideal weight, you are obese.  50% or more over your ideal weight is usually considered “Grossly Obese” (“Morbidly Obese”).  In other words, if you should weigh 150 and you weigh 225; you would fall into this category. 

“Obesity Guidance” is one of the four parts of the NEW CARDIOVASCULAR GUIDELINES I dealt with the other day.  Dr. Ryan wants obesity to be dealt with on every single doctor visit and wants insurance to pay for it all.   Not to say that obesity should not be dealt with in the doctor’s office, but let’s be honest with each other for a moment.  With approximately half of all doctors being either overweight or obese, how’s that whole thing working out so far?  Click on the previous link to find out.

After reading a recent article on the numbers of weight loss drugs currently in development, I am more convinced than ever that the new emphasis on WEIGHT LOSS will really be looked at as a way to sell more drugs (HERE).  Argue with me all you want, but take a hard look at the financial conflicts of interest on the last link, and you will come to the same conclusion.  In fact, let’s just look at the conflicts personally reported by Dr. Ryan regarding the publication of her Guidelines

For this study, Dr. Ryan reported relationships with

  • Alere Alere is a company who, among other things, manufactures tests for both cholesterol levels and blood chemistry related to the heart.  Dr. Ryan helped write the newest guidelines concerning both of these.
  • Amylin  According to Wikipedia, “Amylin Pharmaceuticals is a biopharmaceutical company based in San Diego, CA, that was founded in 1987. The company is engaged in the discovery, development and commercialization of drug candidates for the treatment of diabetes, obesity and other diseases.
  • Arena Pharmaceuticals   Again, according to Wikipedia, “Arena Pharmaceuticals, Inc. is a biopharmaceutical company located in San Diego, California that manufactures the drug lorcaserin (Beliviq).  Lorcaserin is approved for use in adults with a body mass index (BMI) of 30 or greater, and who have at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol.
  • Eisai  Eisai is a Japanese pharmaceutical company that is ranked in the top 25 in the world according to its revenue (approximately 10 billion a year).  You would recognize many of their drugs, including Acotnel (OSTEOPOROSIS), and Asiphex (REFLUX).
  • Novo Nordisk  Novo is a Danish company which has been around for almost a century.  Novo is famous for its “Insulin Pens”.  The company has been in the news lately for problems with its Diabetes drug Tresiba.  From what I can gather, Novo makes about half of the world’s supply of anti-diabetes drugs.
  • Nutrisystem  Nutrisystem advertises a great deal on TV using celebrities or ex-athletes who have lost weight on their products and with their “weight loss counseling”.  Webmd states that Nutrisystem is a problematic way of addressing eating issues because, “dieters may only experience success while they are ordering the prepackaged foods because once they are on their own, they are faced with the real world of cooking, meal preparation, and issues they are not prepared to handle because they were not addressed on the plan“.  I have a number of issues with the Nutrisystem Diet that time constraints will not allow me to cover.
  • Orexigen  The company Orexigen Therapeutics does very similar things that Arena (above) does.  It is a company based in San Diego and Osaka (Japan) whose chief purpose is creating drugs for weight loss.
  • Takeda  As you might imagine, this company (it’s been around since 1781) is Japanese.  It is in to just about everything, with a strong emphasis on drugs for TYPE II DIABETES (Actos and Basen)
  • Vivus  Vivus is a smaller California company whose website says, “Developing innovative, next generation therapies to address unmet needs in obesity, diabetes, and sexual health [they have their own version of Viagra]”.  I have written previously about the widespread problems of drugs used for DEPRESSION / Weight Loss (HERE).  Vivus also happens to be the company about which the documentary movie ORGASM, INC was created.
  • Scientific Intake  SI makes a creature called “The SMART Device”.  This is a custom mouthpiece that fits against the upper palate, forcing a person to take smaller bites and chew more in order to be able to swallow.  Kind of a cool, non-invasive idea.

Although Dr. Ryan has some serious conflicts (there were others I did not list), the other members of the committee reported “numerous relationships with industry” as well.  This probably means that for the number of people on the committee, listing all of the “relationships” would have taken up far too much valuable journal space.  For those who are not aware, this is status quo.  After reading the list above, do you think that Dr. Ryan can be trusted to do what is in your best interest as far as things like diabetes and weight are concerned?

Am I saying that Dr. Ryan or the individuals on her committee are corrupt?  No.  A financial “conflict-of-interest” does not necessarily mean that these people have done anything devious or underhanded.  It is, however, at the very least, the appearance of such.  She and the other members who have their hands in more cookies jars than we can keep track of, simply need to recuse themselves from having anything to do with these guidelines.  By the way, there are several Physicians Organizations that do not support the guidelines put forth by Dr. Ryan’s committee.

And as far as other recommendations (which diet or exercise programs to use), there was a great deal of disagreement within the committee.  They looked at 17 different diets and could not come to a consensus other than to say that, “clinicians should prescribe a diet based on patients’ other risk factors“.  This sounds well and good, but where are these clinicians being trained to do this? Oh, and the other recommendation for dealing with obesity….?  BARIATRIC SURGERY.  At best I am leery of turning weight loss over the medical community.  At worst, the overweight will become (as if they haven’t already) another commodity to be looked at by those who control healthcare as walking, breathing dollar signs.  And on top of this, it simply does not work (HERE)!

THE BEST WAY(S) TO LOSE WEIGHT

I hate to break it to people, but there are no viable shortcuts to weight loss.  As long as you do not have a fouled up THYROID GLAND, or other ENDOCRINE PROBLEM; and as long as you understand GUT HEALTH, you can lose weight.  HERE is the link to a post on what I consider (according to the scientific research) the best ways to going about this.  If you feel you are too addicted to sugar or carbs to follow through, read THIS and THIS first.
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