When I was a child I had four great-grandparents. Two were from Russia and two were from Poland. My grandparents were actually born in the United States. My last great-grandparent died at the age of 96 when I was 31 and in training after medical school. She was someone I knew as a full person and not just as a grandparent. Interestingly enough she actually came to the United States not once but twice. She returned to Russia because she did not like the conditions in New York City when my maternal grandmother was five years old. She quickly returned to the United States when she got back to Russia.
My great grandmother suffered from congestive heart failure and loved to eat anything salty. Pickles, lox you name it she ate it and then she would call me up and complain she was short of breath. She wanted no part of diet restriction and all she would say was “Gimmee a pill”. Then she would infer that I wasn’t as smart as I should have been because I didn’t have a pill to solve her problem.
We as a population have become much like my great grandmother. Maybe she was on to something. The area of life which comes to mind the fastest is that of weight loss. No one wants to hear or deal with the knowledge base we have. Eat less, actually a great deal less, and get some exercise, actually a great deal of exercise, and guess what? You will lose weight and keep it off. Whoa that’s just not going to cut it. “Gimmee a pill” screams America and what America wants is big Pharma to continue to serve up.
What is a significant weight loss induced by pills? Give up? One would hope it would be 20-30 pounds, or in the case of gastric bypass or the Biggest Loser TV show, at least an entire person worth. You will find out that’s not the case.
Should drugs even be used in what is generally a self induced problem? Obesity is epidemic in this country, and childhood obesity has become a national disaster that will dwarf all health care spending deficits. As you will see in my next blog, approving these drugs is not an easy task, and as most people will remember the diet drug combo known as Phen-Fen was removed from the market only when its serious side effect of heart valve problems became an issue. This has made it even harder to approve these drugs as the heart problems did not become evident for many years after the drugs were marketed. What is “reasonably safe” and is this a problem for which there is a “medical solution”?
I will discuss these issues in my next blog. Until then I’m going for ice cream.