Diet Drugs Work: Why Won’t Doctors Prescribe Them? • Hacker News Board

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#51

Post by refurb » Thu, Dec 05, 2013, 3:51 PM UTC

tocomment wrote: post #29

Couldn't another part of the problem simply be lack of marketing for these drugs? Everyone is aware there are goto drugs to toenail fungus and restless leg syndrome from all of the commercials. Shouldn't drugs like these that apply to even more people be all over the airwaves?

This is actually a relevant point. Both Qnexa and Belviq were only recently approved. The companies who got them approved are pretty small and don't have the backing of a massive pharma company to help them with marketing.

In fact, the maker of Qnexa, Vivus, has had 3 CEOs over the past year and they are getting a lot of flack from shareholders over not putting in enough effort to market the drug.

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#52

Post by loceng » Thu, Dec 05, 2013, 3:52 PM UTC

spodek wrote: post #5

More relevant questions: - Why don't we stop subsidizing corn so much? - Why don't we teach effective nutrition and cooking in school? - Why don't we teach effective exercise, sports, and fitness in schools? - If we can ban alcohol and tobacco sales to children, why not things like added sugar, hydrogenated oils, corn syrup, etc? - If we can ban alcohol and tobacco advertising to children, why not products with added…

When you're addicted to sugar, fresh fruit and vegetables won't taste as good - so it's a catch 22 - people will have to go through a shift, however I think it would help for them to hear or know that is what's going on.

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#53

Post by varelse » Thu, Dec 05, 2013, 3:52 PM UTC

normloman wrote: post #31

spodek wrote: post #5

More relevant questions: - Why don't we stop subsidizing corn so much? - Why don't we teach effective nutrition and cooking in school? - Why don't we teach effective exercise, sports, and fitness in schools? - If we can ban alcohol and tobacco sales to children, why not things like added sugar, hydrogenated oils, corn syrup, etc? - If we can ban alcohol and tobacco advertising to children, why not products with added…

"Why don't we stop subsidizing corn so much?" Lobbyists. "Why don't we teach effective nutrition and cooking in school?" We do. It's called home economics. "Why don't we teach effective exercise, sports, and fitness in schools?" We do. It's called gym. "If we can ban alcohol and tobacco sales to children, why not things like added sugar, hydrogenated oils, corn syrup, etc?" Go tell a 6 year old they can't have cake o…

"Why don't we teach effective exercise, sports, and fitness in schools?" We do. It's called gym.

Um no, and that's part of the problem. In my experience, gym class was a Hunger Games like spectacle for the athletically (but not otherwise) gifted to enjoy their brief decade in the sun at the expense of those who will peak much later in life (but of course, they're more likely to be sedentary in part because of such a negative early impression of physical activity). Evidence? Do I need to mention anything else beyond Shirts vs. Skins Battle Ball? What kind of %$*!ing psychotic thought this sounded like a good idea at the time?

"Why don't we align our medical system with prevention instead of expensive and risky cures?" That's a good question, actually.

No money in it for big pharma, a segment increasingly under attack from the FDA for many of its practices and for which many critical drugs are facing patent expiration. So now they're trying to play good guy by increasingly focusing on orphan diseases ($10K to $500K/year per patient) where if someone blocks a promising therapy, its entire population of victims is doomed. And since these are the long-tail, it also creates an effective barrier to entry for smaller competitors.

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#54

Post by utnick » Thu, Dec 05, 2013, 3:53 PM UTC

tekacs wrote: post #13

spodek wrote: post #5

More relevant questions: - Why don't we stop subsidizing corn so much? - Why don't we teach effective nutrition and cooking in school? - Why don't we teach effective exercise, sports, and fitness in schools? - If we can ban alcohol and tobacco sales to children, why not things like added sugar, hydrogenated oils, corn syrup, etc? - If we can ban alcohol and tobacco advertising to children, why not products with added…

Mostly obviate my foot. The number of issues that would need addressing to make it possible for everyone to eat a healthy diet (hell how do we go about making cheap, convenient, healthy food on such a scale?) vastly exceeds the number involved in coming up with post-hoc remedies. More relevant questions are surely those which enable us to do something about the problem in the foreseeable future (such as diet pills) r…

Don't we already have cheap convenient healthy food?

I mostly eat tacos for dinner, beans, occasionaly rice, random vegetables, a little bit of hot sauce, sometimes eggs.

Its cheaper than mcdonalds and takes about 5 minutes to make.

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#55

Post by herge » Thu, Dec 05, 2013, 3:53 PM UTC

marrs wrote: post #33

3pt14159 wrote: post #24

Earlier quoted context omitted.

Obviously preventative measures should be our first resort. Obviously all farm subsidize (or at least those that are not in alignment with a healthy population) should be ended. But I take issue with banning sugary, hydrogenated things. The problem with the modern diet isn't that a kid drinks a Coca Cola with his McDonald's fries once a month when he goes out for a treat with his mom after swim practice. The problem…

I hear this kind of argument all the time and I don't buy it at all. How do poor people have less time to cook than well off people? We all work the same hours. Pasta costs next to nothing, as does rice, as do beans. Veg and dairy are a bit more but still cheap by any standards. Cigarettes and alcohol, on the other hand, are expensive. As is running a car, or going to McDonalds. So maybe try subsidising your meals by…

Man, you need to adjust your privileged-lifestyle viewpoint.

Ever try to buy groceries without a car? How much time would you add to your day if you had to take the bus from work to the supermarket, and then the bus back to your house. A 15 minute 2 stop car trip becomes an hour+ with all the waiting, shuffling to and from the bus stop, etc.

Also, ever notice how those big supermarkets with the cheap prices aren't really present in poor neighbourhoods? All you can find are cheap bodegas and convenience stores in those neighbourhoods.

Finally, a lot of poor people have 2 jobs or try to get as much overtime as they can to supplement their income, so 'We all work the same hours.' is a bit of a fallacy.

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#56

Post by refurb » Thu, Dec 05, 2013, 3:53 PM UTC

drzaiusapelord wrote: post #12

power2u wrote: post #2

>The drugs work by suppressing appetite, by increasing metabolism, and by other mechanisms that are not yet fully understood. Why would FDA approve something which it we don't fully understand?

Because they're ultimately beholden to big business? I mean, we have no idea how many drugs work yet the FDA goes after 23andme and other organizations (selling stevia as a sweetner before they allowed it recently, etc), etc with questionable motives. I think there's an obvious double standard when it comes to big pharma. I'm not attacking the FDA per se, but the entire USG. It seems like the buck stops with congress…

Ultimately beholden to big business? Tell that to all the drug companies who have either had their drug denied by the FDA or pulled after approval [1].

[1]http://www.fda.gov/safety/recalls/

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#57

Post by unfasten » Thu, Dec 05, 2013, 3:53 PM UTC

tocomment wrote: post #20

spodek wrote: post #5

More relevant questions: - Why don't we stop subsidizing corn so much? - Why don't we teach effective nutrition and cooking in school? - Why don't we teach effective exercise, sports, and fitness in schools? - If we can ban alcohol and tobacco sales to children, why not things like added sugar, hydrogenated oils, corn syrup, etc? - If we can ban alcohol and tobacco advertising to children, why not products with added…

I've been looking for a way to make vegetables like brocoli or green beans palatable. What's your secret?

Try http://www.amateurgourmet.com/2008/11/the_best_brocco.html

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#58

Post by apendleton » Thu, Dec 05, 2013, 3:54 PM UTC

marrs wrote: post #33

3pt14159 wrote: post #24

Earlier quoted context omitted.

Obviously preventative measures should be our first resort. Obviously all farm subsidize (or at least those that are not in alignment with a healthy population) should be ended. But I take issue with banning sugary, hydrogenated things. The problem with the modern diet isn't that a kid drinks a Coca Cola with his McDonald's fries once a month when he goes out for a treat with his mom after swim practice. The problem…

I hear this kind of argument all the time and I don't buy it at all. How do poor people have less time to cook than well off people? We all work the same hours. Pasta costs next to nothing, as does rice, as do beans. Veg and dairy are a bit more but still cheap by any standards. Cigarettes and alcohol, on the other hand, are expensive. As is running a car, or going to McDonalds. So maybe try subsidising your meals by…

> I hear this kind of argument all the time and I don't buy it at all. How do poor people have less time to cook than well off people? We all work the same hours.

This is almost undoubtedly false. 40 hours at the federal minimum wage doesn't come anywhere close to providing a livable income, particularly if the person is supporting a family; many low-income workers work multiple jobs.

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#59

Post by syntheticnature » Thu, Dec 05, 2013, 3:54 PM UTC

marrs wrote: post #33

3pt14159 wrote: post #24

Earlier quoted context omitted.

Obviously preventative measures should be our first resort. Obviously all farm subsidize (or at least those that are not in alignment with a healthy population) should be ended. But I take issue with banning sugary, hydrogenated things. The problem with the modern diet isn't that a kid drinks a Coca Cola with his McDonald's fries once a month when he goes out for a treat with his mom after swim practice. The problem…

I hear this kind of argument all the time and I don't buy it at all. How do poor people have less time to cook than well off people? We all work the same hours. Pasta costs next to nothing, as does rice, as do beans. Veg and dairy are a bit more but still cheap by any standards. Cigarettes and alcohol, on the other hand, are expensive. As is running a car, or going to McDonalds. So maybe try subsidising your meals by…

All work the same hours? Not if you're working two part-time jobs because that's what you can get.

Not to mention the difference in commute time between owning a car versus taking a bus and walking in many areas. It takes me fifteen minutes to get to work; if I took the available buses it would be nearly three hours each way.

(We'll leave aside whether cheap pasta and rice are actually healthy eating.)

Re: Diet Drugs Work: Why Won’t Doctors Prescribe Them?

#60

Post by mseebach » Thu, Dec 05, 2013, 3:56 PM UTC

marrs wrote: post #33

3pt14159 wrote: post #24

Earlier quoted context omitted.

Obviously preventative measures should be our first resort. Obviously all farm subsidize (or at least those that are not in alignment with a healthy population) should be ended. But I take issue with banning sugary, hydrogenated things. The problem with the modern diet isn't that a kid drinks a Coca Cola with his McDonald's fries once a month when he goes out for a treat with his mom after swim practice. The problem…

I hear this kind of argument all the time and I don't buy it at all. How do poor people have less time to cook than well off people? We all work the same hours. Pasta costs next to nothing, as does rice, as do beans. Veg and dairy are a bit more but still cheap by any standards. Cigarettes and alcohol, on the other hand, are expensive. As is running a car, or going to McDonalds. So maybe try subsidising your meals by…

A better word than "time" is probably energy. Also, the GP added skills and money to the list.

To make good food on the cheap, you need a bit of equipment and you need an upfront investment in spices and staples, all of which are significantly cheaper in the long run in bulk. Besides the investment, you need to plan long term, something the poor often struggle with (being poor is rarely only a question of lacking money).

With that in mind, it's pretty naïve to expect banning marketing to achieve much improvement in poor people's diets.