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

newyorker.com

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

#61

Post by jrs235 »

awjr wrote: post #21
thefuzz wrote: post #11

Earlier quoted context omitted.

I don't see him as being cynical. I think these are questions worth asking given that the OP is asking why diet pills aren't prescribed. It's looking at a problem in a systemic way rather than isolated events, at least according to me.

Allowing the prescription of diet pills treats the symptom and not the cause. Anecdotally I've been overweight most of my life and it is only through a change in lifestyle (cycling to work and a shift to low carb diet i.e. low sugar) that I have seen significant weight loss. That's not to say prescription diet pills wouldn't work, but without underlying lifestyle changes I would expect the person to using the pills t…

"it is only through a change in lifestyle"

And that's the difficult thing people aren't willing to do. Taking a pill might help for the near term (we are so short sighted these days!) but it won't address the long term. "I've been taking this pill so now I'm not overweight [so now] I don't need to take the stairs over the elevator!" A few years later, you might not be overweight but you still aren't healthy!

"it is only through a change in lifestyle"

Reminds me of a coworker that complains about his financial situation. He complains about not making enough money and thinking that if he made more then he'd be able to "pay his bills and get ahead"... that might work for the short term, but without a change in how he handles money he's going to end up as "poor" as he is now.

(Preface: He makes more than the average American, this isn't about true poverty) If you live paycheck to paycheck because you are unwilling to make the difficult change in your lifestyle by living slightly under your income level in an effort to pay off debt and save for the future, you will continue to live paycheck to paycheck after you get a raise (that you claim is what you need to "get ahead"). If you spend what you make, you'll just spend more when you make more.

Discipline. It's not easy.

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

#62

Post by cylinder »

sspiff wrote: post #45
normloman wrote: post #31

Earlier quoted context omitted.

"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…

In Belgium, the biggest health-insurance provider (and probably others) subsidizes sports club membership fees, gym subscriptions, .... Their goal is to reduce the cost of treatment by encouraging prevention. I'm not sure how many people make use of it.

Most private insurers provide this option in the US as well.

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

#63

Post by pmahoney »

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?

Boil some water, throw the green beans in for just a couple minutes. Remove the beans and put them in a colander to dry. Mince and fry a shallot (or onion) in oil or butter. Throw in the beans, chopped walnuts, and a little bit of feta cheese. Salt to taste (salt is often the difference between bland and tasty).

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

#64

Post by normloman »

JulianMorrison wrote: post #43
normloman wrote: post #31

Earlier quoted context omitted.

"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…

You seem very willing to wish away the structural power of money by blaming the middleman. This is rather like blaming maggots for death.

Na, I'm with you on the money thing. Lobbyists are just a symptom of the winner-take-all economic system we've got here. That said, it's probably more realistic to control the symptoms right now than try to reform our entire economy.

You could probably answer every question with "People in power use their fortunes to preserve power" and you'd nail it 90% of the time.

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

#65

Post by visakanv »

nkoren wrote: post #37
tocomment wrote: post #20

Earlier quoted context omitted.

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

Two suggestions, slightly contradictory, but either will work: 1.) Spices. there are loads of really interesting, amazing spices out there, but even a simple sautée of olive oil, lemon juice, garlic, salt, and black pepper can make almost any vegetable taste amazing. 2.) Stop eating over-flavoured foods. Doritos etc. have a ridiculous amount of flavouring; if you eat foods like this consistently then you'll desensiti…

This is great advice, and worked for me beautifully since I stopped smoking and started eating at home with my wife. +1

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

#66

Post by Someone »

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…

Lobbyists can't be the whole answer; tobacco hasn't had lack of lobbyists or lack of quality of lobbyists, but it got severely restricted.

In the end I think the answer is "because we, society, allow it.". It is very hard to lobby for things we really do not want.

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

#67

Post by hackinthebochs »

wil421 wrote: post #19

Because the markets have been flooded with either snake oil products or unproven chemicals like ephedra. Nothing is a replacement for diet and exercise. Diet drugs should be used in tandem with proper diet and exercise.

>Nothing is a replacement for diet and exercise.

I don't know why people say this. The benefits of exercise are simply initiating biochemical processes that cause your body to grow and become more efficient (drugs that target the SIRT1 gene are an example). There's absolutely no reason why we can't develop drugs that initiate that same process. Same goes for preventing fat accumulation. Claiming that there's no substitute is a cop-out and its an unfounded assumption.

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

#68

Post by cLeEOGPw »

brianbreslin wrote: post #9

This is an interesting issue. If you're morbidly obese, a 5-10% reduction in weight could add up to significant LBs/KGs lost. So it would seem to me like this would be a great way to jumpstart and re-enforce the other aspects of weight loss. Many people give up because they don't see results fast enough. So much of weight loss is mis-understood, but a lot of it boils down to convenience, will power (choosing to resis…

I have the opposite problem - can't gain weight. Doesn't matter if I eat more or less, what kind of food, how many times a day and if I am training or not - it just stays the same no matter what. Recently it's been even worse - a simple 2 hour exercise would leave me with -1 kg and I had to wait like 4 days to gain back that 1 kg lost in one exercise. I think the hormones almost singlehandedly decides what you look like. I knew people that were obese and gained weight simply by drinking water and not eating anything. I thought maybe "survival instinct" would help me gain at least fat, where it supposedly activates when you are eating very little, and that is supposed to be the reason why not eating does not help fat people lose weight, but my weight even then just stays the same. I occasionally go for a whole day without eating (not intentionally) and never start to gain fat. It's really frustrating. Sometimes I just wish I could be fat and just go to gym.

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

#69

Post by Killah911 »

7Figures2Commas wrote: post #39

It's worth pointing out that "losing weight" isn't a panacea for health. Yes, it would almost certainly be a very good thing for significantly overweight and obese individuals to shed pounds, period, but the article doesn't address the fact that in and of itself this is unlikely to make them "healthy." There are lots of people who are not overweight who have many of the same cardiovascular issues commonly associated…

Finally a well thought out comment. One of the big issues I see with obesity is that the problem is oversimplified, as are the solutions. I know of several people on whom counter-obesity problems have had a significantly detrimental effect.

I've seen ineffective gastric bypass surgery which led to a friend gaining even more weight and watched helplessly as he slipped into a very depressed and negative state. As the article points out, if someone said there's a drug that just cures cancer it would be laughable. It is indeed so with weight loss. Phentermine will have minor side effects with impulse control, addiction, paranoia etc.

Interestingly enough, obesity is typically not associated with the "poor" in the rest of the world. I have often heard it mentioned as an anecdote to how "wealthy" Americans really are. But therein lies a very interesting problem to which I simply haven't seen a very good answer. Unfortunately the sigtma associated with obesity and the well entrenched and highly profitable "weight-loss" industry gets in the way of significant advances being made in this arena. Again, as is mentioned in the article, there is even a stigma associated with "diet doctors", which surely has dissuaded more than a few brilliant minds to explore the field more.

Ofcourse, as a programmer who is very familiar with a sedentary lifestyle and the pizza culture, obesity is a serious issues that does affect more than just the poor. And for crying out loud, I hope someone figures out more about it than pseudo science of obesity we have now. It's not as simple as it looks at first glance.

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

#70

Post by dpark »

at-fates-hands wrote: post #23
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…

It's as much about the unhealthy lifestyles which are promoted as it is about the "internet" society we live in. People simply want something right now. They don't want to go to the gym and do the hard work and lose those 10lbs over say six to eight months. They want to take a pill so they can lose 10-20lbs over two months. It's like anything in life. You have to put in the hard work to get the results you want. I fe…

>They don't want to go to the gym and do the hard work and lose those 10lbs over say six to eight months.

I wouldn't want to do that, either. That's miserably slow. A pound per week (which is a fairly slow weight loss, equivalent to a roughly 500 Calorie/day deficit) loses you about 24 pounds in 6 months. Two pounds per week is still well within the healthy range and gets you nearly 50 pounds lost in 6 months.

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