MAY 21, 2011 OBESITY

"Friendship is precious, not only in the shade, but in the sunshine of life, and thanks to a benevolent arrangement the greater part of life is sunshine."

- Thomas Jefferson, 2nd President of the United States

When I went to grade school we learned about the Presidents. Do children still learn about US Presidents? My brother, Paul and I inherited many toys from our cousins. My Uncle Sonny brought over this 1950's White House Kit complete with a miniature White House and plastic 2 inch figures of US Presidents. The last President in this kit was Johnson. I loved knowing about presidents. I have read many biographies of US Presidents. I have admired many for various reasons, but I am very fond of Thomas Jefferson's writings, poems and quotes.

"The man who reads nothing at all is better educated than the man who reads nothing but newspapers ."

In relation to flowers and friends, Leo Buscaglia states, "A single rose can be my garden..a single friend, my world."

During the past 10 years, the prevalence of obesity has climbed dramatically. Between 2007 and 2009, 2.4 million more US adults became obese. I wonder if obesity was an issue in Jefferson's time? You rarely see a painting or portrait portraying an obese individual. Some individuals want the quick answer or magic pill. In the last year, three drugs went before the FDA for weight loss. You have not heard of these drugs because all three were rejected. These were lorcaserin, phentermine plus topiramate, and naltrexone plus bupropion. Earlier in my career there was fastin, and phen phen. Phen Phen is no longer available. I feel people stay on phentermine too long . The actual dosing is for only 3 months. Obesity is the major leading cause of heart disease and diabetes, in addition to abnormalities in your lipid profile.

Phentermine was approved 52 years ago (1959) for three month use. Since that time there has been no long term studies on any use greater than 3 months. So if you doctor is prescribing this drug for longer than 3 months, then it is off label. I would not want to take the legal chance in writing it for more than 3 months. The FDA at this time is on a rampage. I find it interesting that the FDA is closing companies that produce intravenous Vitamin C , but cannot demand a long term study on a drug. In the same regard, federal insurance companies consider intravenous Vitamin C to be not medically necessary for certain diseases, but again what about health care professionals using approved drugs off label?

It seems it is all about finances. The FDA approves lap banding for a lower BMI so more people can get the procedure. The more procedures that are done, the more money is made. I am on the fence about weight loss drugs. There needs to be more approved in one sense since every patient does not respond to one drug, but on the other hand we should be promoting a healthier lifestyle that included changes in exercise, food choice and water intake.

The future is the prevention of disease. This is what I practice: smart prevention utilizing every single aspect of medicine both conventional and integrative modalities. What happened to just changing your dietary lifestyle? Yes, it is harder than taking a diet pill, but in the long haul it is a healthier way to lose weight.

Until tomorrow...