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Mark Hyman, MD

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Pharmageddon: Can a New Weight Loss Drug Really Save Us?

Posted: 02/27/2012 9:20 am

This week, in an act of desperation to turn back the tide of the obesity epidemic that now affects almost seven out of every 10 Americans and more than 80 percent of some populations (African-American women), the advisory committee to the Food and Drug Administration (FDA) voted 20 to 2 to recommend approval of Qnexa, a "new" obesity drug that is simply the combination of two older medications, phentermine (the "phen" of phen-fen") and topiramate (Topamax).

It is a misguided effort at best, and a dangerous one at worst. Mounting evidence proves that the solution to lifestyle and diet-driven obesity-related illnesses including heart disease, diabetes, dementia, and even cancer won't be found at the bottom of a prescription bottle.

By 2020, more than 50 percent of the U.S. adult population will have Type 2 diabetes or prediabetes, with annual costs approaching $500 billion. By 2030, total annual economic costs of cardiovascular disease in the U.S. are predicted to exceed $1 trillion. By 2030, globally we will spend $47 trillion, yes trillion, to address the effects of chronic lifestyle-driven disease.

Prescription medication for lifestyle disease has failed to bend the obesity and disease curve. Statins have been recently found to increase the risk of diabetes in women by 48 percent. And large data reviews by independent international scientists from the Cochrane Collaborative found that statins only work to prevent second heart attacks, not first heart attacks, which means they are not helpful and most likely harmful for 75 percent of those who take them.

Avandia, the No. 1 blockbuster drug for Type 2 diabetes, has caused nearly 200,000 deaths from heart attacks since it was introduced in 1999. The drug was designed to prevent complications of diabetes, yet heart attacks are the very disease that kills most Type 2 diabetics. In 2011, the FDA issued stricter prescribing guidelines for Avandia, but the drug is still on the market.

The large ACCORD trial found in more than 10,000 diabetics that intensive blood-sugar lowering with medication and insulin actually led to more heart attacks and deaths.

Something is deeply wrong with our medical approach.

The problem of chronic disease, including obesity, diabetes, and heart disease, is not a medication deficiency, but a problem with what we put at the end of our fork.

The emperor truly has no clothes. Why would good men and women of science vote to approve a medication for a condition that is a social disease and requires a social cure? The social, environmental, economic, and political conditions of America and increasingly the global community have created an obesogenic environment.

Clearly we need to do something. But it is not better medication or surgery or more angioplasties and stents, which have no proven benefit in more than 90 percent of those who receive them. The data show they work for acute coronary events, but not stable angina or blockages.

We continue to pay for expensive treatments for chronic disease, despite the fact that they don't work, while insurance does not pay for nutrition counseling unless the patient has kidney failure or diabetes.

Chronic disease is a food-borne illness. We ate our way into this mess and we must eat our way out.

Every year the average American consumes 24 pounds of French fries, 23 pounds of pizza, 24 pounds of ice cream, 53 gallons of soda (or a gallon each week), 24 pounds of artificial sweeteners, 2.7 pounds of salt, 90,700 mg of caffeine, and about 2,700 calories a day. And that's just the average.

Do we really think that we can medicate our way of this problem with a repackaged old diet drug (phentermine), combined with an older anti-seizure medication (Topamax)? Both these drugs have concerning side effects, including increased heart rate, heart attacks, and birth defects such as cleft lip.

I recently saw a patient on 26 medications and 450 units of insulin. This is Pharmageddon. His physicians were treating the downstream symptoms, not the causes. They were mopping up the floor while the sink was overflowing.

Large studies published over many decades show that 90 percent of coronary heart disease cases, 90 percent of Type 2 diabetes cases, and one-third of cancers can be avoided by maintaining a healthier diet, increasing physical activity, and stopping smoking. We must treat the cause, not the symptoms.

Mounting evidence points to the power of food to reverse heart disease, diabetes, and cancer, and even to lengthen our telomeres, slowing the aging process. In a recent study, intensive dietary change reversed advanced Type 2 diabetes in only 12 weeks. There is no medication that can achieve those results.

The science of epigenetics and nutrigenomics documents how food regulates gene expression and can upgrade our biologic software, reversing obesity, Type 2 diabetes and chronic disease.

There is a solution to our obesity epidemic. But it is not at the bottom of a pill bottle. It is at the end of our forks. It is simply more effective than any medication and works better, faster, and cheaper, not just as prevention, but also as treatment for what ails us in the 21st century. We can change our obesogenic environment through individual small choices we make every day, and by making changes in our homes, our families, our schools, our workplaces, our faith-based communities. We have the power to take back our health. Let's start today.

My new book The Blood Sugar Solution is a personal plan for individuals to get healthy, for us to get healthy together in our communities and for us to take back our health as a society. Obesity and diabetes is a social disease and we need a social cure.

My personal hope is that together we can create a national conversation about a real, practical solution for the prevention, treatment, and reversal of our diabesity epidemic.

To learn more and to get a free sneak preview of the book go to www.drhyman.com.

For more by Mark Hyman, M.D., click here.

For more on diet and nutrition, click here.

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