Posted by: Street | March 6, 2010

Take This, Or Do That?

It is quite clear what needs to be done by those who suffer from obesity and diabetes. Despite all of the information out there about the benefits of living a healthy lifestyle, why has there not been a shift in the tide of obesity and diabetes? It is amazing to me the addiction people have to their unhealthy lifestyle. Until health and fitness professionals are recognized as healthy lifestyle experts, it will be difficult to touch the masses of people who struggle from diseases associated with living an unhealthy lifestyle. That being said, I think doctors need to step up to the plate and help educate the public about the benefits of physical activity and eating a healthy diet, because after all, they are the “experts.”

Health education focusing on improving nutrition, physical activity, and healthy lifestyles for school children and their parents should become a leading role for physicians. Prevention of obesity through diet and physical activity should be the number one priority because its success will have a positive and direct effect on dyslipidemia, arterial hypertension, and alterations in the metabolism of carbohydrates. The benefits associated with physical activity in young individuals include weight loss, improvement in metabolic parameters, reduction in BP and insulin resistance, psychic well-being, predisposition to maintain physical activity in adulthood, and, consequently, a decrease in the risk of cardiovascular disease and an increase in life expectancy (Ayrton Pires Branda˜o, 2008).

Medicine is big business, and the doctor’s approach to the problems of obesity and diabetes has traditionally been to treat the symptoms and not the underlying problem. For example, someone who is obese is recommended to undergo gastric bypass, or the like, instead of treating the reason of why that person is obese. Rarely is a person obese just because that’s the hand of cards he/she was dealt. To provide insight to what I’m referring to when I say, “Medicine is big business,” read the following:

Advertising Drugs and Selling Sickness

Public advertising gets increasingly powerful using aggressive direct-to-consumer marketing, payments to celebrities for appearing on TV shows and telling about their illnesses and cures, and sophisticated targeting of consumer groups that will then effectively lobby insurers and regulators for the industry’s causes (23, 24).

A most remarkable tactic for expanding drug markets is “disease mongering,” i.e., trying to convince essentially well people that they are sick by medicalization of trivial conditions: for instance, defining abdominal discomfort as irritable bowel syndrome or normal aging as menopause and osteoporosis, inducing people to believe they need treatment (29). Psychosocial conditions are especially susceptible to framing by experts as medical conditions: attention deficit hyperactivity disorder (ADHD), depression, social anxiety disorder, sexual dysfunction, and premenstrual “dysphoria.” Pharmaceutical companies use the Internet to access teachers and to influence their brokerage role to increase ADHD diagnosis and Ritalin usage (30). For concerned parents, a suggested response by Novartis to teachers is: “Make it clear to them that it is important for them – and their child – to understand and follow the doctor s medical advice about medication and other therapies for ADHD. ADHD is a serious condition that may require the child to be on medication and undergo counseling for a long duration” (30). Big Pharma has taken an aggressive marketing interest in sex, using public relations, advertising, and a variety of tactics to create a sense of widespread sexual inadequacy and interest in drug treatments, both for women and men. People are often enchanted by simple solutions, fitting a cultural overinvestment in biological explanations, to bypass sexual embarrassment, ignorance, and anxiety (31). Pfizer hired a former baseball player as spokesman, teaming up with Sports Illustrated magazine, in an attempt to convince men to enhance normal sexual function with Viagra, as a lifestyle drug. Because of public pressure on insurers, an important concern is that paying for lifestyle drugs will limit resources for other health care (32). A collection of articles on disease mongering and how to counteract the problem was recently published in the 2006 April issue of Public Library of Science Medicine (Brezis & Belmaker, 2008).

A potential solution could be to require continuing education in physical activity and nutrition for the medical doctors. This may sound silly, but I have had clients, who were medical doctors, who knew very little about the benefits of leading a healthy lifestyle. They were wired to treat the symptoms of the problem. A similar problem exists with some personal trainers, PTs, and Chiropractors when they treat the pain site versus the source of the problem (another discussionJ). Perhaps what the doctor should be doing is offering clearance to sedentary patients to see if they are ready for a structured exercise and nutrition program, a real solution to many underlying problems. Developing a strong referral network of doctors, physical therapists, chiropractors, registered dieticians, and health and fitness professionals should be a vision of the near future.

Ayrton Pires Branda˜o, P. A. (2008). Management of Metabolic Syndrome in Young Population. Journal of Therapeutics , 356-361.

Brezis, M., & Belmaker, R. H. (2008). Big Pharma and Health Care: Unsolvable Conflicts of Interest between Private Enterprises and Public Health. The Israel Journal of Psychiatry and Related Sciences , 83-94.




  1. I agree, Brandon. I’ve heard that doctors have little to no educational training in nutrtion and probably exercise as well. It also sounds like drug reps hound the doctors to push their meds and doctors seem perfectly compliant to do so.

    On the other hand, I’m encouraged to see insurance companies doing more to encourage healthy lifestyles through various weight loss programs they offer, offering discounts on local gyms, etc. I also recently read that many hospitals/health plans are startingn to do follow up phone calls with patients to make sure they’re taking their meds in a timely and appropriate manner. This is leading to higher compliance rates. While it may still be a form of pill pushing, at least it seems to helping people to stay healthier.

    As the obesity problem in this country continues to ramp up, it does seem like there are more initiatives being developed to address it; however, it most people want quick fixes and aren’t willing to put in the time and effort necessary and will instead turn to pills, unfortunately.

    Then there’s the whole socio-economic factors involved, especially with childhood obesity…

    We have our work cut out for us!

  2. Another big problem is that people without insurance do not go to their primary care physician and use the emergency room to be seen for things that normally would be seen at their primary care doctor or specialist. There is no time for education regarding nutrition, smoking cessation and exercise in the emergency room as it is hard enough to get people to follow up with a specialist or primary care physician. We even arrange follow up care but patients consistently bounce back to the ER for care without ever following up as directed from the ER. It is a vicious cycle!!!

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