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description=8 posts published by Henry Bauer during September 2014;

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share, this, anti, obesity, the, fuss, science, and, recent, health, nova, propaganda, on, skepticism, about, medicine, archive, for, september, 2014, in, search, of, disinterested, meta, archives, categories, comments, posts, subscribe, public, individual, vaccine, media, coverage, big, pharma, beware, comedians, are, to, you, vaccines, documentary, or, surgery, weight, loss, prevents, alzheimer, iv, drug, peddling, iii, ii, worse, than, useless, official, reports, where, is, common, sense,

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(13), even (13), side (13), nova (13), 2013 (13), practices (12), september (12), after (12), diet (12), could (12), associated (12), research (12), possible (12), its (12), pharma (12), well (12), alzheimer (12), 2017 (12), report (11), heart (11), official (11), reports (11), same (11), public (11), cause (11), patients (11), might (11), many (11), reactions (11), comment (10), national (10), them (10), words (10), propaganda (10), their (10), bmi (10), much (10), trials (10), august (10), big (10), gardasil (10), cervical (10), 2018 (10), loading (9), sense (9), obese (9), eat (9), way (9), against (9), few (9), these (9), individuals (9), will (9), diseases (9), harm (9), why (9), serious (9), polio (9), tagged (8), leave (8), epidemic (8), prescription (8), blood (8), industry (8), into (8), further (8), far (8), effective (8), policy (8), nothing (8), media (8), body (8), 2012 (8), alone (8), factors (8), being (8), treated (8), because (8), based (8), time (8), 000 (8), part 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factors or diseases the risk factors and diseases considered important enough to warrant pharmacotherapy at a bmi of 27 to 29 9 are hypertension dyslipidemia chd type 2 diabetes and sleep apnea continual assessment by the physician of drug therapy for efficacy and safety is necessary p xx in 1 emphases added all this may seem unexceptionable yet it is dangerously misleading in the real world of actual medical practice patients are far from carefully selected and prescriptions are written without the doctor having good evidence that the prescribing actually augments rather than replacing what should have been tried first and for some reasonable length of time namely diet the naming of bmi ranges where drugs are appropriate depending on concomitant risk factors makes no sense since that range of bmi 27 to 29 9 is already itself such a risk all adults with a bmi of 25 are considered at risk for developing associated morbidities or diseases such as hypertension high blood cholesterol type 2 diabetes coronary heart disease and other diseases p xii fda approved drugs have often had to be later withdrawn because the initial approval was unwarranted thus at the present time 1998 sibutramine is available for long term use p xx but it was withdrawn in 2010 based on information from a recent clinical study showing increased incidence of heart attack and stroke why had that not shown up in pre approval clinical trials that question is rhetorical and cynical clinical trials submitted in support of drug approval are carefully designed and chosen to emphasize benefits and to mask deleterious side effects it is normal for later studies to show more harm and less benefit 2 but even in 1998 the risk to benefit ratio did not look good it enhances weight loss modestly and can help facilitate weight loss maintenance emphases added hardly describes something that is genuinely effective on the other hand side effects weree known to be potentially serious increases in blood pressure and heart rate may occur in 1998 orlistat was being considered for approval which was soon granted orlistat disrupts the body s normal fat metabolizing mechanisms in order to decrease the absorption of fat in the diet in 2010 the food and drug administration issued a warning about potentially severe liver damage from orlistat either the prescription form xenical 120 mg or the over the counter version alli 60 mg another rhetorical question who would have guessed that disrupting the body s fat metabolizing mechanisms could cause liver damage as well as lord knows what else our bodies are complex systems in which substances and mechanisms are shared and interact in many ways with feedbacks and regulators it is naïve stupid ignorant to imagine that one can disrupt one reaction or mechanism without producing multiple effects yet drug treatments are based on that mistaken assumption hence side effects are universal and all too often they are significanty harmful for example the same reaction pathway that generates cholesterol also generates ubiquinone coenzyme q10 which is an essential part of the body s energy producing reactions therefore weakening of muscles is an inevitable side effect of statins statins scandalous new guidelines statins weaken muscles by design the peddling of anti obesity drugs proceeds even as their claimed benefits are small to non existent it is reported that lifestyle changes alone can yield weight loss of about 10 in a year pp xxv xxvi in 1 yet the fda s criterion for approving anti obesity drugs is an even smaller weight loss p 7 in guidance for industry developing products for weight management in general a product can be considered effective for weight management if after 1 year of treatment either of the following occurs the difference in mean weight loss between the active product and placebo treated groups is at least 5 percent and the difference is statistically significant the proportion of subjects who lose greater than or equal to 5 percent of baseline body weight in the active product group is at least 35 percent is approximately double the proportion in the placebo treated group and the difference between groups is statistically significant this trivial goal has allowed approval of drugs that turned out to be lethal fen phen fenfluramine phentermine damaged lungs and heart valves and yielded damages of billions of dollars to subsequent law suits sibutramine once approved for long term use had to be withdrawn only a dozen years later i m reminded of the monument i saw in strasburg in 1958 the thousand year reich 1933 1945 these drugs suppress appetite by acting on the brain s neurotransmitters primarily serotonin in other words they mess with brain functioning affecting substances that are involved in much more than appetite for example serotonin is targeted also by anti depressants since this guidance for industry had been published in 2007 and labeled a guidance document distributed for comment purposes only i sought a later version there is none 3 the 2007 draft guidance for industry developing products for weight management is the most up to date version of the guidance unfortunately this guidance is not final and we do not have an estimated date of when this will become final these blog posts were stimulated by recent plaudits for purportedly brand new anti obesity drugs not a moment too soon why new diet drugs belviq and qsymia are just in time according to this story more than one third of the usa population is obese and 300 000 die annually from related complications however these new wonder drugs are the same thing all over again belviq lorcaserin is a serotonin 2c receptor agonist indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults emphases added it should only be used if diet alone hasn t worked and it messes up brain function so it s not at all surprising that its side effects include potentially life threatening serotonin syndrome confusion cognitive impairment disturbances in attention or memory psychiatric disorders including euphoria and dissociation depression or suicidal thoughts emphasis added as well as priapism erections lasting longer than 4 hours 4 qsymia formerly qnexa goes one better than belviq by combining two medicals phentermine and topiramate phentermine is an amphetamine that was part of fen phen deemed safe but was not effective in weight control without its heart failure inducing partner fenfluramine its new partner topiramate previously fda approved for epilepsy is unrelated to any other drug no one really knows how topiramate works on the brain exactly but it seems to influence a wide range of neuropsychiatric symptoms so qsymia also messes up brain functioning moreover in a manner that isn t understood so again it s no surprise that its side effects include suicidal thoughts or actions depression anxiety agitation panic attacks insomnia irritability aggression anger violence acting on dangerous impulses mania as well as increased heart rate and serious eye problems sudden decrease in vision that could bring permanent blindness about qsymia the merest hint of these possible side effects ought to disqualify these drugs from being used in anything other than cases of imminently life threatening obesity it is nothing short of absurd to suggest let alone recommend that over eating should be treated with drugs that disrupt the body s fat metabolism or the brain s functioning however the interests vested in drug based anti obesity measures are vast bureaucracies and jobs are at stake and research careers the decisive interest though comes from the drug industry big pharma is fixated on blockbuster drugs things that many people will take over long periods hence the relentless marketing of statins blood pressure and blood sugar lowering drugs bone density increasing drugs etc big pharma has no interest in anti obesity drugs to treat that tiny proportion of people who might actually need them those with hereditary endogenous obesity instead there are intensive advertising campaigns to convince doctors as well as the general public that drugs are an appropriate way to combat the epidemic of over eating this is yet another illustration that drug companies nowadays market diseases 5 in order to sell supposed remedies perfectly normal conditions are medicalized by equating them with their extremes that feeling low disappointed grieving is essentially the same as debilitating clinical depression say that declining libido with increasing age is erectile dysfunction that blood pressure higher than normal for twenty year olds constitutes hypertension 6 and so on and on 1 national heart lung and blood institute in cooperation with the national institute of diabetes and digestive and kidney disease clinical guidelines on the identification evaluation and treatment of overweight and obesity in adults the evidence report publication 98 4083 september 1998 national institutes of health 2 john p a ioannidis why most published research findings are false plos medicine 2 2005 696 701 contradicted and initially stronger effects in highly cited clinical research jama 294 2005 218 28 3 e mail of 22 august 2014 from cder drug info druginfo fda hhs gov 4 belviq revised 08 2012 5 moynihan cassels selling sickness how the world s biggest pharmaceutical companies are turning us all into patients nation books 2005 and many others see what s wrong with present day medicine 6 henry h bauer seeking immortality challenging the drug based medical paradigm journal of scientific exploration 26 2012 867 80 share this share on facebook opens in new window facebook share on linkedin opens in new window linkedin more share on tumblr opens in new window tumblr share on reddit opens in new window reddit share on x opens in new window x share on pinterest opens in new window pinterest like loading posted in conflicts of interest legal considerations medical practices prescription drugs science policy tagged alli belviq blockbuster drugs dangerous anti obesity drugs inventing and peddling diseases lorcaserin orlistat phentermine qsymia sibutramine topiramate xenical leave a comment the anti obesity fuss ii worse than useless official reports posted by henry bauer on 2014 09 03 clinical guidelines on the identification evaluation and treatment of overweight and obesity in adults the evidence report 1 from the national institutes of health has the typical flaws of official reports that i ve illustrated elsewhere 2 excessive verbiage hiding rather than revealing essential issues incompetent drawing of conclusions innumerable eminent names panel members or committee members shown as the purported authors while the actual research and writing was done by non eminent staff this particular report has 262 pages but what is worth saying would take no more than a few pages typically all the right things are said and then ignored for example that bmi body mass index alone is not a decisive determinant of risks supposedly associated with obesity followed by defining obesity precisely by bmi slightly modified by waist size the report s unnecessary verbiage includes many such banalities as standard obesity treatment approaches should be tailored to the needs of various patients or patient groups the possibility that a standard approach to weight loss will work differently in diverse patient populations must be considered when setting expectations about treatment outcomes evidence category b italics in original category b pertains when few randomized trials exist they are small in size and the trial results are somewhat inconsistent or the trials were undertaken in a population that differs from the target population of the recommendation p xiii does it really need to be said that individual patients should be treated as individuals is an evidence category necessary to support that recommendation further the description of evidence category b amounts to saying that it isn t really evidence at all just inadequate trials and no replication no better than anecdotes but this is far from the weakest evidence on which this report bases its pretentious conclusions and recommendations some of them are supported only at level c or d c describes anecdotes which mainstream sources typically pooh pooh when they contradict official dogma as for d panel consensual judgment sounds so much more impressive than the equally correct description mere opinion in absence of evidence upon which an informed opinion could be based other things that don t need to be said include a diet that is individually planned to help create a deficit of 500 to 1 000 kcal day should be an integral part of any weight loss program p xix an integral part how about the whole thing as i pointed out in an earlier post an effective diet is easily constructed and then there s this an increase in physical activity is an important component of weight loss therapy although it will not lead to substantially greater weight loss over 6 months p xix an important component that doesn t do anything and also this family involvement helps against progression of obesity p 11 what a surprise not only is over eating medicalized as obesity more research is needed p 21 to confirm or disconfirm that obesity may be related to psychological disorders in the meantime such future research is preempted by already defining binge eating disorder bed characterized by eating larger amounts of food than most people would eat in a discrete time period e g 2 hours with a sense of lack of control during these episodes hardly a precise definition and presumably one would exclude fraternity rites of passage or eating contests as only sociologically but not individually psychopathological there is also a treatment algorithm that adds nothing to common sense but serves presumably to add to the illusion that there is something scientific and worthwhile here the report s goals bear little relation to the asserted risk the initial goal of weight loss therapy is to reduce body weight by approximately 10 percent from baseline if this goal is achieved further weight loss can be attempted if indicated through further evaluation p xix but how often would that be a meaningful reduction of risk with extreme obesity 10 lower would get at most from extremely high risk to very high risk with very high risk not everyone in that class would get to merely high how meaningful would those apparent reductions in estimated risk be that remains inscrutable because there is not even claimed to be definitive evidence of any real benefit although there have been no prospective trials to show changes in mortality with weight loss in obese patients reductions in risk factors would suggest that development of type 2 diabetes and cvd would be reduced with weight loss pp xiii xiv would suggest once again this is guesswork speculation not an evidence based conclusion moreover risk factors ar...