Who benefits from bad science?

18th March 2008

Who benefits from bad science?

posted in Book Reviews, Health/Nutrition |

A recent article published in the New Scientist this month examines the role anti-depressants play in causing and exacerbating fatness. Article author Paula J. Caplan, an author and clinical and research psychologist at Harvard University, cites the growing popularity of psychotropic drugs - taken by around 50 million Americans - could be potentially causing a significant portion of the so-called obesity epidemic. This is, just after another study claimed that most modern drugs prescribed for depression generally do not work.

Sheana at the blog SeeWorthy has a great discussion on this, as well as Cthulhu’s Cafeteria.

Melody Petersen - Our Daily Meds Raised in front of ubiquitous drug-company advertisements, my generation, along with the elderly and many others, seems to have acquired the notion that prescription pills fix everything, and that they are less dangerous than street drugs. Now an increasing number of writers and researchers are taking Big Pharma to task, and calling them on their flawed studies and adverse health risks posed by their products. Crusader Shannon Brownlee recently published Overtreated, followed now by Melody Petersen’s Our Daily Meds - check out the book’s review in the New York Times.

As Brownlee’s book suggests - and I highlighted in a previous post on the subject - health care not only suffers from a dearth of credible research, national policy and legislation governing health care are victims to heavy pressure from lobbyists and industry. Petersen picks up on the subject, calling for an increased awareness of the increasingly serious consequences of what she calls Americans’ dependency on prescription drugs. She echoes Brownlee’s insistence of flawed, rigged studies cooked up by Big Pharma, that deem a drug “effective” if it performs only slightly better than a sugar pill.

Petersen even finds feedback from doctors about bribe-style amenities offered by drug company junkets. Want to know if your doctor has been influenced by drug companies? Just look at the pens and tissue boxes in your doctor’s office. If they feature drug ads, chances are a drug company rep has been courting your physician to influence which prescriptions they write. We have a family friend who is a psychiatrist. After moving his office to a different city several years ago, I asked him how his new practice was going. “I just listen to ‘em for 15 minutes and then prescribe medication,” he admitted. His medication of choice? Welbutrin, because its representatives give out the most perks and benefits so that he will prescribe it.

Like Brownlee, Petersen calls out the ways in which Big Pharma have collaborated to create illnesses in need of medication, where no illness existed before. Or as the Times reviewer writes, “There are the business strategies that have created illnesses out of what used to be facts of life, labeled them as syndromes, and have hooked customers into long-term use of medication to cure them.”

Case in point: What’s the best way to instantly create 35 million more consumers in need of your product overnight? Simply lower the BMI standards so that more people qualify as overweight or obese. It worked in 1997, when BMI standards defining overweight were lowered from 27.3 to 25. Or, have obesity classified as a disease or mental illness, so government and private insurance will be forced to cover services and medications for the treatment thereof.

As a reader at Harriet Brown’s blog noted, doctors have also lowered guidelines for blood pressure from 140/90 to 130/80. Similarly with blood sugar guidelines, which can now identify even someone with a healthy blood sugar level with “pre-diabetes.” And now that cholesterol levels of American adults are ideal for the first time in 50 years, what are the chances these standards will also soon be lowered? As Harriet astutely notes, “Who benefits?”

Obesity is a convenient hook upon which to lie the blame of America’s soaring health costs, but as Petersen notes, during the years 1980 to 2003, Americans increased their spending on prescription drugs 17 times over. “Could drugs be killing people but escaping all blame, leaving them to harm even more Americans until someone, finally, catches on?” she asks. As one natural living site suggests, Big Pharma and Big Tobacco are more similar than different; both use the same tactics, only different chemicals.

Advances in drug technology have benefited a lot of people and saved countless numbers of lives (including my own) and for this, pharmaceutical companies should be applauded. But we must also demand they adhere to ethical guidelines in developing and promoting their products. As both Petersen and Brownlee advocate, we need an independent, non-government-affiliated watchdog agency to oversee and regulate drug companies.

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1 On March 18th, 2008, BigLiberty

said:

Rachel,

You bring up a very significant point, a point I’ve been battling even before my eyes were opened to the fact behind the so-called “obesity epidemic.” It is this (as I understand it): normal human variation, present all throughout history, is being labeled ‘diseased’ and some arbitrary average value labeled ‘healthy.’

This isn’t just the fat person’s struggle; for instance, I have undiagnosed Asperger’s. Why undiagnosed? Because, from reading countless papers in psychiatric and neurobiology journals, I’ve decided based on the evidence presented me that Asperger’s is a normal human variation, affecting a small percentage of the population, and has been around since the dawn of the written word (and likely before). We think and interact somewhat differently, true, but Aspies are as human as anyone. Our ‘difficulties’ are only such in the context of interacting with Neurotypicals (those who do not display Asperger characteristics); subtract the NTs, and the ‘difficulties’ disappear.

However, we’re seen as ‘diseased’ (Asperger ‘Syndrome’) and not a normal variation, because there are more NT’s than Aspies. The arbitrary average value gets skewed towards NT’s, and hence Aspie characteristics are seen as ‘aberrations,’ not variations.

Indeed, the attempted ‘normalization’ of human variation is the underlying motive for countless horrors perpetrated on the human race. Lobotomies — attempts to normalize variation. Genocide — an attempt to normalize variation. Oppression (physical, philosophical, psychological) — an attempt to normalize variation.

I learned when I was about 12 that there is no such thing as ‘normal.’ Most people learn this. However, I don’t think most people understand what that statement really entails. It would be an interesting study, to undergo research into the many ways we still engage in the normalization behavior, though we see ourselves as far more liberal-minded than we’ve been in the past.

This normalization dynamic never seems to go away, it just seems to change shape and form. Why do some feel the need to squeeze everyone else into their definition of ‘normal’? I surely don’t know…variation is one of the things that has made humanity truly great. I don’t want us all to think the same, and to look the same. But that’s just me.

posted on March 18th, 2008 at 11:38 am

2 On March 18th, 2008, Fat Girl

This is definitely something to really chew on. In general, I’m in favor of drugs- IF THEY HELP. But truthfully, I don’t know if any of the drugs I’ve been on (other than painkillers) have ever really helped me.

Also I do wanna point out that it’s true that a lot of doctor’s offices prescribe certain meds because they are getting perks, but I’ve had multiple doctors that I’m pretty sure prescribed something to me because they had samples and they knew I couldn’t afford to buy it- I’m still skeptical about whether or not the multiple anti-depressants I’ve been on (and am currently on) helped (or are helping) but I thought I’d share that just so people realize not EVERY doctor is doing it just for the perks. Sometimes they are trying to help the patient in one way or another.

Also just wanna say that I wish I could really convince myself of what the above poster has said about variation from normal- because much of my “depressed” time is me sitting around and thinking “What is wrong with me? NORMAL people don’t feel like this.”

I think I’ll go try to wrap my head around that. Thanks.

posted on March 18th, 2008 at 12:19 pm

3 On March 18th, 2008, Meowser

Big Liberty, I think part of the reason it took a psychologist rather than a psychiatrist to tell me I was Aspie (despite having seen about a dozen psychiatrists over the years who never so much as mentined it) is because there are no drugs to prescribe for it. They have drugs to treat the depression that comes from years of being treated like a space alien, but no drug will make someone “NT,” and it’s likely no drug ever will. So in many adults it goes “undiagnosed,” and we run around for years insisting that our brains function differently, no really they do, and psychiatrists tell us it’s the depression talking.

Don’t get me wrong, psychiatrists have their purpose; if not for them I could not have held a job and afforded a better quality of care. But I’m glad I didn’t stop there.

Also, anyone who yowls about health care costs in this country needs to be schooled about the fact that you can’t simultaneously save both Big Pharma and Big Insurance money. Meds require prescriptions; prescriptions require doctor visits; the more scrips, the more visits. As long as Big Pharma’s agenda remains a priority to fill, we will never be thin or “healthy” enough to “not cost health care money,” because the standards keep getting ratcheted down and soon anyone with a fasting glucose over 70 will be considered “prediabetic.”

posted on March 18th, 2008 at 1:14 pm

4 On March 18th, 2008, Angela

Very interesting reading. I was on two anti depressants, first, I was on Wellbutrin. It was supposed to be an anti depressant that would also help with weight loss. The side effects were scary…tingling arms, constant dizziness, hallucinogenic “daydreams”….so the doctor put me on Prozac. Weight gain was a side effect but I convinced myself the weight gain would be worth it if I could become a normal, functioning member of society again. I needed to for my kids. I figured I could take the weight off at a later point.

About a year and a half of being on Prozac, my dosage was upped to the “weight loss dose”….60 mg. This was supposed to be the dose that is prescribed as a weight loss drug. It wasn’t working, in fact, I was gaining weight same as before. So the doctor put me back on the 40 mg dose and added Wellbutrin. 70 pounds later, I am not taking ANY anti depressants, even though I probably should. I have always been a larger woman, always had problems losing weight (no problems gaining!) so to add another 70 pounds to my already “curvy” frame was very difficult. I still haven’t been able to take the weight off.

posted on March 18th, 2008 at 6:12 pm

5 On March 18th, 2008, queendom

I’m still skeptical about whether or not the multiple anti-depressants I’ve been on (and am currently on) helped (or are helping)

Actually, since depression is usually diagnosed with self-report questionnaires like the Beck’s Depression Inventory you should know if the antidepressants have helped you or not - if you don’t think that there was a change it probably wasn’t there (and in case of depression you are a far better judge than any doctor). Also, nobody should feel obligated to take antidepressants. Yes, they help some people, but they don’t work with others and there are alternatives (such as several forms of cognitive behavioral therapy).

posted on March 18th, 2008 at 9:16 pm

6 On March 18th, 2008, Rachel

Angela, I had several doctors also promote Welbutrin to me as a weight loss drug. It never caused me to lose weight, but I continue to take it because it is noticeably effective for me, and is weight-neutral. I still have a morbid fear of medication that numerous people cite as the reason for weight gain. Fortunately, I’ve not had any adverse health problems from Welbutrin, and it also supposedly helps with my ADD treatment.

For many people, depression is caused by chemical imbalances in the brain. But other people have found cognitive therapy and a variety of other natural treatments to be effective for the treatment of their depression. Medication is not always the magical cure-all its promoted as. Have you ever explored any of these routes?

posted on March 18th, 2008 at 9:36 pm

7 On March 18th, 2008, Angela

Rachel,I have explored other alternatives. I have explored natural remedies as well as talking to professionals and making sure I take more time for myself.

I took myself off of the medications. I weaned myself off of them gradually. I felt like, at that time, I didn’t need them anymore. Within the last year I have had four deaths in my family, the most traumatic to me being my dad 9 months ago. I say that I probably have a need for the medications because I have at time had difficulties coping with his death and the manner in which he died.

Thank you so much for your thoughts.

posted on March 18th, 2008 at 11:11 pm

8 On March 19th, 2008, twincats

In the late 1980s, I started noticing how many new drugs were becoming the targets of class-action lawsuits via both pharma ads and TV lawyer ads. As in “Ask your doctor about drug X” then “If you or a loved one has suffered Y from taking X, call the law offices of Z.” There seems to be a new class-action against drug companies every year or so.

I have been a PITA (pain in the a**) patient ever since; any doc who wants to prescribe meds I haven’t been on before had better be prepared to convince me why I should take ‘em and why they’re better than older drugs or OTC remedies. I was only convinced once in the last 15 years.

Health care is an industry. Its first priority is making money, not your health.

posted on March 19th, 2008 at 3:52 pm

9 On March 19th, 2008, nonegiven

It looks like anti-depressants contribute to the development of diabetes, also.
http://www.medscape.com/viewarticle/539078

As a PWD, I’m supposed to keep my bp below 120/80 and my LDL below 100. I am pretty sure that I was already getting complications from high after meal blood sugars when my ‘normal’ fasting glucose was between 100 and 110 for many years. I think I would have flunked an OGTT if the idiot doctor would have given me one when I reported relentless hunger and peeing a lot. (Instead, he told me to eat less fat, which just made the hunger worse, and to drink less, *hello* increased thirst?)

posted on March 19th, 2008 at 6:03 pm