Search Results for "why i support"
Why Coverage Of Anti-Obesity Medications For Federal Employees Is Only Fair
One of the rather explicit biases that has hindered greater investment into finding more effective obesity medications, has been the unwillingness of many health care plans to cover the cost of such medications for their members. Indeed, many private and public health plans around the world explicitly exclude obesity medications (and other obesity treatments) from coverage. This is clearly a double standard, given that the very same plans have no problem covering medications for other “lifestyle” diseases such as type 2 diabetes, hypertension, or high-cholesterol. Now, in a rather dramatic move last month, the US Office of Personnel Management (OPM), responsible for health insurance coverage for over 2.7 million Federal Employees, ruled in support of health coverage for FDA-approved weight-loss treatments stating that obesity exclusions are no longer permissible in health plans for federal employees. This move should set an important precedent for other health plans to follow. In the March 20th letter to all FEHB carriers, John O’Brien, the Director of Healthcare and Insurance at OPM, agrees that while “diet and exercise are the preferred methods for losing weight, …drug therapy can assist [those] who do not achieve weight loss through diet and exercise alone.” In the letter, O’Brien provides further clarification: “It has come to our attention that many FEHB carriers exclude coverage of weight-loss medications. Accordingly, we want to clarify that excluding weight loss drugs from FEHB coverage on the basis that obesity is a “lifestyle” condition and not a medical one or that obesity treatment is “cosmetic”- is not permissible. In addition, there is no prohibition for carriers to extend coverage to this class of prescription drugs, provided that appropriate safeguards are implemented concurrently to ensure safe and effective use.” This ruling should end the long-standing practice of discrimination against people with obesity who require and are willing to take medications for their condition. Obviously, medications for obesity need to always be used as an “adjunct” to diet and exercise, in the same manner that medications for diabetes, hypertension or high-cholesterol should always be used as an adjunct to diet and exercise. It goes without stating that prescription medications for obesity, diabetes, hypertension or high-cholesterol should only be made available to those who fail to control their weight, blood sugar, blood pressure, or cholesterol levels with diet and exercise alone. (there is no “special case” for the role of diet and exercise in obesity management that does… Read More »
Why We Need Medications For Obesity
Regular readers will know of my support for bariatric surgery. Despite all caveats (discussed in previous posts), it remains the most effective (and perhaps only feasible) option for many struggling with severe obesity. However, even under the best circumstances, surgery is not a realistic option to deal with an epidemic that affects millions of individuals. Even with 10,000 surgeries a year, it would only take about 100 years to operate on every eligible patient in Canada, who is severely obese today. This is neither feasible nor affordable. Thus, numbers dictate that overweight and obesity will require treatments that can be taken by millions. To use an analogy: if there were no pharmacological treatments for hypertension or diabetes and the only treatment was an operation, most people would still be dying of heart disease and other complications that are now perfectly preventable and treatable because we have a large armamentum of anti-hypertensive and anti-diabetic medications. Yes, people could perhaps do more to prevent getting hypertension and diabetes in the first place – we know that healthy diets and regular exercise go a long way in preventing both conditions – but even if we can adopt prevention measures that miraculously cut the incidence of these conditions in half – we are still left with millions who will have hypertension and diabetes. If we had no drugs, some of these folks may get some relief by reducing their salt intake or following a strict diet – but we know that in real-life, these interventions are neither realistic nor powerful – without anti-hypertensive and anti-diabetic medications we would certainly not have seen the recent remarkable (over 50%) reduction in cardiovascular diseases – we are seeing far fewer strokes and heart attacks than ever before despite an increasingly overweight and obese populations, an increased prevalence of risk factors (except perhaps smoking) and an aging population. The only reasonable explanation for this decline is the widespread use of highly effective and “proven” medical treatments for these conditions. While it is impossible for 10s of millions of people to be operated upon, there is nothing to stop 10s of millions of people taking a tablet or two everyday if it helps lower their blood pressure or control their blood glucose. These medications were not discovered or tested overnight. It took decades of medical research and innovation to develop the wide range of anti-hypertensive and anti-diabetic medications we… Read More »
Why I Welcome “Big Food” At the Canadian Obesity Summit
In our blog posts today, my good friend Yoni Freedhoff and I discuss our respective views on the issue of including “Big Food” as sponsors for the 3rd Canadian Obesity Summit, beginning next week in Vancouver (May 1-4). To be entirely clear, our posts reflect our personal views. I certainly have no intention of speaking on behalf of the Network, its Board of Directors or its Scientific Committee. Although Yoni and I agree on virtually all aspects of obesity prevention and management, the one area where our opinions clearly differ is in our approach to confronting and engaging the food industry. While Yoni takes a brilliantly polemic activist position on this, I firmly believe in the merits of constructive dialogue between ALL stakeholders, which in my view is exactly what the Summit should be about. In fact, the very mandate of the Network, which was founded in 2006 with the support of Industry Canada, has always been to engage ALL sectors (especially industry!) to work towards solutions to Canada’s obesity problem. Thus, although many would rather see the Obesity Network slip into an advocacy role, calling on governments, health authorities or others to implement policies for or against whatever this or the other group envisions as “the solution”, this has never been the role of the Network. Rather, the Board of Directors of the Network has always emphasized the Network’s role in engaging and fostering dialogue between ALL relevant stakeholders. Accordingly, the sponsors and exhibitors come from a wide range of sectors including government (CIHR, PHAC, etc.), non-government organizations (Heart and Stroke Foundation, Canadian Diabetes Association, Michael Smith Foundation, etc.), trade organizations (Dairy Farmers, Food and Consumer Products of Canada, Canadian Beverage Association, etc.), and industry including pharma (Novo Nordisk, Lilly), surgery (Ethicon Endo Surgery), weight-loss industry (PGX, Bariatrix Nutrition, Nestle Health Science) and food companies (Coca Cola, McDonalds). Given the particular importance of the food landscape, it is indeed notable that this year’s Summit, for the first time, includes the very companies that are often presented as the “poster children” of what is wrong with our nutritional landscape, namely Coca-Cola and McDonalds. Critics may say that this is nothing more than a blatant exercise in “health washing” their brands and trying to avoid government regulation. But, if simply supporting the Canadian Obesity Summit would be enough to “health wash” companies, there should have been no shortage of “Big Food” lining… Read More »
A Canadian Love Story and Why Jackrabbits Change Colour
Today’s post is a shameless plug for a venture by my daughter Linnie (known to some readers as DR Eye Candy) and her friend Rebecca to raise money via Indiegogo for a children’s book. This incredibly cute and heartwarming story of recent immigration to Canada (the draft of which was written on the back of an Air Canada puke bag) is one that will certainly resonate with anyone (especially kids), who (like us) have decided to make Canada their new home. Or in the words of the hopeful author (Linnie) and illustrator (Rebecca)” “By publishing Our Canadian Love Story we sincerely hope that our little tale will inspire dialogue within your families, schools & playgroups about what immigration means to the fabric of our joint Canadian life. And if you’re feeling a little less philosophical: then it’s simply a whimsical tale about two jackrabbits who fall in love…with each other and with Canada. El señor Giacomo and mademoiselle Jacqueline, the main jackrabbits of our tale, arrive in Canada much like you did…or maybe your mom and dad or gran and pop, or oma and opa, or nonna and nonno, or grand-père and grand-mère…because somebody they knew said to them: “There is a place where the horizon is endless. Where the sky dances with the light that is the music of our planet and where the ground is dusted in white diamond powder. And the best part is, that it tastes and smells like sweet sugary maple, right from the Atlantic coast on the East all the way to the Pacific coast on the West.” Help them pack their bag in a land far away from ours. Learn why jackrabbit fur changes colour. Watch them chug a spoonful of courage and fly to Canada on an Air Canada Goose flight. And finally wave at them as they arrive at Terminal 1 of Canada International Airport.” To support their venture on Indiegogo click here. To like their Facebook page click here. To watch their trailor on YouTube click here. To visit their website click here. Please help Linnie and Rebecca make their story come true. AMS Edmonton, AB
Why Are Some People Successful At Maintaining Weight Loss?
Over the past few posts, I have been discussing the findings of the National Weight Control Registry, which found that the people, who successfully manage to keep weight off, fall into roughly four clusters. As readers will recall, the prototypical representatives of these clusters (Golden Boy Mark, Fitness Enthusiast Julie, Poor Eater Gertrude, and Struggler Janice), all have lost considerable amounts of weight, but each is using a different approach and coping differently. But why are they successful? Frankly, I have no idea! Of course, we now know “what” Mark, Julie, Gertrude and Janice are doing – we know “how” they are keeping the weight off – but nothing in the NWCR data tells us “why” they can do what they do. Not only, do we not find any answers to why these folks are “successful” at something that the overwhelmingly vast majority of people with excess weight tend to fail at, nor does the data tell us how to take someone, who is not “successful” and lead them to “success”. In fact, we do not even understand what makes Mark, Julie, Gertrude and Janice different from each other. Are the reasons for their different strategies genetic, physiological, psychological, social, or environmental? Does Mark find it effortless to manage his weight because of the make up of his mitochondrial DNA, his mental resilience, his extra-ordinarily large frontal lobe, or simply the fact that he has a job that allows him ample of time to pursue his healthy eating and physically active lifestyle. Perhaps, he has a social support system that supports rather than sabotages his efforts. Perhaps he has a healthy dose of narcissism (some might call it “selfishness”) that allows him to put himself before others. We don’t know. What led Julie to take up her active lifestyle and why has she decided to devote such considerable energy to her sporting activities – has she perhaps simply transferred here addictions from food to workouts? We don’t know. Why can Gertrude get by by eating so little. We don’t know. So, while it is of considerable “academic” interest to know “what” successful weight-loss maintainers do, it is not at all clear how to turn an average Joe into Mark or an average Jane into Julie. Which brings me back to clinical practice. If I were simply to tell my patients that successful weight loss maintainers tend to eat 1400 Cal… Read More »
