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Monday, September 17, 2012

To Medicate or Not to Medicate?

That is the question.

Dietitians…opinionated. Armed with a stack of controversial and repudiated facts, we will debate any nutrition idea. You can think of it in terms of liberal vs. conservative. (I hate to use the terms democrat vs. republican as these terms hold little meaning anymore as to which stands for what.) There are the "idealist” dietitians, or those who push for organic eating, farm-to-market principles, and who would like to see everyone with their own compost bin.  And then there are the dietitians who sit back and say, “That’s great but probably not happening in this lifetime.” We can call these dietitians “realists.”

I park myself in the realist camp. I would love to live in a world where produce is local and affordable. I would love for everyone to eat a low fat lifestyle while increasing servings of lean fish. I would love for everyone to cook at home and rarely eat out. But I live in this world where even I have to drag myself to the kitchen to cook during the week. I like to teach people how to eat in today’s world while meeting their health goals. For the record, the idealists are a necessary part of the dietetics field and I would secretly like to be a little bit more like them.

Now, the argument of artificial sweeteners continues to cause such emotional reactions in people.  We have yet to find a link between artificial sweeteners and cancer.  (I mean a scientific link with trials, studies and paid researchers. Not the latest yahoo article.) Yet we do know there is a strong link between obesity and cancer. According to, obesity can be linked to esophagus, pancreas, colon, breast, endometrium, kidney, thyroid, and gallbladder cancers. It is estimated obesity can account for as much as 40% of these cancers. So if I am trying to help decrease someone’s waistline and they need the aid of artificial sweeteners to get them through the day, then so be it!

The FDA banned Ephedra,
 in 2004 due to reported
deaths and heart complications
Which brings me to today’s topic. Recently the FDA approvedtwo new drugs for weight loss called Qysmia and Belviq. Qysmia uses an appetite suppressant, phentermine and a drug for epilepsy called topiramate. Belviq works with the brain to reduce hunger signals. I personally am terrified to use a drug that alters my brain chemistry without a clinic diagnosis of anything wrong with my brain chemistry. But to each his own. Both drugs are designed to be used long term so that the individual is able to lose and maintain weight. Both drugs are designed to be aids.

Is it appropriate to use medication for weight loss? My quick response is no. What can medication do to change behaviors and set that individual up for long term weight loss maintenance? But upon further reflection I would say, “it depends.” It depends on that individual’s view of the drug and its role in their weight loss success. A study based on participants in the National Weight Control Registry found that only 4.3% of people used medications for weight loss.* However 20% used liquid formulas and 55% used a program or professional assistance. Meaning that approximately 80% of individuals used some sort of aid to lose and maintain their weight. But what these participants realized is that these were just aids, not solutions. They still had to reduce caloric intake and increase exercise to meet and keep the weight off.  

Now I’m a realist. While I prefer that people lose weight without the use of medications, I’m a realist. We may need aids to lose weight and the benefits of being at a long term healthy weight may be well worth the side effects of drugs.**  In fact, I have been known to use a liquid formula to maintain weight. It’s an aid, not the solution. But again, Im a realist. You absolutely can lose weight without aids, but should you decide to add them make sure and keep perspective. It’s an aid, not the solution.

*Also, this study occurred in 1997, when there fewer drugs available for weight loss.

**Side effects of these drugs are tingling of hands and feet (paresthesia), dizziness, altered taste sensation, insomnia, constipation, and dry mouth. Enjoy! J

Today’s Verse:  “Because he himself suffered when he was tempted, he is able to help those who are being tempted” Romans 2:18.

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