Now that two appetite-suppressing medications have obtained FDA approval, you’ll be hearing lots of discussions posing an either/or view. Should you use medications to lose weight and rely on a magic pill, or should you watch your diet and get more exercise? Weight Watchers or Pill Poppers? Which is the best approach? I believe this is a ridiculous view of the problem. We know that the human body is designed to want food whenever it’s available. We know that the pathways in the brain that cause strong desire for food are the same pathways involved in addiction to narcotic drugs. So this is a major battle. Or should I say “war” because this is a long term process with no end in sight?
You bring all of the tools you have available to fight a war. You wouldn’t go to war using just the Army, while leaving the Navy and Air Force behind, would you? Would you say “Oh, we’ll bring them in later if we need them.) Use all of the resources at your disposal.
Sure, there are some people in our society who can lose weight and keep it off without help from medications. There are some people who can quit any kind of addiction by going cold turkey. My father quit smoking cold turkey at age 32 and remained tobacco-free for the rest of his 92 years. But does that mean everyone can do these things? Why did we turn these addictions into moral questions? Before we had an understanding of the biological mechanisms of addiction, we felt these were moral issues. Alcoholics, drug addicts, smokers, all of these people were considered to be of weak moral character. The more we have learned about the biology of addiction, the more we understand that there are many biological differences between individuals. Sure we all know that people have different hair and eye color, and different likelihoods of reaching a specific height. Those are things you can clearly see. Do you think I am a failure because the NBA never even considered me for a job in pro basketball? (I’m not much over 5 feet.) Of course not. So let’s start accepting the fact that there are differences in people’s brain chemistry, stomach hormones, insulin levels, etc. that make it harder for some people to avoid the most appealing foods. And don’t forget that the most successful people in primitive times were the ones who managed to get the most food so they could live long enough and have many children who survived to reproduce. We are the product of those success stories.
Bottom line here: Let’s use every tool we can to achieve weight loss. You certainly have to consume fewer calories, one way or another. (Lots of ways to do that. We’ll discuss that at a later date.) But why not help people eat fewer calories using medications that can decrease interest in food and make you feel full sooner. In our society, we are stimulated by the sight of food almost constantly – every place from the bank to the office supply store, to the gas station – put food in front of your face, to say nothing of the ads on TV. This is way more challenging than it was even 40 or 50 years ago when food was sold at grocery stores only and fast food restaurants had not yet appeared.
I often hear people say, “I like to take as few medications as possible” or “I don’t believe people should take medications to lose weight.” (There’s that moral issue again.) But when you consider that losing weight can reverse or prevent many problems, it starts to become a different question. Many people have all three of these diseases: Type 2 diabetes, high blood pressure, and heart disease. Often, one person will be on a total of nine or more medications just for these three problems. What possible reason could there be to avoid using medications that can help with all three of these problems? It’s certainly well known that most people will see improvement of each of these conditions if they can achieve and maintain weight loss.
So how come there are people who remain skinny and aren’t so interested in food? Some of these differences are genetic and some are environmental. Some environmental effects occur in the womb, based on how much food your mother had while she was pregnant with you. So we are all different for lots of reasons. Many of those reasons are not your fault. Get past the blame business here. Now look forward and see what you can do about it.
In future posts, we’ll talk about some of the other tools (or weapons or branches of the military) you should be thinking about using in this fight against the waistline.