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Wednesday, Nov. 25th 2009
This October saw yet another medical device fail in a high-profile clinical trial. Alongside the pharmaceutical industry, manufacturers have been designing devices to help people lose weight. Why? Well, with obesity reaching epidemic proportions around the world, there are millions of people “out there” waiting to buy something that will help them shed unwanted pounds. Everyone wants a quick and easy solution to an age-old problem: how do you lose weight without any change in your lifestyle? Everyone wants to keep on eating without paying the price in extra pounds. Unfortunately, just as there’s no sign of a magic bullet drug that will burn away those unwanted pounds, the latest scientific implant has also failed. It has been deja vu all over again. The pre-trial hype claimed this revolutionary device would use technology to suppress appetite. If people do not feel hungry, they will eat less and lose weight. The result? The device proved absolutely safe. Why? Probably because the device had no measurable effect on the bodies of those who tried it out.
This latest failure forces everyone back to the real world. There are no drugs in the development pipeline to save people from themselves. There are no magic machines you can wave over your body or have a surgeon implant. The only way to lose weight is to eat a sensible diet and exercise. The hard rule is that you have to burn more calories than you eat. In the stock exchange, the share price of the latest manufacturer to claim a miracle treatment fell by almost 80% when the news of failure was announced. Reading this, your spirits have also fallen sharply. This is sad news. Indeed, this is why most people fail to lose weight. They get depressed when weight does not fall off. They give up the “unequal struggle” with their waistlines. The necessary lifestyle changes never materialize.
The problem starts when you’re young. You’re surrounded by unhealthy food and it comes in giant portions. Worse, your parents now have the money to pay for this food. Go back fifty years and there was less money around. Parents struggled to put food on the table. Most people grew up thin. By a curious coincidence, fifty years ago saw the release of phentermine into the weight loss market. This was a revolutionary drug designed to reduce appetite. Now that the world desperately needs a way to help people lose weight, phentermine is still the drug of choice. Except there’s just one small problem. All phentermine does is to reduce your appetite. This leaves you with the hard lifting. You still have to change your eating habits and eat smaller portions of healthier food. The most weight will only be lost if you also exercise. The need is still to burn more calories than you eat. If your lifestyle remains the same, you will fail even though the drug has an unbeatable track record – fifty years of safe and effective treatment.

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Wednesday, Nov. 25th 2009
Put boldly like this as the title to the article, this is close to being politically incorrect. We are not supposed to talk about people who are overweight. This intrudes into their privacy. We are being discriminatory in some way. Yet, when you come to the hard statistics collected by the federal Center for Disease Control and Prevention, there is absolutely no doubt about the national trend. The CDC has been producing the National Health and Nutrition Examination Surveys for decades. It’s the CDC’s way of keeping its finger on the pulse of the average American. The first study was done almost sixty years ago.
At that time, about one quarter of all Americans were overweight, i.e. had a Body Mass Index of more than 27. This was the steady result as time passed until the Survey results came in the 1980′s. Suddenly, one third of the population was overweight. In just ten years, millions of Americans switched their eating habits from moderate to excessive. If you could be persuaded to think of this as being like the spread of a disease, this would be an epidemic. And, just like a disease, it has continued to spread. Now more than twelve million adults have a BMI of 40 or more. In everyday terms, this has meant the replacement of the routine things we use in public places. Revolving doors are now bigger. Chairs are wider and strengthened. Even coffins have had to be enlarged.
So what changed and why? The answer is rooted in evolution. For survival purposes, we are hard-wired to eat during the years of plenty so we can live through the inevitable famine. Except, in modern times, no famine appears. This just leaves us with the appetite for high calorie foods to build up fat. Worse, as hunter gatherers, we had to run after our food to catch and kill it, or endlessly dig in the field to grow it. Now we drive down to the convenience store. Our lifestyles changed from active to sedentary. The final nail in the coffin was price. Before we applied technology to agriculture, food was quite expensive but, over the last forty years, the real price of food has been falling fast. Now we can all afford to overeat.
So to lose weight, we have to fight evolution. Just as our brains keep telling our bodies to eat more fat to store up energy, we have to tell ourselves to eat less and exercise more to burn off the fat. One of the key weapons to use in this fight is phentermine. This is a chemical designed to work in our brains. Instead of our stomach having a clear line of communication to our heads with the message that our stomachs are empty, this drug blocks the message. So, when some people start feeling hungry and automatically reach for the cookie jar, the phentermine user does not feel like eating snacks between meals. It kills the hunger pangs and makes it easier to keep to a diet. Now when we tell ourselves to exercise alongside the diet, there is more likelihood we will burn off some of these unwanted pounds and start looking and feeling more healthy.

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Wednesday, Nov. 25th 2009
One of the fascinations of life is to look at idioms. More often than not, they capture wisdom in just a few brief words. Take the title to this article. Literally, it means you are prepared to commit a crime to pay off a debt but it shows a more general circularity. If you borrowed from Peter to repay Paul, you would still be in debt. You would be no better off. In fact, you might be worse off if Peter charged a higher rate of interest than Paul. Except, there might be times when the robbery brings you out ahead of the game. Where you could get away with the “crime” and at least be no worse off. In some cases, you might even be better off. Let’s go back a few brief months to a press conference called by President Obama. He was pressing on with his campaign pledge to reform the healthcare industry and he wanted to give the various players a chance to show they were on his side. In this case, the moguls from the pharmaceutical industry made a pledge in support of reform. They were prepared to make cuts of $8 billion a year in the price of drugs sold to the people of America. Put another way. If the premium rates you pay for health insurance are to fall, the cost of drugs and services also have to fall. That way the insurers still make their profit, but you get the same drugs and services at a lower price.
Now, if you were sitting in the board rooms of the drug companies, what would you be thinking? To avoid being humiliated and made to look really bad on national television, you have to pony up $8 billion in cuts next year. What will your stockholders say when you report seriously reduced profits and no dividends? They will not be happy bunnies. So you decide to raise prices this year. That way, when you cut them next year, you are no worse off. Perhaps no-one will notice. Well, industry watchers have noticed. The wholesale prices of branded drugs have been raised by an average of 9% since the start of this year. This at a time when the Consumer Price Index has actually been falling. This at a time when the prices of the generic drugs have been falling because of price competition. The result is a new record. Experts believe the total price paid by you for drugs next years will be more than $300 billion. Assuming, of course, you do not buy your drugs from trusted online pharmacies at prices well below the usual wholesale prices paid by your neighborhood drug store.
In one sense, this should not affect you. This article is written for people with an interest in ambien and, in our most rational moments, we all admit the best cure for insomnia is cognitive behavioral therapy. Except that is not always available in your area or affordable. So millions depend on this drug to get us to sleep and to keep us asleep until dawn. As the cost of branded drugs rises faster than ever, you are the ones standing in for Peter and your money is being used to pay the stockholders like Paul when President Obama gets his cuts. Remember that the next time you buy ambien online and save money.