An earlier blog on the "medicalisation of obesity" sensitized me to the issue of the role physicians play in reducing obesity.
In the August 9, 2007, blog, I referred to an interview with Dr. Hamish Meldrum, the head of the British Medical Association, reported in the August 2, 2007, London Evening Standard. Dr. Meldrum argued that altering fat-generating behavior (eating less and moving more) was a better solution than prescribing a weight-loss pill.
Because of Dr. Meldrum's argument, I paid particular attention to a headline in the August 4, 2007 issue of Diabetes Health: "Illinois Doctor Prescribes Amphetamine to Help Kids Lose Weight and Avoid Type 2 Diabetes".
Dr. Fuad Ziai, a pediatric endocrinologist, has prescribed Adderall, which contains amphetamine, to over 800 teenage patients who are suffering emotionally and potentially physically from obesity, 90 percent of whom have lost weight. His rationale for the use of Adderall, typically used for attention-deficit disorders, is the absence of other treatment viable options.
Adderall is a Schedule II controlled substance and is considered addictive. It is informally referred to as "legal cocaine." Because of its speed-like effects, it is popular with college students. Al Gore's son was recently arrested for possession of Adderall without a prescription.
I asked my teenage granddaughters, Heather (17) and Danielle (15), their opinion: Is it appropriate to treat obese teens with amphetamines?
Even though I carefully posed the question in neutral terms, I was certain that they would argue on the behalf of addressing the immediate needs of the obese teenagers, even if it meant prescribing an amphetamine.
I was wrong. Here's what they wrote:
"Few teens, or adults for that matter would choose to become obese. Yet all of us have the choice of what we consume and how much we exercise
The Illinois doctor who is prescribing Adderall is giving teens a lazy way to lose weight. He is reinforcing the mistaken idea that we can eat whatever we choose without consequences. A better solution would be to teach teens how to take and keep off the weight through exercising regularly and healthful food choices.
Besides that, amphetamines have severe side effects. While the teenager may have more energy, the teen might also have drowsiness, hallucinations, headaches, nausea, diarrhea, constipation, insomnia, dizziness, anxiety, an irregular heartbeat and extremely high blood pressure. These side effects could be potentially harmful to an adolescent's maturing body.
Would a few pounds really be worth risking one's life? And once the prescription runs out, what then? Will the teen be hooked on amphetamines? Will the teen regain the weight? And even more? If so, then it would become even more important to exercise and eat healthily.
Taking amphetamines to produce weight loss only postpones the inevitable. Instead of wasting precious time and money on an addictive drug, it makes more sense to learn lifelong habits today-habits that will keep teens thin and healthy for the rest of their lives."
As a layperson, I'm not in a position to cast aspersions on Dr. Ziai's medical practices. Certainly his intentions are good. Even so, like my teenage granddaughters, I have reservations about whether his approach is the right one.
Taking a shortcut makes the destination more important than the journey. But isn't making the journey how we acquire self-restraint and self-respect? What do you think?
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