Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Sunday, April 26, 2015

Binge-Eating Consequences and Curatives

"We have essentially a fake diagnosis that will be vigorously peddled on airwaves across the Canadian border, convincing people that the reason they're overweight is they have binge eating disorder [BED] and that there is a chemical solution."
"It's called disease mongering; sell the illness, and then sell the pill."
Dr. Allen Frances, professor emeritus, Duke University, North Carolina

Now there's an interesting observation from a fascinating source, in that Dr. Frances chaired the task force producing the fourth version of the the Diagnostic and Statistical Manual of Mental Disorders (DSM) which its critics fault for classifying too many obsessive human traits as genuinely authentic mental disorders requiring treatment with a pharmacopoeia of drugs. And he himself is bitterly assailing those who have gone overboard in assessing and claiming that compulsive overeating is being classified as a mental disorder.
"Most of the clients I see clearly talk about dieting at six, seven or eight years old. So they start getting into the habit of sneaking food, and eating huge amounts of their forbidden foods when they can, because they're not going to get it again."
"You start to develop these really abnormal eating patterns."
"The reason they were struggling with their weight was that they couldn't follow a meal plan, they couldn't make healthy, non-impulsive choices -- they were kind of all over the place."
"Once they were put on treatment for attention deficit they were actually able to lose weight."
"It would be very bad if every single person who had weight difficulty simply went in to their family doctor and said, 'I want to be on this drug to be thin', and they were given this drug."
"This is not just, 'I only wanted to eat one cookie and I ate four. This is, 'I ate the box and then I went back and got two more'."
Dr. Valerie Taylor, psychiatrist-in-chief, Women's College Hospital, Toronto
Some critics accuse the drug manufacturer of 'disease mongering' and fear Vyanse will be prescribed to overweight people who don’t have binge-eating disorder.
Andrew Barr/National Post  

American drug regulators have given the green light to the first pill to treat binge-eating disorder; it's called Vyvanse and was designed for the express purpose of treating attention deficit disorder. Now, however, it is going to be used as a prescription pharmaceutical not only in the treatment of hyperactive minds, but because it has the capacity of reducing impulsive-hyper-overeating in adults, it is set to hit the North American market. Most often when a drug is approved in the U.S. it also is approved for use in Canada, and Vyvanse is now awaiting Health Canada approval.

Its developer and manufacturer Shire makes claim to the drug's efficacy for binge-eating; emphasizing it is not a dieting tool. It will not be approved or recommended for use as a weight loss agent, or in the treatment of obesity. Its use is limited as strictly relating to a drug whose potency is meant to 'normalize' eating for people whose compulsive-obsessive focus leads them to binge-eating and the inevitable regrets that follow, let alone the weight factor that ensues, impairing health outcomes both short- and long-term.

There have been other, previous drugs on the market purporting to successfully do what Shire's new venture is promising. And they've also been taken off the market as a result of their serious side effects which have included liver damage and sudden death. Two decades ago, the weight loss fix known as fen-phen was taken out of distribution when users started having leaking heart valve and other heat problems. Spurring the pharmaceutical industry to develop a number of new anti-obesity drugs because the potential market and the vast sums of money to be made are that influential.

In Canada alone, 'normal weight' people are in the minority, with 62 percent of the population now deemed overweight or obese. People with "morbid" obesity, with a body mass index of 40 or over represent the fastest growing demographic in this health-afflicted category. The formula is inflexible in its results; the greater the weight, the higher the risk of diabetes, high blood pressure, coronary artery disease, fatty livers and obesity-related illness of various descriptions. Greater numbers of people are showing up with BMIs in the 50s and 60s, once thought unheard-of.

Public health messages urging people to watch their food intake, to eat more wholesome foods and reject processed foods; to get out and exercise, are not influencing those that should be taking heed. Lifestyle modification messaging "has very little efficacy when it comes to decreased weight" for those in the obese category, stated Dr. Sean Wheaton, an internal medical specialist and medical director of the Wharton Medical Clinic in Mississauga, Ontario. Dr. Wheaton speaks of obesity as a chronic, progressive, relapsing medical problem, neurochemicals- and hormones-driven.

Taking human biology back to primal times when existence was a struggle to find sufficient nutrients to sustain daily energy needs, when humans were equipped with the built-in urge to consume whatever was available, as much as was available, as insurance against lean times. Drugs that do appear on the market, approved in Canada, such as orlistat [Xenical] to prevent dietary fats from absorption by the intestines have had the field to themselves. More recently Health Canada approved Saxenda, an injectable drug known for its "weight management" function.

 JB Reed/Bloomberg News
JB Reed/Bloomberg News    Xenical is a drug that prevents dietary fats from being absorbed by the intestines but whose side effects include oily or fatty stools.

The ADHD drug Vyvanse, is a central nervous system stimulant which the FDA warns may cause psychotic or manic symptoms, like hallucinations. Its other risks are somewhat more serious, and include heart complications or sudden death in people with heart disease. What is also worrying for regulators is that the drug may become another social medical-health problem, through its high potential for abuse by people wanting to lose weight, despite its inappropriateness for that purpose.

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