“Your health is not a commodity to be bargained for, nor can it be swallowed in the form of drugs and pills, it has to be earned through sweat.” – B.K.S. Iyengar
B.K.S. Iyengar does have a way with words and distilling the truth. This yogic sage, at 93, still practices yoga.
Sadly, in America, his wisdom about health is not universally or even marginally adopted. Rather it exists in small subcultures, pockets of urban (usually) enclaves. No, in America we love popping pills to cure almost anything (granted some people legitimately need the medications they’re prescribed).
In America, this reliance on the pharmaceutical industry, generally, is a coping mechanism or scapegoat for two things:
1. Lack of education, both in schools about health and proper care, and on a government level, for preventative care.
2. Lack of personal responsibility for health and wellness: the vast majority of Americans do not exercise nearly enough or eat properly. According to the Center for Disease Control, the level of exercise and physical activity in American is staggeringly low (as of 2009):
a. Percent of adults 18 and over who meet physical activity guidelines for aerobic physical activity: 47.0%
b. Percent of adults 18 and over who meet guidelines for muscle strengthening activity: 22.4%
c. Percent who meet both guidelines (aerobic and muscle-strengthening): 18.8%
One of our biggest problems is obesity. This is no secret—just look around you, more than 1 in 3 adults are obese. Sadly 17% of American children between the ages of 7-19 are obese. Obesity leads to other diseases—type 2 diabetes being the most common—and is a risk factor for heart disease.
The economic costs to obesity are quite high, both in economic direct economic costs (medical care) and indirect costs (related to the value of income lost form decreased productivity, missed work, sick days—morbidity costs—or future income lost by premature death—mortality costs). In 2008 dollars, these costs were $147 billion, which is roughly equivalent to the 2010 budget request for the 2010 U.S. Navy (inflation adjusted).
So, when FDA advisors recommended that the FDA approve Qnexa last month, many now expect final approval to be announced later this year. While this will likely be highly profitable for Vivus, I’m not quite sure it solves the larger health picture at hand. Yes, Qnexa suppresses appetites. Yes, it helps treat type 2 diabetes and sleep apnea. But it does not help re-wire behavioral changes. It does not fundamentally change people’s eating habit—to eat healthfully, or to eat “real” foods (i.e., non-processed)—and it does not get people off the couch and to some sort of regular physical activity regimin. To the core, it does not push people to take charge of their own health.
While certainly a feat of science, this is perhaps not the best avenue for it. Put that kind of innovation to cancer research, or something else.
Going forward, we need innovations in healthcare and technology that motivate people to take their health into their own hands. Applying gaming technology is one popular trend or the idea of “crowdsourcing” a la Lucien Engelen.
But whatever we do, let’s resist the urge to find another answer in a pill.
Some food for thought:
Bloomberg article about Vivus/Qnexa:
The CDC’s famous interactive obesity map, which captures the growth in obesity in America:
Slightly old CNN article about Obesity costs: