Post Author: Arya M. Sharma, MD

Simply knowing about health risks does not change behavior

Conditions
June 6, 2013

Exercise is good for you. Eat more fruits and vegetables. Stop smoking. Drink less alcohol. Such messages abound in public health campaigns and there is a firm belief that they will ultimately change behavior. This is based on the assumption that individuals are motivated to change behaviors to reduce their individual health risks.

While healthy individuals may understandably ignore such messages, one would certainly assume that people who already have conditions …

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Charging passengers by the pound is unfair

Physician
June 1, 2013

obese airplanes

Recently the wires have been active with suggestions that people with obesity pay more for airline travel. This discussion was prompted by a Samoan airline announcing that they would begin charging passengers by the pound. It was also stimulated by Bharat Bhatta, an economist from Norway suggesting that heavier passengers pay a surcharge while lighter passengers are offered discounts.

The logical argument …

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Why weight loss advice may be unethical

Physician
September 4, 2012

And issue of Newsweek quotes me as saying, “A lot of our weight-loss recommendations are unethical because we shouldn’t be saying lose weight when there is no chance people will keep it off.“

This quote appears in the context of a lengthy article by Daniel Heimpel that examines whether or not the obesity epidemic is being oversold.

While I personally do not think that the obesity epidemic is being oversold, I do …

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Obesity is a sign of good health in some cultures

Conditions
January 20, 2012

On the first day of the 1st Caribbean Obesity Forum, I presented various talks on obesity – its economic implications, its assessment and the need for firmly anchoring obesity treatment in primary care.

Interestingly, several family doctors in the audience raised the interesting issue that here on Barbados (as probably on other islands) many patients are actually quite happy with their weights.

One family physician noted in his presentation the case of …

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Obesity needs to be treated in primary care

Conditions
August 30, 2011

Given the staggering prevalence of overweight and obesity in most developed countries, there is no other hope than to have general practitioners (and their allied health colleagues) take on the considerable burden of managing obesity in their practices.

In fact, a recent example of a successful weight management program run in primary care just found considerable media attention in local newspapers.

But research shows that most general practitioners (GPs) neither feel confident …

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How obesity is like alcoholism

Conditions
March 21, 2011

Recently, I attended a scientific symposium on addictions.

One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.

While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.

The definition reads as follows:

Alcoholism is a primary chronic disease …

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Should obesity prevention be a personal matter?

Patient
January 17, 2011

Obesity is now increasingly recognized as the “natural” consequence of societal changes that have occurred over the past decades to foster an increasingly obesogenic environment.

Yet, rather than focus on the root causes of these societal drivers of obesity, governments apparently prefer to make obesity prevention a personal matter, with a strong emphasis on trying to get individuals to change their lifestyles.

It is clearly far easier to simply tell people to …

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Taxing soft drinks to combat obesity

Patient
November 19, 2010

One commonly heard propositions to combat the obesity epidemic is to tax soft drinks. No doubt, sugary soft drinks are a common and important source of “empty” calories, but will taxing soft drinks really reduce obesity rates?

This assumption was now examined by Yale University’s Jason Fletcher and colleagues, in a paper just published in Contemporary Economic Policy.

The researchers collected information on taxation of soft drinks with respect to specific excise …

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The benefit of a drug cannot be measured by the law of averages

Meds
October 1, 2010

One of the topics that I have often thought about (especially in light of our seeming inability to develop zero-risk obesity drugs) is the problem of averages. Our entire medical philosophy of “evidence-based” medicine seems built on the “Gaussian” assumption that averages can reflect the true benefit (or risk) of a drug, when in real life (or medical practice) there is no such thing as the truly average patient.

Clearly, a …

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Obesity is a complex problem that may not have simple solutions

Conditions
August 28, 2010

A single mom juggling two jobs and four kids may be right in thinking her life is complicated – but it is certainly not complex – at least not in the scientific sense of the word.

In medicine we also differentiate between procedures that are complicated (difficult, requiring skill) and complex (no clear solutions, unknown and incalculable risks, unpredictable outcome).

The best description of complexity was the “simplified” one I found in …

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Obesity should not require specialists to manage

Conditions
July 28, 2010

Medical school trains us to deal with a wide range of medical problems.

No matter what our current practice or specialty, at some point during medical school we will have had to study and demonstrate our knowledge and competency in dealing with common disorders like diabetes, hypertension, depression, chronic pain and countless other ailments. In addition, we will have spent hours poring over much rarer disorders, conditions that many of us …

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