As we think about the increasing sophistication and technological instruments we bring to medicine, we’ve increasingly neglected the human/ psychological components of healthy behaviors.
For example, how much of a difference can primary care docs make on smoking in a 6 minute visit? And when smokers resist the temptation, what is the impact on the rest of their health?
“There is no question that smoking affects the epidemic” of obesity, said Dr. Neil Grunberg, a psychologist and neuroscientist at the Uniformed Services University of the Health Sciences in Bethesda, Md.
Smokers who quit, he noted, gain about 10 to 12 pounds on average, in part because they crave sweet foods and carbohydrates. In addition, Grunberg said, smokers’ metabolism slows after they quit.
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As we go down the path to consumerism, its important to remember that when we put consumers in control, we don’t have top-down control over what goes on to be successful. In an environment where Furby is wildly popular one year (selling at 10X multiples of the retail price), and neglected the next, rating it against clinical studies of childhood satisfaction seem wildly irrelevant.
The thought was triggered as I was reading the NYTimes article on sleep drugs. The title was: Sleep drugs found only mildly effective, but wildly popular.
American consumers spend $4.5 billion a year for sleep medications. Their popularity may lie in a mystery that confounds researchers. Many people who take them think they work far better than laboratory measurements show they do.
The analysis said that viewed as a group, the pills reduced the average time to go to sleep 12.8 minutes compared with fake pills, and increased total sleep time 11.4 minutes. The drug makers point to individual studies with better results.
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Can I tell you how much I detest the BMI as a metric for monitoring an individual’s levels of fat? It really equates to a statistical chart for insurance companies that does a simple calculation based on height and weight and spits out a number.
Unfortunately for consumers, that number really doesn’t tell you anything. Weight consists of a couple of factors: Lean body mass (including water) and fat (not water soluble). Knowing what percent of your body weight is fat (and its distribution) can be really useful information. Having a number solely based on weight is extremely misleading (to individuals, as BMI was made for populations) especially to track progress from a new diet and exercise plan.
In med school, I was horrified when a patient had come to tell us her story of getting a gastric bypass operation when her diet and exercise program “didn’t work” because she was losing inches, but not pounds (i.e., she was lifting weights, gaining muscle, and losing fat…the best outcome you can get from starting an exercise program).
The WSJ has an article this week on new ways for consumers to measure their body fat. All may at some point be coming to a weight-loss clinic near you…
