This week, in an act of desperation to turn back the tide of the obesity epidemic that now affects almost seven out of every ten Americans and over 80% of some populations (African American women), the advisory committee to the Food and Drug Administration (FDA) voted 20 to 2 to recommend approval of Qnexa, a “new” obesity drug that is simply the combination of two older medications, phentermine (the “phen” of phen-fen”) and topiramate (Topamax).
It is a misguided effort at best, and a dangerous one at worst. Mounting evidence proves that the solution to lifestyle and diet-driven obesity-related illnesses including heart disease, diabetes, dementia, and even cancer, won’t be found at the bottom of a prescription bottle.
By 2020, over 50% of the US adult population will have type 2 diabetes or prediabetes, with annual costs approaching $500 billion. By 2030, total annual economic costs of cardiovascular disease in the US are predicted to exceed $1 trillion. By 2030, globally we will spend $47 trillion; yes trillion, to address the effects of chronic lifestyle-driven disease.
Prescription medication for lifestyle disease has failed to bend the obesity and disease curve. Statins have been recently found to increase the risk of diabetes in women by 48%. And large data reviews by independent international scientists from the Cochrane Collaborative found that statins only work to prevent second heart attacks, not first heart attacks, which means they are not helpful and most likely harmful for 75% of those who take them.
Avandia, the number one blockbuster drug for type 2 diabetes has caused nearly 200,000 deaths from heart attacks since it was introduced in 1999. The drug was designed to prevent complications of diabetes, yet heart attacks are the very disease that kills most type 2 diabetics. In 2011, the FDA issued stricter prescribing guidelines for Avandia, but the drug is still on the market.
The large ACCORD trial found in over 10,000 diabetics that intensive blood-sugar lowering with medication and insulin actually led to more heart attacks and deaths.
Something is deeply wrong with our medical approach.
The problem of chronic disease, including obesity, diabetes, and heart disease, is not a medication deficiency, but a problem with what we put at the end of our fork.
The emperor truly has no clothes. Why would good men and women of science vote to approve a medication for a condition that is a social disease and requires a social cure? The social, environmental, economic, and political conditions of America and increasingly the global community have created an obesogenic environment.
Clearly we need to do something. But it is not better medication or surgery or more angioplasties and stents, which have no proven benefit in over 90% of those who receive them. The data show they work for acute coronary events, but not stable angina or blockages.
We continue to pay for expensive treatments for chronic disease, despite the fact that they don’t work, while insurance does not pay for nutrition counseling unless the patient has kidney failure or diabetes.
Chronic disease is a food-borne illness. We ate our way into this mess and we must eat our way out.
Every year the average American consumes 24 pounds of French fries, 23 pounds of pizza, 24 pounds of ice cream, 53 gallons of soda (or a gallon each week), 24 pounds of artificial sweeteners, 2.7 pounds of salt, 90,700 mg of caffeine, and about 2,700 calories a day. And that’s just the average.
Do we really think that we can medicate our way of this problem with a repackaged old diet drug (phentermine), combined with an older anti-seizure medication (Topamax)? Both these drugs have concerning side effects, including increased heart rate, heart attacks, and birth defects such as cleft lip.
I recently saw a patient on 26 medications and 450 units of insulin. This is Pharmageddon. His physicians were treating the downstream symptoms, not the causes. They were mopping up the floor while the sink was overflowing.
Large studies published over many decades show that 90% of coronary heart disease cases, 90% of type 2 diabetes cases, and one-third of cancers can be avoided by maintaining a healthier diet, increasing physical activity, and stopping smoking. We must treat the cause, not the symptoms.
Mounting evidence points to the power of food to reverse heart disease, diabetes, and cancer, and even to lengthen our telomeres, slowing the aging process. In a recent study, intensive dietary change reversed advanced type 2 diabetes in only 12 weeks. There is no medication that can achieve those results.
The science of epigenetics and nutrigenomics documents how food regulates gene expression and can upgrade our biologic software reversing obesity, type 2 diabetes and chronic disease.
There is a solution to our obesity epidemic. But it is not at the bottom of a pill bottle. It is at the end of our forks. It is simply more effective than any medication and works better, faster, and cheaper, not just as prevention, but also as treatment for what ails us in the 21st century. We can change our obesogenic environment through individual small choices we make every day, and making changes in our homes, our families, our schools, our workplaces, our faith-based communities. We have the power to take back our health. Let’s start today.
My new book The Blood Sugar Solution is a personal plan for individuals to get healthy, for us to get healthy together in our communities and for us to take back our health as a society. Obesity and diabetes is a social disease and we need a social cure.
My personal hope is that together we can create a national conversation about a real, practical solution for the prevention, treatment, and reversal of our diabesity epidemic.
To learn more and to get a free sneak preview of the book go to www.drhyman.com.
Now I’d like to hear from you…
Are you currently taking statins and what is your experience on them?
Have you developed diabetes as a result of taking statins?
Please let me know your thoughts by leaving a comment below.
To your good health,
Mark Hyman, MD
I have been taking statins for 15 years. Now I have type 2 diabetes. Trying to decide if I should stop or continue taking. I have had open heart surgery a heart attack 2 years after surgery and three stents. Bought your book The Blood Sugar Solution. Hope I will be able to control with diet instead of taking metformin as my cardiologist thinks it could be doing more harm than good. Enjoying your book hope it will open door for me to stop some of my medicines.
Hi CD,
We are excited to have you join the BSS community! Make sure to check out this group: http://drhyman.com/groups/heart-disease/
Please check out nutrition coaching if you have any questions regarding the diet protocol or supplement suggestions. http://www.bloodsugarsolution.com/nutrition-coaching/
Also, here is an article you might find interesting: http://drhyman.com/blog/conditions/seven-tips-to-fix-your-cholesterol-without-medication/
In good health!
Lizzy
I am a 56 year old woman and I am so happy to hear AGAIN what you state in the book. I don’t take any medications, my weight is good, 124, and I have recently started using a Vitamix for blending vegies into smoothies. My doctor wrote me a prescription for statins but I did not need them. My HDL is 99 but my total cholesterol was 245.
I work out and I eat as healthy as I can. I had a melanoma removed last year and there was no spread of the disease so I take extra care with my diet to eat organic, and stay away from sugar and processed foods as much as i can to prevent a recurrence of the cancer. It’s a battle but I feel like I am winning it. We need a medical paradigm shift to change our lifestyle choices for our health. I love the information in your book. I can do for myself what no doctor and big pharma can do – eat healthy whole foods and exercise.
It is about time that society in general and especially the media took a reality check and woke up to the simple truth that if you live a healthy lifestyle you will not only improve the quality but also the length of your life. This is not just about diet, it is about your psychological state, your level of daily activity and every decision that make through your whole life. Most of all it is about taking personal responsibility for individual choices and actions BEFORE health problems develop. On the other side it is also about society promoting accurate information about what the healthier choices are. For me, the irony is that the latter is well known in the historical records of many cultures (e.g. homeopathy) but simply ignored or criticised by the key stakeholders in the medical community (e.g. the big pharmas) because they can not profit from it. Money talks.
Wow! This is pretty scary information. As a RN, I think using an anti-seizure medication (Topamax) with known side effects when combined with Phentermine is the wrong way to go for weight loss. This could be a deadly combination. Phetermine is recommended for people who are actively dieting AND exercising. Topamax is known to decrease sweat production and make it harder for the body to cool itself. It also can lead to kidney problems and increase suicidal thoughts. I’m really disappointed that Qnexa was approved by the FDA. I think the ramifications will be deep and far reaching and adverse effects of the medication will be numerous and outweigh the benefits.
Can you explain why statins don’t help prevent first heart attacks, but they do help prevent second heart attacks? I am trying to figure out what the difference could be. Thank you.
Dr. Hyman,
Whether or not what you say is scientifically provable or not is totally beside the point. It just makes sense. Big anything exists JUST to make money and they really don’t care if the people using their products die or get sick from them. It’s the bottom line above everything else. It’s like the patient who went to the doctor because everytime he drank tea, he got a stabbing pain in his eye. The doctor asked if he removed the teaspoon first. The patient said no. The doctor said the solution is simple then – simply remove the teaspoon and the problem will go away. In other words, stop doing what caused the problem in the first place and you just might have come across the cure. The hope for the magic bullet (which, it seems, ALWAYS misfires) allows us to continue on this merry-go-round but it will eventually spin so fast, we can’t get off. But we can now and we’ve simply got to.
Hi. I was diagnosed as having type 2 diabetes nearly four years ago. I suspect I was actually diabetic for as much as a decade previously, since I began experiencing what I now know to be diabetic neuropathy in my feet in the late 90′s. As early as 2003 a VHA doctor requested I go back for second labs, as he suspected I was diabetic, however I played ostrich, and refused to go back in for more lab work. Then in 2008 a friend convinced me to get tested, telling me I would feel better if I knew. That is when I was finally diagnosed.
Since diagnosis I have managed to lose 15% of my body weight at the time of diagnosis. I also learned from family members that I have a strong family history of both diabetes and heart disease in my paternal grandfather’s line. When I found this out, I decided to let my doctor put me on statins, as my LDL was around 140. The first statin they put me on causes muscle pain and weakness in my legs. The second statin (provastatin) hey put me on worked beautifully, until after a year on it, I developed horrible, crushing fatigue. I have been taking a half dose of rosuvastatin (Crestor) for many months now – and not even daily – but rather ever third or fourth day. This has worked well to lower my LDL (last check was near 70) and I don’t seem to have any ill effects from the drug.
Since I was already diabetic at the time I began taking the statins, I feel no worry that they will lead to diabetes. I know, that sounds sort of like a “duh” moment, but I felt it needed to be said. With the strong family history of heart disease and also stroke (paternal grandmother had many, and died from a stroke that left a blood clot lodged in her liver in 1984) I feel that staying on the rosuvastatin is a good idea for me.
As to my blood glucose levels, I have had problems getting them under control until just recently. And somehow, something finally clicked in my brain. I’ve changed my diet even further, plus I am attempting to drink at least 8-10 oz of water every waking hour. This is easier when I am at work than at home, I should add. My doctor tells me that water helps to cut the amount of glucose in the blood. I don’t know if there is truth in that, but I’m willing to try anything, as my A1C had steadily climbed from a 5.8 18 months ago to 6.9 last month. I am determined to not die from a diabetes related problem.
Hi Jan,
It is great to hear about your keen sense of yourself and what your body needs. Your ability to provide yourself the appropriate changes in lifestyle and diet are quite important and telling of a positive outcome! Have you seen Dr. Hyman’s nee book, The Blood Sugar Solution? If not, you can see more about how the information provided helps to reverse poor blood sugar imbalance and even turn insulin resistance around. Check it out: http://www.bloodsugarsolution.com Also, have you joined any of the new groups? This one might be perfect for you! http://drhyman.com/groups/heart-disease/
In good health!
Lizzy
Nutrition Coaching Program
Everything you say makes sense. I have an example I think helps prove it. Our cat was diagnosed with diabetes with blood sugar at 535. Vet was amazed he was not in a diabetic coma or dead. We started insulin shots twice a day and a prescription diabetes diet cat food that mimics a cats natural diet without carbs, wheat, etc. he said cats are often able to get off insulin after being on the special diet and the vet said the reason was that cats can’t “cheat” and eat things that raise blood sugar where humans do all the time. 6 months later, our cats sugar dropped to around 95-110 without any insulin for months. We do not give him treats unless they are diabetic treats. Our cat is around 16 years old and runs, plays and has the curiosity of a kitten. This experience has prompted me to eat better, starting with cutting out gluten and high fructose corn syrup. 3 months into my transition I feel better than ever.
There is something to this that cannot be ignored. Results….
Sorry, I don’t agree with you, Dr. Hyman. My weight ballooned up to 326 pounds. My doctor gave me a prescription for phentermine. I lost 30 pounds. She said I could only stay on it for so long. Then, I lost another 30 pounds on my own. I found out that my blood sugar was very high. The doctor said I must have had diabetes for 5 years. I said that was not true, my blood sugar had never been above 125 before. Then I read one of your letters and realized that my blood sugar seemed to start to move up at about the same time I started taking Lipitor – So, I thank you for that. I switched my diet to a vegan, low-fat diet. I lost another 30 – 40 pounds. My blood sugar is now 100 in the morning and 85 in the afternoon. So, I stopped taking the Lipitor and the cholesterol is back up – I don’t know why since I don’t eat meat or dairy and very little oil. I have to figure this out. It would be an enormous help, I am sure, if I lost another 40 pounds. I would very much like to have phentermine again to help me out but my doctor has retired and her replacement won’t prescribe it. I think I could manage to keep the weight off, if only I had some help losing it. You are wrong to condemn getting help from this drug – as long as people recognize there are other things that need to be done along with it. My next step is to step up the exercise and see if that will get rid of the next 40 lbs. There is room for this drug to help a determined and intelligent person get where one needs to be.
This news is very disturbing. I took Topamax for only a few months for migraine headaches and had terrible short term memory loss. I didn’t have headaches, but how would I know? I couldn’t remember what I had for breakfast….and I was 33 years old. My family says that I still suffer from the side effects of the medication. It has been almost four years since I was on it. I certainly do hope it doesn’t happen to others. Most definitely read about the medication you are planning to take. If I would have seen that a third of patients suffer from short term memory loss, I doubt I would have taken it. I almost lost my job because of it.
Excellent, Dr,. Hyman. Good to see another M.D. calling out Big Pharma, there should be many more. You’ve hit the bullseye on this, keep up the great work!
I am a 53 year old postmenopausal woman who has taken simvastatin for about 10 years keeping my total CHO around 140, LDL around 70, HDL around 50 and TRI around 50-70. I exercise regularly and eat very similarly to the BSS. I am about 10 pounds overweight. I stopped taking simvastatin and had my cholesterol tested 5 weeks later. Total CHO was 220, LDL was 164, HDL was 46 and TRI was 49. I did the NMR test and had 2201 LDL-P, HDL-P was 27, small LDL-P was 897 and LDL size was 20.6. I’m a little confused as to whether I have a problem since my TRI / HDL is about one, which is significantly below optimal of 4, even though my particle counts are very high. I am pretty sure my doctor will tell me to start taking simvastatin again. Your thoughts?
Hi Teresa,
Thank you for writing in about your cholesterol results. We are excited you have an interest in functional medicine. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org/practitioner_search.aspx?id=117 and scroll down to where it says “locate a practitioner” and enter your zip. Progress accordingly from there.
Or,to make an appointment at Dr. Hyman’s UltraWellness Center in Lenox, MA please go to: http://www.ultrawellnesscenter.com/becoming-a-patient/ When you are finished reading through the material you may call the office at After you have reviewed this, please contact our office to make an appointment. By phone, (413) 637-9991; by email, office@ultrawellnesscenter.com
You can also work with Dr. Hyman’s nutrition coaches to design a personalized nutrition plan. please see:http://store.drhyman.com/Store/List/Coaching-Programs
For more info on cholesterol management please see- http://drhyman.com/blog/conditions/seven-tips-to-fix-your-cholesterol-without-medication/
In good health!
Lizzy
Nutrition Coaching Program
Dr. Hyman,
Thank you for sharing this well-written and passionate article. Your information resonated deeply with me, as I work in the government-regulated, clinical research industry for medical devices and am currently pondering if I am playing for the right team.
I say that, because I am starting to feel a bit hopeless. I have realized that, if I am employed by a for-profit industry that is regulated by the FDA, then I also work for the for-profit health insurance companies that determine which therapies should be covered. Unfortunately, I feel that the FDA and health insurance companies are heavily influenced by lobbying efforts and financial donations, not to mention the conflict of physicians who tend to recommend therapies based on the influence of the various sales representatives who line the walls of their practices. With so many of those organizations focused on revenue and profit, how can I help ensure that my mother, your sister, my best friend is receiving a treatment that will truly help them live a healthy lifestyle and not solely extend the longevity of those organizations with little regard for patients’ long-term health? I try to keep an open mind, but it’s hard to do when I read about the billions of dollars that pharmaceutical companies make from people’s sedentary, unhealthy lifestyles – it doesn’t seem like they’re trying to reverse the conditions, they’re merely providing less than adequate coping techniques.
Before working with medical devices, I was involved in pre-clinical and clinical research for the pharmaceutical industry, which I came to refer to as “Alice in Wonderland research.” Here, take this pill and let’s see what happens to you…somewhat similar to the approach taken with GMO foods, but I’ll leave that for another conversation.
As you mentioned, our Western medicine approaches are driven to treat symptoms, rather than to focus on the true diagnosis, hence the ever-increasing number of pill bottles in a patient’s medicine cabinet. It’s frustrating on many levels, because 1) I feel that patients are misinformed to trust their allopathic physicians when prescribed prescription after prescription, 2) many individuals are subscribers to the “fix me quick” approach to living, rather than truly holding themselves accountable for what they eat, drink, breathe, feel, think, watch, read, and do, 3) similar to the word “love,” the words “nutrition,” “exercise,” “therapy,” and the like have somehow become terms that are not to be taken seriously. Implementing the aforementioned terms would have monumental effects on our global health and economic status if we took the time to improve ourselves – to love, like and respect ourselves, and truly want to become more intelligent, empowered, healthy individuals who can enjoy and succeed in life, and to help those less fortunate than us to have access to the resources needed to succeed, as well.
We have become an introverted, lazy, selfish, and greedy society, but that’s not to say there isn’t a large percentage of individuals who truly want to make a difference. Unfortunately, so many of us are silenced by the power of corporate spending and political influence (e.g. inverted government subsidies for meats and dairy compared to fruits and vegetables) – what I’m finding, however, is that more and more individuals are speaking up and holding true to their beliefs, which is so incredibly inspiring.
I don’t want to say that Western medicine has it all wrong, because I know if I was in car accident or needed access to innovative, potentially life-saving therapies, there are many things we do well – and I also recognize that I’m generalizing, that there are many physicians frustrated by the system and their inability to instill positive change in their patients. However, since the establishment of the American Medical Association and its desire to silence the benefits of complementary and alternative medicine (e.g. chiropractic care), we continually step forward with the wrong foot. Wouldn’t it be remarkable to see all medical schools embrace the benefits of nutrition and exercise, and actually include those fundamentals in their medical school curriculums? Until I recently started seeing my naturopath, I didn’t realize how little my typical, allopathic physicians knew about my health, my lifestyle, etc. – how does a physician make recommendations on living a healthy lifestyle when they hardly know me at all (e.g. how much sleep do you get, what type of exercise do you, what do you typically eat, do you work in a stressful environment, how much fresh air do you get)?
I am hopeful that I can become part of a scientific community that expands the research and education on the many benefits of nutrition, exercise, love, and service to others. Until then, I will continue to educate myself, my family and friends, and anyone who will listen to the urgency for reform that we need to instill in ourselves and our fellow human.
Very best wishes & thank you for all that you do,
~Sonrisa42
Thank you Dr. Hyman for your passion and dedication to help us heal, but most importantly wake up. I “woke up” last year when I had an aha moment that led me to truly understand that I could diet until the cows came home and until I addressed the other life issues of relationships, work and spirituality, I would remain overweight, ill and colossally unhappy. I mean who could do Medifast and actually GAIN pounds! (that would be me) I am listening to your talk on IIN’s webinar and I hope you don’t mind that going forward I will liberally use and repeat something that you said (paraphrasing): Food is the most powerful medicine we have to heal ourselves. And I would add “heal our planet.” The politics of food and medicine has resulted in one of the biggest cons ever perpetrated on us. Again, thank you so much for all your work and advocacy! In peace always.
~Anna
Thank you Dr. Hyman. For telling ‘us’ about this. Your Blood Sugar Solution program is working for me. I have been on the program since 9 April 2012 and I have lost pounds every week. Now, the total of pounds is 15. None of the yo-yoing effect that I have struggled with for so many years. All the diet pills that I took in my earlier years have weakened my heart… but now I truly believe I am on the right and healthy path to controlling my weight!
I have enjoyed your program so much so that I have created a blog for myself and others (if they want to visit) so that I will stay connected in a way that will increase my chances of success.
http://www.goodfoodbuzz.com/