Wellness requires more ownership

Not every Friday brings doctoring bliss. Sorry.

Some Fridays, the wrongness of our healthcare approach squeezes you like a vice-grip.

The medical news of the week can hit you hard.

–This highly tweeted report on how Overweight is the new normal speaks to the futility of asking people to help themselves. That our strong, vibrant, and proud citizenry is succumbing to fatness saddens me deeply. Building wider doors, heavier toilets and restaurant seats without armrests is the wrong approach to fighting obesity.

–We also learned this week that the advancing fury of medical therapeutics cannot counter high rates of obesity, smoking and inactivity. The WSJ health blog reports life expectancy in some Southern US counties trails that of El Salvador and Latvia.

–The nation’s chief doctor prescribes prevention over treatment, and no one retweets her. Silence.

–And the final egg on the face of wellness was this warning from the FDA: The popular anti-smoking drug, Varenicline (Chantix) might increase the risk of adverse heart events. Would it surprise you that a drug which can cause hostile behavior, agitation and depressed mood increases the risk of heart problems? Though I concede that the heart-related data against Chantix is weak, the message that pills are not the answer to wellness is consistent: In obesity, pills do not work; in raising HDL, pills might make us worse; and in Arthritis, NSAIDs clearly do make us sicker.

As a heart rhythm doctor, I see a variety of patients each day: young, old and middle-aged. I witness the evolution of trouble. The overweight young patient with high blood pressure and poor sleep habits is followed by the middle-aged patient with heart rhythm problems, who is then followed by the elder with a weak heart, from the cycle above.

Like a Dad tries to tell his teenager, you try to tell younger patients where their poor choices are leading them. But in the real world, Olive Garden builds wider seats, doctors prescribe more pills and hospitals build bigger beds and wheelchairs.

We are adapting, accepting, succumbing to our fatness, rather than addressing its root cause.

John Kennedy famously said, “Ask not what you country can do for you, but what you can do for your country.” Ronald Reagan reminded us of the value of reaching down and pulling ourselves up by the bootstraps.

Is it mean to ask patients to help themselves? Shouldn’t we as a profession stand up and recommend that people take more ownership of their own health?

We need more truth. More bootstraps.

And less pills.

JMM

Now I am going riding. Hopefully that will uplift my mood to something more heart-healthy.