Wednesday, July 10, 2013

Medical stuff: BPA or disease?

So my AMA wire links to a USAToday/PLOS article to tells me that BPA,  a plastic related chemical, might be causing obesity in young girls.

But they place this fact on the "women physician" part of their newsletter, presumably because only women docs treat girls.

I don't belong to the AMA for 20 years since their "ethics" committee said it was okay to take organs from living babies with brain defects, but never mind (they "Changed their mind" after a huge public outcry, but it shows how their experts are isolated from normal humanity).

And I never belonged to their "women physician" part, partly because I was a physician period, not a "woman physician" (I graduated before feminism...and then the pro death feminists took over the "women physician" group so I refused to join them).

Yet BPA is a universal health hazard. A good way to monitor the world wide cause of obesity is to monitor Asia: Our farmers are thin but the middle class children are gaining weight. Is it BPA? (everything here comes in "sachets", small plastic packetts, not bottles, which no one can afford). I suspect it might be more from less hard work: even our school kids now rent a tricycle/taxi to go to and from school (20 pesos for five kids)...

related item behind a wall: Obesity as a disease.

one third of Americans are overweight and one third are obese. That is the reality. If we say that obesity is not a disease, that is a call to inaction. It means that we can blame it on gluttony, slothfulness, and a lack of willpower, and I don't think our patients in the clinic need to hear that one more time. What they do need to hear is that their physicians care about them as people, that we understand what they are dealing with in terms of their weight and how they struggle not only with the cosmetic or societal issues, but also the health consequences of obesity.
and what they aren't saying: The "cure rate" for obesity is less than ten percent...
but having it as a "disease" means we can "bill" the gov/t insurance companies for it, while the big pharm will make oodles of money because their pills will be paid for too.

And I am not alone in this cynical take if you read the comments by physicians. What is interesting is the "others" who comment tend to go along with the AMA/ PC part, but not the docs...indeed, very few docs seem to be commenting at all, which tells you a lot about those who have time on their hands.

When  obesity to becomes a disease, what does that do to the overall cost of health care in the US? A third of the people are suddenly eligible for massive health expenditures. I am not trying to state it is not a disease and rob people of access to health care, I am trying to ask whether we are being fiscally responsible. If a child is declared obese and a large number of children are, does that mean they have an automatic ticket to subsidized health care for the rest of their life. When followed to one, two and five years only about 6% manage to keep their weight off even in the best wieght management control programs. 

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