Fat Cell Switcheroo*

Humans, mice — indeed all mammals — have two types of fat cells in their bodies; white and brown. White fat cells store energy. In contrast, brown fat cells dissipate energy as heat, thus counteracting obesity. Much to the chagrin of humans living in industrialized societies, most fat cells in our (adult) bodies are white fat cells. While this trait served our kind well throughout our evolutionary history, we now face a vast abundance of inexpensive, easily accessible, high energy content foods. This, combined with our body’s tendency to want to store up energy for times when food is scarce, leads to obesity and its accompanying adverse health effects. Wouldn’t it be great if we could have more brown fat cells and less white fat cells?

 

My First Guest Blogger Writes About… The Wad of Fat: A Secret Every Woman Needs to Know

I am honored to have Elise LeQuire as my first guest blogger. Here she shares her unfortunate experience with the gross insensitivity that many breast cancer patients face from the medical establishment. Elise is a highly experienced freelance Science Writer and a member of the National Association of Science Writers (NASW). You can learn more about Elise’s extensive experience at http://www.eliselequire.com/.

The Wad of Fat: A Secret Every Woman Needs to Know

For women diagnosed with breast cancer, perhaps facing mastectomy, there is a dirty little secret out there we need to know in advance, before surgery. It’s called the wad of fat. Listen up.

 

“Procreative Beneficence” Examined

In the spirit of raising awareness of the ethical challenges inherent in today’s most advanced medical technologies, the IHEU-Appignani Center for Bioethics and Bioethics International recently sponsored a one-day conference in New York City entitled “New Dilemmas in Medicine”. Three panels of distinguished experts, in turn, addressed three pressing issues: Professor Julian Savulescu’s theory of “Procreative Beneficence” (Journal of Medical Ethics 2007;33:284-288; doi:10.1136/jme.2006.018184), ethical considerations in pharmaceutical R&D, and “conscientious objection” by medical professionals to performing medical procedures, such as abortions, to patients who want them.

 

My Two Cents on the Medical Writing /Ghost Writing Issue

With regard to the recent New York Times article about ghost writing for the pharmaceutical industry, I have been laying low and just seeing what happens. I worked for a Medical Communications company for 4 years as a Medical Writer. It is really incumbent upon the American Medical Writers Association (AMWA, http://www.amwa.org) to be the voice of medical writers, and indeed, the current Chair of AMWA responded to this article and it was published in the Times.

I really believe that while there may be some funny business going on from time to time, most medical writers and pharma companies, along with the doctors that the companies “recruit” as the authors are on the up and up. The doctors who were asked to be authors on the papers I worked on were always primary investigators in the clinical trial that was to be published, and were recruited at the initial stages of publication development. In every case that I came across, the author contributed significantly to the paper, even if they didn’t write every word. I never witnessed any case of an author being on the paper without providing comments on the drafts. It is true that the medical writers write drafts, but they are always circulated for comments, which are always incorporated. The meat of the papers, the Materials and Methods and Results sections, are technical, and there’s no reason why a professional medical writer shouldn’t put that together for busy physicians. I don’t see anything wrong with that. The authors always had the final say on the content of the paper and are often required by the journals to sign their names to a statement that the work is original and that they contributed to it significantly.

The real ethical issues that have arisen from the whole medical writing industry, in my opinion, are all grey areas with blurry lines. What bothered me about medical writing for the pharma industry was the vague sense of playing games with subtle language and presenting things a certain way, mostly in the Discussion section (and to some extent the Introduction section) of the paper. The publications I worked on were scientifically solid, and most scientists know to concentrate mostly on the quality of the data presented and don’t pay too much mind to the Discussion section, where most of the “creativity” comes in. It really is time for psychologists to weigh in on how the subtleties of marketing messages in publications written in conjunction with medical writers are perceived and absorbed, and particularly how that advertising affects the prescribing practices of “target audience” physicians. As with most technology today, the development of strong, clear, legally enforceable guidelines lags behind the complex issues that influence the way they manifest themselves in our society.

 

The Pharmacrap Ecosystem

UNACCEPTABLE. I just saw a completely ridiculous commercial for a “restless leg syndrome” drug on TV. Direct-to-consumer (DTC) advertising of pharmaceuticals must include a clear statement of the potential adverse effects of the drug, according to the FDA. The potential adverse effects of this particular drug included such tasty morsels as falling asleep at inopportune times, such as when you’re driving, and having sudden, intense urges to have sex or to gamble (these scenarios have the making of one heck of a movie – you think?). One wonders how, with side effects like this, the drug was ever approved. Those who criticize the FDA for being unduly influenced by the pharmaceutical industry, because the powers that be in the FDA are on various company advisory boards, or are stock holders, or have an otherwise vested economic interest in a particular company would correctly argue that this is the reason why. There are also several other compelling reasons why this happens.

I’ll bet my bottom dollar that a major reason most people have restless leg syndrome is because they simply have too much stress, too little exercise and sleep, and/or unhealthy eating habits. This is what happens when profit, rather than the health and quality of life of the masses, becomes the number one priority for our economy. Most companies are also overburdened by the cost of providing health care benefits in this economic environment. And one big reason for the vast increase in healthcare costs is the high cost of drugs developed by the pharmaceutical industry.

The health problems in our society are overwhelming but are actually very profitable for the pharmaceutical industry. We hear about diabetes, high cholesterol, restless leg syndrome, arthritis pain, erectile dysfunction, insomnia, etc., and any other disease or symptom for which there is a major blockbuster drug. Why do we have such problems with these things? Most people know the benefits of eating healthy, exercising, and properly nurturing one’s family (not just economically), but how many really have time to do it adequately? The cost of living has risen in vast disproportion to the growth of salaries over the last 20-30 years or so. In the 1950s, 60s, and 70s, the price of a decent home may have been 1 – 2 times the average annual salary. Today, in most parts of the country, even with depreciation, it is more likely 5 – 10 times. You may ask, what does this have to do with pharmaceutical advertising? Well, if corporate greed had not gotten out of hand the way it has, people would have healthier lives and reduced need for these drugs. Therefore, the pharmaceutical industry, as well as the junk food industry, has a vested interest in keeping people stuck in an unhealthy lifestyle. They want to retain the status quo, because it is making them very rich. Each component of our society is inter-dependent, much as in an ecosystem. If a food chain is interrupted by destroying habitat, the consequences for the surrounding environment snowball.

I recently visited my local pharmacy, a branch of a major national chain of drugstores, and noticed that there was a special Snickers bar display within an arms length of where the line met the counter. I felt compelled to ask the pharmacist (who of course had no say in the placement of the display) whether they were offering free diabetes drugs with the purchase of a Snickers bar. Sadly, the answer was no. I can’t imagine a more ironic analogy to the problems in our society.