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February 19, 2012 / JayMan

A cure for obesity?

ABC News recently aired a story about the drug Qnexa, which is a combination drug which seems to treat obesity (watch the story here).  The results have been impressive, as can bee seen in the featured before and after photos.  And yes, like almost all other diet drugs, it comes with side effects.  The question, in this case, is do those side effects outweigh the benefits (no pun intended)?

In other words, this asks that if the adverse effects of the drug are worse that the health problems associated with obesity, which include heart disease and type II diabetes.  We will see what the FDA decides, but make no mistake, a drug like this is badly needed.

The conventional wisdom about the current obesity epidemic is that stressing a “better lifestyle,” that is, improved diet and more exercise is the solution.  But this has clearly been an utter failure.  What society at large does not understand that a guideline for a better lifestyle isn’t a treatment for obesity, but rather—like education—is a sorting mechanism.  Only those who are inclined to follow whatever recommendations given will do so.  Many of the rest continue to have expanding waistlines.

The prescription for better diet and exercise is based on the flawed belief that people have free will and have an unlimited ability to choose whatever lifestyle they wish.

However, that’s clearly not the case.  Instead, as Cochran and Harpending point out in The 10,000 Year Explosion, most humans spent much of their recent evolutionary history in scare food situations.  Modern people have only recently emerged from the Malthusian trap, that is having population growth checked by the availability of food.   Today’s environment—with high-calorie foods cheaply available any time of the year and not requiring massive amounts of toil to obtain them—is an environment highly different from the environment most humans have evolved to be adapted to.  Obesity and diabetes are diseases arising from this environmental mismatch.  Only a “magic pill” could hope to solve it.

However, make no mistake, if Qnexa is approved, it will be the new crack.  As you might suspect, the drug’s effect requires continual use, so taking it is a life long commitment.  Its approval would be an enormous boon to its makers.  And that is fine; I hardly imagine that it would be any different.  Some people look down on such solutions, hoping for some “natural” cure to the obesity epidemic.  But instead, perhaps they should look at it this way:  it is was an unnatural process that created the obesity crisis (modern society), it would take an unnatural solution to treat it.

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2 Comments

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  1. Ed the Department Head / Jan 25 2013 8:08 PM

    This is excellent analysis of the obesity crisis. Fat is ugly so everyone hates it so much but most people seem to be naturally fat because, as you point out, we live the age of abundance and our genes came from the age of scarcity which favored endomorphs. Picking on naturally fat people and trying to make them eat starvation portions of foul tasting health food coupled with exercise that their bodies simply do not respond to is not going to change this situation. New York Times science journalist Gina Kolata has an excellent book out about this topic called Rethinking Thin.

    Do you think Qnexa (now Qsymia) can really reduce weight substantially over a long period of time, especially if a fat person continues to eat the types of delicious high calorie foods so much of the world loves? I hear about wonder drugs in the works, such as adipotide, beloranib, and mimAB1, which might actually cause the body to release stored fat and cause revolutionary weight lose. At least with Adipoitide however, I hear you can only be on the drug for so many months. Perhaps these drugs are the early stages of the creation of the obesity drug that Ray Kurzweil predicts will be available in 2018 that allows everyone to stay proportional and eat whatever they like: http://www.futuretimeline.net/21stcentury/2018.htm#fat .

    • JayMan / Feb 13 2013 12:25 AM

      Thanks for the tip, I’ll have to check it out. The fat shamers simply have other issues beyond the issue of people’s weight…

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