Another relatively new anti-obesity drug has taken off with our GPs. Acomplia (Rimonabant) has started to be prescribed. I think this is possibly because of the drug-rep with the very short skirt that came around to promote it, rather than it being a particularly useful drug. Me, a cynic, never.....?!
We already have Orlistat (Xenical) and Sibutramine (Reductil (EU) Meridia (US)) for those people that cannot moderate their diets. These are prescription-only, so you might have to persuade your doctor that you fit the NICE guidelines. Well, either that or buy them online. I've seen genuine Reductil that people have purchased online, fake Reductil, and also seemingly genuine generic Sibutramine. This obviously comes from a country such as India that does not have a high regard for intellectual property- a generic is not available legally.
Now, I'm not a particularly stocky chap. That's probably because I'm fairly careful about what I eat and do a moderate (well, minimal to moderate) amount of exercise. It seems fairly basic that if the quantity of energy taken in doesn't equal the total energy expended then one will put on weight? It's not rocket science, is it? Eat crap and sit on your arse watching the television and you'll probably gain weight.
I have patients who seem shocked that they weigh 300lb and have Non-Insulin dependent diabetes. It seems fairly logical that if you are 300lb then at some point in the past you weighed 250lb and even longer ago you were 200lb. Why did you not do something about it then? You really didn't wake up being that obese. In fact so big that you find yourself wedged into one of my dispensary chairs and unable to stand up. Yes, that's it, it's the chairs that are small, not your big lycra-covered arse that's big!
Instead we get:-
- "I have very heavy bones."
- "I think my metabolism is a bit slow, can I buy thyroxine over-the-counter"
- "Do you sell those herbal slimming patches, I think I'll try those because they are natural"
- "You'll be surprised, but I actually eat very little" (Yes, I would be as it would defy the rules of thermodynamics)
- "I'll go on a diet next week, I'll have this big cake now"
- "Have these tablets got sugar in because I'm on a diet and I think they might be causing my slow weight loss?"
Then again all these are possibly better than someone I spoke to who genuinely said:-
"I think I'll start smoking as I need to lose some weight". She said this, without irony, whilst carrying a BigMac and a large packet of crisps. (That's English large, not American large where bags tend to resemble small sacks of potatoes)
I guess, at least in England, there is one benefit of being an obese, non-insulin-dependent diabetic-exemption from paying prescription charges. Which is nice, until you drop dead at age 45.
As the great Bill Hicks said:-
"I don’t mean to sound bitter, cold or cruel, but I am. So that’s how it comes out."
6 comments:
Acomplia hasn't really taken off in my area yet - I think I've dispensed one prescription for it.
What makes me laugh is when I get faxed prescriptions for Xenical. The surgery is only a five minute walk away. If they could be bothered to walk to the surgery and then back to me maybe they wouldn't need xenical in the first place!
lol I know exactly what you mean. I'm fat, I know I'm fat, I admit that most of it is my fault, but a little genetics plays a part in it too. I can't stand people who are like "oh I'm just big boned". It's quite annoying.
Just be glad orlistat (Xenical) isn't going OTC in the UK. Can you guess how many complaints we're going to get when fat people start getting diarrhea and rectal incontinence?
I was wondering why the name Acomplia seemed so familiar to me, heh. It does seem daft that people make excuses but I guess we live in a world where it's easier to lay the blame on someone else than to accept responsibility. Drugs for obesity will always appeal to certain people as an easy option, rather than a healthy combination of diet and exercise
Goodness, that is so annoying, especially the whole 'I'm just really big boned' type thing.
Once, a family friend came around to our house and made a big hoo-haa of how she was on a diet. She rejected almost all of the food that my mother and I had spent ages cooking - grilled lamb chops, salmon, ciabatta bread, the lot.
She also asked for diet Coke, which we didn't have any of, so she ended up eating a morsel of salmon, a small piece of ciabatta bread, and drinking water.
Bring on dessert, and she has portions of trifle, tiramisu, ice cream and cake.
No, it didn't make any sense to us, either.
I love the one about starting to smoke, so they could lose weight. When I was getting ready to stop smoking I will admit the prospects of possible weight gain did scare me. My husband had gained over 60 lbs in the first year when he stopped smoking. But, it did not have this effect on me. I gained about 4 lbs.
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