If I had to use a single word to describe the mindset of the average American regarding health information, I would choose the word confused. Let me explain what I mean by that. You all know what propaganda means. Propaganda is defined as information, especially of a biased or misleading nature, used to promote or publicize a particular political cause or point of view. Advertising is the commercial version of that. Especially in medicine, you need reliable sources of information.
But that is not what you get at all. Just think about the topic of weight loss. I get it. Losing weight is very important to me. I once weighed 307 pounds. Valid information on weight loss is critical to me, and for many of you, but that is not what we get. If you watch any television, you are constantly bombarded by messages promoting special foods, gummies, drugs, exercise routines, coaching programs, behavioral change programs, injections that cost $1000 a month and on and on. Most of it has no value. That is especially sad because losing weight is so important to our health and our personal lives.
It is even more tragic because the answer is so easy. Seventy years ago, almost everyone was thin. Now most of us are too heavy and the reason is simple. We changed what we eat. Seventy years ago we ate real, whole foods prepared at home. Now we eat fast food, prepared foods, and highly processed foods promoted by constant advertising. This food is so delicious we will eat it when we are not hungry and the more we eat, the more we want. It is addictive. Worse, this food has very little in the way of vitamins, minerals, micronutrients, and fiber which are all essential to good health. It is possible to weigh 307 pounds like I did and be malnourished. Here is the scientific fact. Weight loss is simple and easy. Eat real whole food—lean meats, seafood, low fat dairy, fruits, vegetables, beans, peas, and nuts. Take in very little sugar. Cut back and carbs and use whole grains when you eat them. Intermittent fasting helps. Take in all of your calories in 6-8 hours. Enjoy junk food one meal a week. That is practical and it is something almost everyone can do with much less bother than all this craziness. That is valid health information that works.
Medication is another great example. You are inundated with many advertisements a day for drugs for weight control, diabetes, psoriasis, chronic bowel disease, arthritis, vaccines, cancer and so on. The list goes on and on. What you must remember is that these ads are medical propaganda. It is information, especially of a biased or misleading nature, used to promote a product. The sole purpose of the ad is to get you to use that product. The sponsor wants to sell more medication. Period. Full stop. That is the reason they sponsor the ad. They want to increase their market share.
Let’s just look at ads for medications for type 2 diabetes that cost $500-1000 dollars a month. When you hear the ad, all you hear about is the wonderful benefit of that medication. Here is an example. There is a class of drug that lowers the glucose and promotes weight loss (GLP-1 agonists). Victoza has the largest market share in this class at just over 40%. Ads promote drugs in the class for their heart protective effects. Victoza reduces the risk of death from cardiovascular causes, non-fatal heart attack, or non-fatal stroke by 13%. The patients in this trial had a high cardiovascular risk. Forty percent had a history of prior heart attack or stroke, another third had blockages in other arteries, and just over a quarter had risk factors alone. Targeting higher risk patients makes it easier to show benefit. Victoza is not the best single drug to reduce diabetic complications.
A study sponsored by the Agency for Healthcare Research and Quality and performed by Johns Hopkins “involving more than 1.4 million people suggests that metformin, the most frequently prescribed stand-alone drug for type 2 diabetes, reduces the relative risk of a patient dying from heart disease by about 30 to 40 percent compared to its closest competitor drug, sulfonylurea.” Based on the results of many studies, the investigators at Johns Hopkins said that metformin is the first choice drug for diabetes. Another study in patients just diagnosed with type 2 diabetes showed that metformin reduced all-cause death by 36% and heart attacks by 39%. Metformin reduces the risk of cardiovascular death by 30-40% whereas Victoza lowers the risk of cardiovascular death, heart attack, and stroke by 13%. When you add more outcomes you have a greater chance of showing a difference. Metformin lowered the risk of cardiovascular death by 30 to 40 percent. It lowered all-cause mortality by 36% and heart attack by 39%. Victoza lowered the risk of cardiovascular death AND heart attack AND stroke by 13%. Metformin is much more powerful in protecting you from the things that matter. The ads don’t tell you that. They are information of a biased and misleading nature. Metformin costs $4 a month. The retail price of Victoza is $1344 per month. That is the difference between ads and reliable health information.
Even that is not the whole story. No medication for type 2 diabetes produces the maximum reduction in bad outcomes for type two diabetes. I just showed you how Victoza reduces bad cardiovascular outcomes by 13%. Metformin alone reduces heart attack alone by almost 40%. It is a combination of diet, exercise, metformin for diabetes, a statin for cholesterol, an ACE inhibitor like lisinopril for high blood pressure and chronic kidney disease and stopping smoke that produces a 4-fold reduction in heart attack. Nine patients treated with this combination had a heart attack vs 36 in the usual care group. That is what every person with type 2 diabetes should know. People are dying and suffering diabetic complications every day because they don’t know it.
So far we have just talked about prescription drugs. There are all kinds of non-prescription items to supposedly increase your energy, help you lose weight, increase you testosterone, increase growth hormone, and help you remember things. The evidence for benefit for these medicines is even weaker and the ads even more misleading.
That is what this site is all about. I will never accept ads on this site. I depend on subscriptions to support my work.
Excellent article and advice. Common sense has been thrown out with the baby and bath water. You are correct that what we all are subjected to on a daily basis is wide spread disinformation or as you called it medical propaganda. It is critical to our health and well-being and let’s not forget damage to our wallets. I look forward to shining the light on saving lives rather than harming health and draining peoples wallets for profit.
There are only 2 countries that allow direct advertising of pharmaceuticals, the US and New Zealand.