HealthZette

Why are Pill-Popping Americans So Lazy?

Eating better, exercising more — why aren't we doing it?

Andy Bellatti, a registered dietician in Las Vegas, sees it all the time: Patients are turning to drugs for conditions that instead can be reversed through healthier eating and more exercise.

Sure — weight loss, cholesterol and high blood pressure medications are lifesaving for some people who have uncontrollable genetic factors that impact their health, said Bellatti. But there are some who could reverse those conditions by eating better and exercising more. And they’re simply not doing it.

“I see so many people who are prescribed low doses of both [cholesterol and hypertension drugs], when in reality addressing dietary changes would be just as effective,” Bellatti told LifeZette.

Recent studies have found that people who took low doses of a statin drug for five years or more reduced their risk of a heart attack, stroke and other cardiac issues by 25 percent. Recent research also has found that some people who do not tolerate statins can use an injectable known as a PCSK9 inhibitor.

One of the studies involved more than 12,700 people of various ethnic backgrounds in 21 countries, NBC News reported. They were given 10 mg per day of rosuvastatin, which significantly lowered their risk of cardiovascular events compared to a placebo, the researchers stated.  

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None were considered at high risk of heart disease, however; they simply had abdominal obesity and nearly a quarter of them were smokers. Researchers told NBC the findings suggest that people who normally would not be considered for statins might be helped by them.

Lifestyle changes can reduce the risk of chronic disease by 80 percent. Sharon Palmer, a California-based dietitian, said lifestyle changes can reduce the risk of chronic disease by 80 percent.

“There are no medications that can do this for you,” she told LifeZette. Palmer said a big factor for a healthy lifestyle is diet, along with exercise and not smoking or drinking too much.

“We know that diet and exercise can effectively reduce blood LDL cholesterol and blood pressure. Yet all too often, doctors prescribe medications to accomplish this without even trying diet and exercise,” Palmer said.

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“I’m not saying someone should forego medications to lower cholesterol or blood pressure — it’s very important to get these levels down. But I do think diet should be a huge part of the lifestyle regimen, and you may find that diet and exercise can reduce the levels sufficiently so that medications may be eliminated.”

Dr. Caroline Apovian, vice president-elect of the Obesity Society in Silver Spring, Maryland, said many people take statins without thinking because those medications are often covered by insurance and they decrease cardiac events.

“And yes, they do give people a false sense of wellness,” she said.

Are Doctors Helping or Hurting?
Statins aren’t the only medications doctors might prescribe to make up for lifestyle choices, said Dr. Charlie Seltzer, a Philadelphia-based weight loss specialist. Many patients are offered weight loss drugs by their primary care physicians. It happens because the doctors typically do not spend enough time with the patients — nor can they, in many cases — to thoroughly assess the patient’s eating habits and health issues, and the behaviors behind them.

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He advises seeing a weight loss specialist.

Patients who go on the medications can see results, but when the effects of the medication wear off, “they’re right back where they started.”

Dr. Seltzer believes in using medication, but thinks patients on them are not receiving the right care and therefore not using them correctly. If patients are not focusing on healthy eating and exercise in addition to medication, it’s not a sustainable way to maintain health.

“Ultimately, in order to get long-term success, you need to change your lifestyle,” he said.

Though his area of expertise isn’t in cholesterol management, he believes that medications can be overprescribed. In some cases, statins can cause weight gain and muscle aches that prevent people from the healthy practice of exercising — but their cholesterol and blood pressure readings can be within normal ranges.

It creates an “artificial sense of security,” Dr. Seltzer said.

“It is not the doctors’ fault. It is not the patients’ fault,” said Dr. Apovian of the Obesity Society. “It is hard in this toxic food environment to stay on a healthy lifestyle diet and exercise program. The default is to eat high-fat, high-sugar processed foods.”

Along with poor food choices, people often do not have as much time to exercise as they would like.

“That is why medications are so popular,” she said. “There is no magic bullet for weight loss. And it is important to stress that obesity medications should only be used in conjunction with lifestyle changes.”