Your recent commentary on weight-loss surgery is a bit off-base. Bariatric surgery is a well-established treatment for morbid obesity (those people who are about 100 pounds overweight). In fact, weight-loss surgery is the only intervention that has been demonstrated to maintain long-term weight loss. When performed in expert comprehensive centers that are interested in long-term follow-up, the benefits far exceed the risks of surgery. Marketing for weight-loss surgery has become an unfortunate part of business. As the media and uninformed medical professionals continue to have significantly biased views against the obese individual and medically necessary procedures, surgeons have adopted other means to educate, most commonly the Internet.
Bariatric surgery is not a marginal solution. Telling a person who is 100 pounds overweight to diet and exercise is a marginal solution. Giving that patient more antidiabetic medications is a marginal solution. Ignoring the health of the obese individual because of deep-rooted societal biases against the obese is against medical ethics. The nutriceutical business is a $300 billion industry that profits without an effective product–and there are no cries of outrage.
I stand by my earlier comments. Even for patients who are 100 pounds overweight, in addition to a careful medical evaluation, I believe that diet and exercise should be tried before surgical options are considered. And by diet, I am not talking about hyped or fad diets. By exercise, I do not automatically mean to refer to expensive health clubs and high-priced trainers. As I said before, surgery has a use for extreme cases. You are right, the nutriceutical business is a “$300 billion industry that profits without an effective product.” But that statement alone is surely not a justification for jumping unthinkingly into surgery.
I very much enjoy some meatless treats like soy burgers topped with soy cheese. My physician suggests that since soy products are sometimes recommended as a supplement to or substitute for female hormones that there might be some issues with the unrestricted use of soy products by men. Are you aware of any such issues?
I know of no such issues, though soy, like most things, should be used in moderation. You’re probably much better off with the soy rather than the fattening hormones and steroids that they inject into the meat that we eat!
I’m 68 and have rheumatoid arthritis (in remission), osteoarthritis, osteoporosis and Graves’ disease. I have good insurance right now, but every year the cost increases, and I won’t be able to afford it much longer. I use several medications and some expensive over-the-counter remedies.
My question: I have been taking prednisone for at least twelve years to keep the rheumatoid arthritis from flaring up. I take only 5 mg. and a few times have had to increase it temporarily. My new doctor tells me to try to get off prednisone but only suggests methotrexate, which I understand is a drug used for chemotherapy. I think that since I am in remission and that the drug does nothing for osteoarthritis it is much too hard on the body to justify continuing with. What do you suggest I do about this, and is there a medication that can help you with getting off prednisone?