Doc Bushwell's Chimpanzee Refuge

Sunday, July 03, 2005

Big Fat Golden Goose Eggs (also to be found on Cognitive Emesis)



Several thunderstorms of Midwestern caliber recently passed through the Land o' Ten Thousand Superfund sites, a.k.a. The Gaaah-dun State, which assured that the Saturday morning air, though laden with dripping moisture, was a darned site more bearable than the cloacal conditions in benighted regions of South Florida, at least as described by the Chief Cognitive Emetic. I hauled my jiggling ass out for an early perambulation with the extra motivation of having obtained a good glimpse of my posterior, ballooning toward barnlike proportions, in the expansive mirrors of a friend's bathroom during a recent visit post-vino.

I know what I need to do to reverse the trend toward buttocks of agricultural outbuilding size. An EFD (Every Fucking Day) plan of lurching bipedal locomotion, and just saying "no" to gorfy junk scattered about at departmental meetings as well as too copious amounts of good food, seem to be the ticket toward decreased adiposity, but only with consistency of these practices over a goodly amount of time. The requirement for this endeavor got me to thinking about the Fattists, oft the brunt of flowery and simultaneously scatological verbosity on this very site, and their rampant braying that the obesity epidemic is a false alarm created by collusion of the medical community and greedy Big Pharma. These ruminations, as inspired by the Campos camp, causes me to come clean and confess the reality of my situation:

I am not the amorphously shaped, menopausal drudge as described above. In truth, I am a reprehensibly wealthy research minion of the pharmaceutical industry. I giggle with glee, digging deep with the heels of my Manolo Blahniks, as I tread up the backs of blue-haired Medicare ladies whilst clambering to my late model Porsche Carrera. There, I rip open my tidy white lab coat, revealing my bosom straining the weft of a snug Juicy T-shirt, legs akimbo beneath my little Prada skirt. I then pull my mane of hair loose from its sensible ponytail. My mouth forms a little pout as I run over various patients and Canadian-bound consumers in search of the bargain basement prescription, on my route to my pied-a-terre in Tribeca. This makes for an ever so bumpy ride after all. I yearn to upgrade my other residence, an all too modest 6 bedroom cottage tucked away in the Hamptons, but that will only come if I, in league with my sinister colleagues, bring forth multiple medications for the obese or even barely overweight. Thus, I am motivated, no, make that hungry to discover the Magic Fat pill which will do a damn slight bit of good, cause multitudes of side effects, but will put reams and reams of dead Presidents in my Gucci pocketbook.

Well, perhaps I have slightly exaggerated my appearance and my financial situation. "Dowdy matron" suits me just fine, and as for my salary, I can't complain but in this affluent neck of the woods, I ain't among the rich. But unfortunately, I know all too well that the industry is pursuing drugs for obesity, but not for the reasons that the Fattists claim. Big Pharma has not concocted the obesity epidemic with their partners in crime, the medical establishment, but rather, in its typical voracious fashion, seized upon the trend toward decreased physical activity and burgeoning gullets as a large (pun intended) market opportunity.

Although we bench monkeys would like to think that good science drives discovery research, and in fact this is not an uncommon event, the pecuniary creatures in market analysis have in the past decade or more, increasingly worked their wiles earlier and earlier in the stages in the drug discovery process. "Good science" is not always first and foremost in marketing's greedy mindset. Consequently, many pharma companies have research efforts directed toward obesity. Woe to those who do not. Other than the niche-directed biotech boutiques, to remain "competitive," obesity targets must be on the research docket {Aside: "targets" meaning discreet biochemical entities such as enzymes and receptors which have potential to be affected pharmacologically.} Now, in terms of pure science, I have to admit there's a certain degree of "Ah ha!" coolness to some of the targets related to obesity. The "Ah ha!" factor is an especially seductive influence in a scientist's work. Hours of tedium are whittled away in experiments for that moment of discovery. I suspect that little spurts of dopamine are released at those moments, tickling the reward centers of the brain, and thereby making the process addictive. For example, interesting enzymes involved with fatty acid metabolism and certain GPCRs, which appear to regulate satiety, represent potential, and challenging, targets. {Second aside: GPCRs = G-protein coupled receptors; remember this, my comrades in emesis, since I may very well use this term again in subsequent verbal vomitus.} But those of us grizzled old veterans, as tempted by the "Ah ha!" factor as we might be, know the pitfalls of bringing forward drugs for chronic indications, and certainly obesity falls into the latter category.

For drugs that treat chronic conditions, for example, high blood pressure or arthritis, the safety of the meds is of great concern. The patient takes these drugs daily for months or years, more likely, so adverse side effects are not particularly tolerable, in contrast to a cancer patient who bears the brunt of cytotoxic chemicals coursing through his or her system in the effort to drive back tumor growth although a thought-trend in oncology is to approach cancer as a chronic state. Unfortunately, with the rush to market certain cox-2 inhibitors, safety and proper direction of the drug toward its intended patient group, went out the window. The Vioxx debacle, in my opinion, was a wake-up call to both the pharma industry and the FDA, but that's the subject for another screed. Drugs cost a fucktacular amount of money to bring to market, and the proper trials to determine efficacy and long term safety of a potential obesity drug (let's not forget Fen-phen; I'm sure Wyeth would like to forget it) will add significantly to this cost. All in the name of what? A 10-20% weight loss versus placebo?

One Friday evening at the local watering hole, a group of us shlub scientists were lamenting the research efforts directed toward obesity. One of the sr. chemists working on an obesity target, himself a moderately portly fellow who was scarfing down pizza and drinking beer like the rest of us, opined that his intellectual blood, sweat and tears were being spilled on a hypothetical pill which a 300 pound person would swallow, only to lose a walloping ten pounds as a result, then sue the manufacturer when his or her stools take on the ballistic strength of an AK-47 or when once pliant skin becomes an infected, arid wasteland due to some pharmacologically induced fuckup in fat metabolism. All of us gathered around that pub table recognized that yes, there exists a population of the morbidly obese who quite likely have some genetic variant predisposing them to the condition, but this population of folks does not exactly represent a billion dollar market. To a person, we investigators each believed that diet and exercise are first line treatments for most garden-variety obesity.

So to the Fattists who believe that the pharma industry wants you to be fat, well, to an extent you are right since your obesity shines like a golden egg to the devils in pharma marketing. However, let me assure you, many of us who actually try to discover drugs wish you'd just walk, bike, swim or run more, and eat less, so we can direct our attention and our "Ah ha!" cravings toward drugs to treat cancer, infectious disease, immune disorders, neurological disease, and such.

3 Comments:

At 2:34 PM, Blogger Seth Cohen said...

Bio-medicine isn't the only group that is looking at fatties as a golden goose.

Fat is the villain here in 'Obeez City'
Taking aim at childhood obesity, interactive games and DVDs use virtual weapons to combat inactivity.


By Dawn MacKeen

To fight a war, one must dress appropriately. And sometimes, camouflage simply won't do. That is the case for Soolynn, the sexy heroine of a new interactive DVD, "Escape From Obeez City."

As Soolynn combats the evil forces that are making people fat, she is armed with only a few weapons — a cat suit, an impressive bust line and an uncanny resemblance to Angelina Jolie in the movie "Tomb Raider."

It's a good thing she's prepared — cholesterol, stress hormones and free radicals reign in this electronic metropolis, located deep inside an obese man. But what happens when Soolynn is captured? For the story to unfold, kids must periodically answer educational questions.

The game's creators hope the game-like format will provide an appealing way for children to learn about the dangers of poor nutrition and inactivity, and motivate them to change their behavior.

"In America, one in three is obese," says Tony Findlay, project director for Big Red Frog, the Sydney, Australia-based company that is releasing the $49 game-movie in September. "We need to do something and we need to do something fast. This is our first stage of attack."

The attack on inactivity is not just coming from the makers of "Escape From Obeez City." It is among a handful of interactive games that aims to rouse kids onto their feet and transform living rooms into exercise zones. After all, 16% of adolescents are overweight, according to the Centers for Disease Control and Prevention. That's an estimated threefold increase since the 1970s.

To be sure, not everyone thinks that video games — often maligned as a key cause of kids' inactivity — are the optimal antidote to children's weight problems. But the new games may signal the start of a shift in attitude.

Last fall, a report on obesity by the prestigious Institute of Medicine recommended that software engineers and game designers use those mediums as a vehicle for encouraging healthier lifestyles. And the National Institutes of Health is funding some video game research projects as part of its anti-obesity efforts.

Game companies, which like to cite the success of Konami's popular Dance Dance Revolution as both a fun game and calorie burner, insist that the marriage of fitness and entertainment may be part of the answer.

"I see this as the first wave of something that will get much more sophisticated over time," says Marc Prensky, a game designer who created the website http://www.socialimpactgames.com , which chronicles the latest health and wellness programs.

In these alternate worlds, cancer patients can battle and kill mutated cells, drivers afraid of the road can try to overcome their fears through virtual reality, and people can learn to meditate with Dr. Deepak Chopra, the author and spiritual guru.

Chopra makes a cameo appearance in "The Journey to Wild Divine: Wisdom Quest," which transports players to a lush sanctuary where they can slow down their mind and body. Breathing must be appropriately controlled to progress to the next level, and there's no cheating since biofeedback finger sensors monitor this. "Wisdom Quest" is a sequel CD-ROM to last year's "The Passage," and is developed by the Wild Divine Project, a company based in Boulder, Colo. The $49.95 "inner-active" computer program is scheduled to debut in September.

Though this may help people unwind, developers say the medium holds the most promise for trimming waistlines.

At the recent E3 gaming industry convention in Los Angeles, Sony Computer Entertainment America previewed a new fitness game in which two well-toned, virtual personal trainers guide teens through workouts in a 12-week training session. The game, EyeToy: Kinetic, is also scheduled for release in September for PlayStation 2 systems.

Instead of doing the same lunges and squats along with a videotape, Kinetic and another game, Yourself!Fitness, offer a menu full of different workouts and environments. Will today's routine consist of downward dog in an outdoor garden or cardio on a rooftop? Players decide.

Yourself!Fitness was released last October for a slightly older audience by ResponDesign Inc., of Portland, Ore., and sells for $34.99. In this game for Xbox, PlayStation 2 and PCs, Maya, a striking young woman, leads players through 650-plus exercises — all with her hair barely tousled. Maya will also chide people for missing scheduled workouts, as do the virtual characters of Kinetic.

Although health-oriented games are growing, they are still just a fraction of America's $7.3-billion gaming industry. And they are not without critics.

Doctors are worried that the games may have an unintended effect: encouraging a workout for the thumbs instead of the whole body. A March report by the Kaiser Family Foundation, a nonprofit health policy organization in Menlo Park, found that kids between the ages of 8 and 18 average six and a half hours of media time a day.

"We don't want people to sit around and be sucked into these kinds of things" at the expense of more vigorous physical activity, says Janet Fulton, an epidemiologist with the CDC's division of nutrition and physical activity.

Video-game researchers acknowledge these concerns, but believe the potential outweighs the risk. Michael Goran, a professor of preventive medicine at USC's Keck School of Medicine, and colleagues have created a CD-ROM dubbed "Project IMPACT."

In this electronic world, kids face another evil character who detests active children. The university is in talks with an educational software company to distribute the game to schools across the country.

"The media has a powerful effect on culture," says Goran. "What if we can tap into that and change the way our culture thinks about food and physical activity and health, instead of printing pyramids on food wrappers?"

Some doctors, however, say that a video game will have little effect if children — and their families — don't change their nutritional and exercise habits.

"If I had to choose between buying a child one of these active games or removing the TV from their bedroom and setting weekly TV time limits," says Dr. Tom Robinson, associate professor of pediatrics at Stanford University, "I would strongly favor the latter."

 
At 7:56 PM, Blogger DocBushwell said...

Seth,

Thanks for calling my attention to "Obeez City." I must say, it was quite difficult to get through this article, since I was nearly overcome from irony vapors. I suppose if the plump gamers twitch enough they might burn off the caloric equivalent of a cup o' carrots.

Just as nature abhors a vacuum, so the marketplace abhors an unfilled niche.

Doc Bushwell

 
At 6:28 PM, Blogger Seth Cohen said...

I think the key line to the article was "Doctors are worried that the games may have an unintended effect: encouraging a workout for the thumbs instead of the whole body."

You wrote about side effects. How would someone even know to test for this?

Medication may cause compulsive behavior
Parkinson's drugs linked to gambling, sex and shopping addictions, a new study finds.


By LINDSEY TANNER The Associated Press

CHICAGO – Joe Neglia was a retired government intelligence worker with Parkinson's disease when he suddenly developed what he calls a gambling habit from hell.

After losing thousands of dollars playing slot machines near his California home several times a day for nearly two years, he stumbled across an Internet report linking a popular Parkinson's drug he used with compulsive gambling.

"I thought, 'Oh my God, this must be it,'" Neglia said. All desire to gamble disappeared three days after he stopped the drug, Mirapex, according to Neglia, 54. "I felt like I had my brain back," he said.

A Mayo Clinic study published Monday in July's Archives of Neurology describes 11 other Parkinson's patients who developed the problem while taking Mirapex or similar drugs between 2002 and 2004. Doctors have since identified 14 additional Mayo patients with the problem, said lead author Dr. M. Leann Dodd, a Mayo psychiatrist.

"It's certainly enough for us to be cautious as we are using it," Dodd said.

The complete article is on Kilgore's message board, endorfin cult.

www.mondokilgore.blogspot.com

 

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