Dr. Sekula on weight loss, fitness and nutrition

Most people I work with are significantly overweight – average weight > 300 pounds. As you might expect, all have a cluster of metabolic disorders. Coincident with their condition,  they take a laundry list of prescription medications. In general the lists are nearly identical and include prescriptions for hypertension, diabetes, cholesterol and digestive disorders.

Given this, I assumed their laundry list was similar to that of the general public. So I went looking for the top 10 prescription drugs of 2008 to see if my thoughts would be confirmed.

Finding the Data.
I scoured the FDA website and could find nothing (for some reason, I thought the organization in charge of controlling this industry might track this stuff – go figure). I decided to contact them by phone and the person I spoke with (after about 3 minutes of menu clicks – seriously), directed me to drugtopics.com – here is their about page.

Table 1 shows information for 2008 (1), including the top 10 prescriptions, the number of prescriptions (millions) and retail sales (in billions) (2). Note: the list is for non-generic drugs only. Additionally, drugtopics.com separates their publications by top prescriptions and top selling. Table 1 is a combination of the two. The Sales column includes rank information.

 Table 1. Top 10 Prescribed Drugs in 2008.

Confirmation and Surprise.

So what was the confirmation? Cholesterol, hypertensive and digestive (GERD) disorder medications occupy spots #1, 2, 7 and 10 (italicized in table). They represent 110.2 million prescriptions and $15.3 billion in retail sales. It’s 40% of the top 10, 45% of all prescriptions and 49% of total retail sales. Lipitor by itself is 20% of all prescriptions and 19% of all retail sales for those in the top 10!

What surprised me? For starters, no diabetes drug in the top 10. Actos was the highest rated and it was 18th, with 12.5 million prescriptions. The $2.4 billion in sales would have been good enough for 10th on the sales list. This piqued my curiosity and led to another visit to drugtopics.com.

Thankfully they track prescriptions and sales of generic drugs too. Guess what was in the top 10? I’ll give you a hint. It starts with “M” and ends with “M.” This list too is dominated similarly and I’m working on a follow-up post.

My thoughts…

Insulin resistance is big business in this country, playing a small or large role in nearly all of these on the list. And the Standard American Diet (SAD) is being pushed down our throats by so many factions, I don’t even know which way is up sometimes.

With all the healthcare debate going on, it’s amazing to me those in charge can’t see what’s right under their noses. I’m blaming cognitive dissonance and the powerful sugar, corn and wheat lobbies.

My advice, trash the food guide pyramid. Ignore nearly all advice from registered dieticians and your doctor – they’re part of the cognitive dissonance crowd. Eat quality protein and healthy fats (including naturally saturated ones) at every meal, along with vegetables and exercise vigorously 2-3 days per week. That and keeping your stress levels down will go a long way to keep you from being on this list.

This post is part of the Kathleen Show, Prevention not Rx.

References (both are pdf documents).

1. 2008 Top 200 branded drugs by total prescriptions.

2. 2008 Top 200 branded drugs by retail dollars.

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