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Healthy Skepticism Library item: 19753

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Gilbert D, Walley T, New B
Lifestyle medicines
BMJ 2000 Nov 25; 321:1341-1344
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119073/


Abstract:

Sildenafil and orlistat, prescribed for erectile dysfunction and obesity respectively, have been labelled as “lifestyle drugs” in the popular imagination. Although this description may trivialise serious medical conditions for which the drugs are indicated, it encapsulates concerns that some indications for these drugs might be regarded as issues of personal choice rather than illness. It is difficult to define what we mean by the term lifestyle drug since the perception of what is illness and what is within the sphere of personal responsibility rather than health care may depend on whether one is a potential patient or a potential “payer.” The perception may depend on social and cultural norms too,1 and it is also a function of how a medicine is used. For instance, most people would agree that the prescription of sildenafil for a healthy man unhappy with his sexual performance is a lifestyle use, but would consider differently the case of a diabetic man with neuropathy.
A working definition for this paper might be that a lifestyle drug is one used for “non-health” problems or for problems that lie at the margins of health and wellbeing (see table). A wider definition would include drugs that are used for health problems that might be better treated by a change in lifestyle; this definition might include drugs such as lipid lowering agents or proton pump inhibitors.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909