The bitter pill of non-medicine

AUSTRALIANS spend $4 billion a year on so-called alternative medicines, hoping against the odds that a largely unregulated industry will deliver cures and health benefits denied them by medical professionals. Many of these customers expect the non-prescription ”therapies” had the tick of scientific verification somewhere along the path to health food stores and pharmacy shelves. Surely authorities would prohibit the sale of pills, ointments, syrups and contraptions that had not withstood the rigours of medical testing?

Far from it. There are 10,000 alternative medicine products. Their efficacy is not tested by the Therapeutic Goods Administration. Instead, makers and other promoters of the products self-certify that they hold evidence substantiating the claims made. Hence pallet loads of over-the-counter ”medicines” pass on to the shelves without any outside testing of their effectiveness.

Officialdom, it seems, is more comfortable with this arrangement than might be expected because, it is argued, most of these products have no active ingredients whatsoever. Unlike prescribed medicines, which are rigorously regulated, these alternatives will not do you much good, but they probably will not do you much harm either. They are more a wealth hazard than a health hazard. 

But does absence of harm justify government inertia on this front? How is the public to know the implied promises of proven capability are empty? Should not the elaborate claims of some promoters be met with more vigour, particularly given the willingness of pharmacists to add their good reputation to assurances of the medical worth of these products?

A more serious problem can arise when the TGA does order a product off the shelves. In a recent test of 400 newly listed alternative medicines, it found 90 per cent of them did not comply with regulations, weak as they are. Most infringements were relatively minor but in 3 per cent of cases flaws were serious enough for the product to be removed from sale. But here is the sting. The tiger is so toothless that banned products can reappear on shelves – sometimes within 24 hours – after re-branding. Little wonder the TGA noted ”the major risk to confidence” in such a sloppy regulatory regime.

The answer lies in more openness. If pre-testing these goods is beyond government resources, consumers should at least be encouraged to scepticism by being told loudly and unambiguously that effectiveness is clinically unproven. Most promoters take compliance seriously, says the TGA. But for the repeat offenders who knowingly push non-compliant products, the language of sanctions that batter their bottom lines is the only one they will hear.

The dieting fad and its dangers

NEWS of the death of the French model Isabelle Caro is sad but salutary. Beautiful, young – she was 28 – and successful, she had served as a conspicuous warning of the dangers of eating disorders among young women – a problem that is getting worse. A study by the University of Western Sydney, published coincidentally this week, found a disquieting level of under-nourishment among young women caused by diets.

The survey of 480 teenage girls from Sydney’s northern suburbs and the central coast found that those who dieted showed signs of nutritional deficit, especially calcium, compared with those who did not diet. The study is vague about whether the proportion of girls dieting is increasing, but it provides more evidence that dieting comes at a price of nutritional deficit with lifelong effects. The study also adds to the growing indications that excessive dieting, and various eating disorders, has roughly doubled over the past decade. This is a terrible trend, unhealthy in every way.

Multiple surveys have shown that most women are insecure about their bodies. This is especially the case for teenagers. Now we have measurable upward trends in both juvenile obesity and excessive dieting. Most of the insecurity about body image comes from two sources: peer pressure, which in turn is fed by the images of ideal beauty coming from the mass media.

On the online gossip sites and gossip magazines tailored for young women, most of the celebrities are stick-thin actresses and models. The fashion industry, and the women’s magazine industry, have a case to answer. They present gaunt young fashion models as the ideal, when in fact this body type is unusual and unattainable for 99 per cent of the population. Then the magazines airbrush imperfections out of already thin stars and models.

The whole image industry has become unreal and unhealthy. The cost of this is trickling down into the ranks of impressionable and insecure young women. At the most extreme end of the spectrum is anorexia. When Isabelle Caro posed full-length naked for large advertising hoardings as part of an ”Against anorexia” campaign in 2007, she was skeletal, weighing just 32 kilograms. The year before, she had fallen into a coma when her weight dropped to 25 kilograms. Although she fought the condition in the ensuing years, she died in France on November 17 of acute respiratory disease. We can only hope the message she leaves behind gets through to some of the young women whose insecurity about their bodies is leading them to damage their health.

Source:
http://www.theage.com.au/opinion/editorial/the-bitter-pill-of-nonmedicine-20101230-19b0c.html