Reduce Health Care Costs. Are We Chasing the Wind?

by Bill Sardi

Recently by Bill Sardi: Will Technological Breakthroughs Save the American Economy? Maybe, If Politicians Would Just Get Out of the Way

Take a gander at the following survey published nearly a decade ago (abstract presented at the end of this report). It reveals the multiple physical effects (elevated blood pressure, blood sugar, cholesterol, incidence of arthritis and infection) of the diabesity epidemic now sweeping the globe. While the doctors have their scopes placed on all over their patients' bodies the elephant in the room is the processed American diet.

The survey was conducted in France where people tend to be leaner, maybe because of the red wine they drink. Consider how modern medicine has capitalized on this situation. Instead of condemning processed food diets, intentionally designed by food purveyors to disarm satiation in order to sell more food, modern medicine piled on and sold more inappropriate drugs and performed more needless surgical procedures.

The whole situation is akin to a frayed wire that continually produces sparks that then triggers repeated fires that have to be put out with a fire extinguisher. In this metaphor, you have to keep taking drugs or even dietary supplements to put out the fires. Such an approach is a giant (intentional?) misdirection. Stop the pyromania and the sales of fire extinguishers will decline.

Modern medicine is pushing anti-cholesterol drugs, blood pressure-lowering pills, pain relievers, antibiotics, anti-diabetic pills, and even performing surgery for a condition known as hyperhidrosis (sweaty palms) that all appear to be diet related, not to mention lap-band and gastric bypass surgery to reduce girth and implantation of artificial hips and knees and a myriad of surgical procedures on vertebral discs to relieve pain.

Is it ethical to implant an artificial knee on a 300-pound man who is 5 foot 7 inches tall? Modern medicine has no hesitation in doing so. Artificial knees in obese patients often require a second surgical procedure.

A few ethical physicians in Australia suggest "unloading" the weight on the knee to reduce obesity-related strain that destroys joints. They say there has been "an overemphasis on drugs and direct surgical repair." Their voice is like a whisper in the opportunistic hurricane that surrounds them.

Orthopedists may attempt to justify the implantation of artificial joints in order to give obese patients greater mobility. But the idea that a knee or hip implant should produce a more mobile patient who can better control their weight through exercise is not substantiated by published studies.

Many joint implant patients are diabetic and are more likely to incur post-surgical infections. This has not deterred orthopedists from performing these operations. After all, they have antibiotics, don't they (another drug to sell)?

A patient who received a hip implant that was allegedly defective is suing its manufacturer because of metal particles that flaked off of the implant. The patient is described as a diabetic with nerve problems, and while his weight is not mentioned, you can bet he is obese. An outfit now recruits patients on the internet who have been harmed by surgical implants. The legal profession is piling on too. It's all good for business.

While America is grappling with how to reduce health care costs, over 1 million Americans now undergo joint replacement operations and that number is expected to grow to 4 million over the next decade or two. Better than 4 in 10 adults over age 60 now report lower body functional impairment. What a market for the opportunist doctors and joint implant companies! And the patients say they were promised their Medicare benefits and oppose any efforts to deprive them of this modern technology. So much for giving up potato chips.

The answer to this problem is dietary, but precisely which one — the Atkins high-fat diet, a vegetarian diet, which one?

Studies show the best results are obtained with low-carbohydrate diets. But does that mean less sugar and so-called high glycemic foods? Not exactly. As long as a person is feeding the sugar-craving yeast in their digestive tract, they will crave sweets and the weight will pile on.

A few years ago modern medicine set out to determine if what I just said is true. So a study was conducted where so-called healthy adults were given a high-carbohydrate (sugar) diet to see if this would raise the concentration of yeast (Candida albicans count) in samples taken from patients.

Well, the study was bogus. Researchers couldn't find an increased yeast count with increased sugar (carbohydrate) consumption. But 78.6% of these so-called healthy subjects in this study already had detectable amounts of Candida albicans in mouthwash samples! Yeast had overgrown all the way up to their mouth and this was considered normal!

These researchers even admitted the flaw in their study when they suggested "follow-up studies should address the question of whether restriction of refined carbohydrates might decrease the number of Candida albicans organisms colonizing the human gastrointestinal tract."

Well, just how severely should refined carbohydrates be restricted? Kat James, who overcame her own eating disorder and wrote a book about it, maintains that not only carbohydrates like bread, pasta, rice and refined sugars, but for the metabolically-compromised even so-called “health foods” like whole grains, some beans and most fruit sugars must be avoided – and more good fats eaten – if one wants to biochemically transform into a fat-burning state. James was invited to present her program in my home and proved her point.

Of note, in her book The Truth About Beauty, James includes two studies where as much as double the calories were consumed with greater weight loss in the higher calorie groups, as long as the calories were low-glycemic. Her advice would be worth a few trillion dollars to a bankrupt disease care system.

Well, so much for Jenny Craig-like limited-calorie diets that only work as long as you can deny your own hunger pangs. Do you think various commercially popularized diet plans really want you to conquer your weight problem once and for all? No, they want you to come back and buy more, just like the doctors and pharmaceutical companies.

Presse Med. 2003 Apr 26; 32(15):689-95.

[Evaluation of discomfort and complications in a population of 18,102 patients overweight or obese patients].

[Article in French]


Service de nutrition, Institut Pasteur de Lille, Lille (59).



The burden of disorders associated with overweight and obesity is a major public health problem. It is therefore important to better identify these concomitant disorders and how their frequencies vary with sex and age.


A survey was carried out during a 5 month-period from September 2001 to January 2002) among 4 727 general practitioners distributed throughout France in 18 102 patients with a body mass index (BMI)>25 kg/m2. The practitioners evaluated the presence of concomitant disorders using a closed questionnaire. The patients assessed global discomfort linked to overweight using an analog visual scale. Univariate and multivariate analyses of the concomitant disorders and self-reported discomfort depending on age, gender and BMI were performed.


The survey population comprised 66.8% of women (W) and 33.2% of men (M). Mean age was 48.0 +/- 13.2 years and mean BMI was 34.6 +/- 6.1, with no differences between the two sexes. The most frequent concomitant disorders were back pain (44.6%), hypertension (high blood pressure) (44.2%), dyslipidemia (elevated blood fats-cholesterol) (39.9%), knee osteoarthritis (30.8%), lower limb edema (ankle swelling) (24.3%), hypersudation (hyperhidrosis; sweaty palms) (23.8%), skin fold mycosis (fungal infection) (22.8%) and type 2 diabetes (21.6%). In multivariate analyses, the distribution of these disorders varied with sex: hypertension, type 2 diabetes, dyslipidemia, and hypersudation/hyperhidrosis were more frequent in men, whereas knee osteoarthritis, back pain, and skin fold mycosis (fungus) were more frequent in women. The prevalence (odd ratio, OR) of back pain and dyslipidemia did not increase with higher BMI and the prevalence of back pain did not increase with age. Overall discomfort related to overweight was rated as 61.3 +/- 19.9 mm on a 0 to 100-mm scale. Discomfort was less marked in men, decreased with age and increased with BMI (and with the consultations in the Paris area).


This study shows the complexity of relationships between concomitant diseases, overall discomfort, BMI, age and sex (in the population of overweight and obese patients) and should improve the management of such patients and their complications.

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