Doctor's society promotes disease prevention over pills

Israel Family Physicians Society has decided to talk to patients about lifestyle changes, including smoking cessation, exercise and diets.

By JUDY SIEGEL-ITZKOVICH
public smoking 224 88 (photo credit: Channel 10)
public smoking 224 88
(photo credit: Channel 10)
Convinced that prescribing pills to help their patients lose weight is impractical and even dangerous since Reductil was removed from pharmacies around the country due to higher risk of heart attacks, the Israel Family Physicians Society has decided on a bold step: From now on, it will promote disease prevention by talking to all patients about lifestyle changes, including smoking cessation, exercise and nutritious diets.
This is regarded as a “revolution” in the society, which has 2,000 members, including family physician specialists and general practitioners. It will launch the policy change with two seminars for members, one in Tel Aviv on October 18 and the other in Jerusalem on November 3.
The sessions will include discussions on osteoporosis prevention, nutrition, probiotics, preventing obesity in children and teenagers and reducing blood cholesterol levels.
The Israel Cancer Association says that 60 percent of all cancers, for example, can be prevented by not smoking, by exercising and by following a nutritious diet. So can much heart disease, diabetes and stroke, as well as a variety of other chronic diseases.
“We regard with much importance the boosting of our involvement as family physicians in all subjects related to healthful eating, treating and preventing overweight and other actions as the basis for treating our patients,” society chairman Prof. Shlomo Vinker said on Thursday.
“We as a society believe that this subject did not get the importance it deserved for many years, as we stressed giving medications because we thought it was very difficult and even impossible to influence [patients] to change their lifestyles. If we all push for [this], we can reduce the mortality and morbidity rate in Israel and even save much money in the treatment of diseases and their complications,” Vinker said.
Hundreds of family physicians and general practitioners are expected to participate in these events, added Dr. Amnon Lahad, a disease-prevention specialist at the Hebrew University-Hadassah Medical School, and deputy head of the doctors’ society.
“We have always talked about nutrition and healthful lifestyles, but for many years, medical students weren’t taught about it. Now they are. We thought anti-obesity pills would help people, but now Reductil has been found risky and removed from the market like other prescription medications for weight loss,” he said.
Lahad said the four public health funds had put more stress on lifestyles in recent years, and now smoking-cessation courses were included in the basket of health services.
“We failed by thinking pills are the answer,” he said. “It is a process. We are aware that we have to do much more.”
He conceded that giving such advice was problematic if the physician himself was overweight or smoked – and that some doctors felt uncomfortable talking to patients about such personal habits, as they might embarrass them or switch physicians.
Lahad said the Health Ministry had not asked his society to change its policy, but that the ministry had been working for several years on a program called “2020” to promote better health for Israelis through prevention by the end of the next decade.
Meanwhile, the National Council for the Child has urged the Israel Pediatric Society – which said it would raise members’ awareness of the need to treat obesity in children – to be careful not to stigmatize overweight children.
Dr. Yitzhak Kadman, in a letter to society chairman Dr. Mati Berkowitz, said that while this was a growing problem, the effort must not be used to “demonize” such children (and their parents) or to cause them to be targeted by their peers for ridicule.
A national public campaign – in the media, in schools and in the Knesset – to fight obesity, while well-intentioned, could cause harm, said Kadman, as overweight children could be depicted as “fat, lazy, voracious and unwilling to exercise. Their peers may call them disparaging names.”
He added that overweight is more common in poor families that subsist on cheap, fattening food and that have little time or money to engage in leisure-time exercise and sports.