Medications can help fight obesityIn response to your May...


June 08, 1996

Medications can help fight obesity

In response to your May 28 article on the concern over Food and Drug Administration approval of the diet pill, Redux, several points are worth clarifying.

The main focus of the article was on the possible risks posed by weight-loss drugs. While this is a valid concern, it must be emphasized that before any drug is administered for any medical condition, the benefits must be weighed against the risks.

In the case of obesity, there are many compelling reasons for aggressive management, including the use of medications.

Obesity causes a very significant increased risk of heart attacks, strokes, diabetes, birth defects, high blood pressure, gallbladder disease, breast and colon cancer, arthritis and premature death.

In addition, overweight people experience myriad other problems, such as education and job discrimination, social stigmas, lack of self-esteem and depression. In fact, there is no condition that is as common and associated with as many physical and psychological problems as obesity.

In treating thousands of overweight patients over the past several years with medications, I have found these medications to be both safe and effective when used properly. Specifically, they should be administered by experienced physicians in the field of obesity management and always at the lowest possible doses.

Frequent and careful medical follow-up of response and side effects is just as necessary as when treating other chronic illnesses.

When used properly, I have seen marked reductions in blood pressures, cholesterol and blood sugar levels, arthritis pain and fatigue -- not to mention the increased self-esteem and sense of well-being provided by weight loss.

On the other hand, I have never seen a case of primary pulmonary hypertension. As with the use of all medications, proper education of both clinical staff and patients is vital to early recognition of any potential side effects.

Obesity is clearly a common and serious illness, and the benefits of medications far outweigh the remote risks when administered carefully to the truly obese person -- defined by the accepted 20 percent above ideal body weight. Careful supervision and knowledge of the use and doses of these medications cannot be taken lightly.

Paul M. Rivas, M.D. Lutherville

Greatness of BSO must not be lost

''One of the world's great orchestras is in town,'' trumpets the '95-96 season brochure of the Baltimore Symphony. The astounding thing in this day of publicity-bloated America is that the statement is absolutely true.

The group is a national treasure. Yet I have heard mention of so-called financial necessities to cut back on the orchestra, its season or both. Somehow, the community simply must not allow this to happen.

I speak as a conductor of 38 years experience -- 35 as a university professor of music -- who has only known about the BSO since last July, when his daughter became its newest member. But everything I had heard proved true beyond expectation upon first hearing the BSO last summer and several times this past year.

The sensitivity and refinement of the BSO is definitely world-class, as much as that cliche is thrown around meaninglessly these days, but the extraordinary diversity of repertoire performed with that level of sensitivity, flexibility and refinement few orchestra at any echelon can match.

This is all, of course, very much related to the abilities and creativity of its music director, David Zinman, who handles an amazing variety of musical styles with consistent insight and level of excellence.

Many professional colleagues to whom I have shown the '95-96 brochure have commended the special level of creativity represented by the programming this season. Many of its recordings are among the best available of that repertoire.

Cultural institutions, particularly the performing arts, are having a rather difficult time right now in this country. We have developed a society that can find all kinds of money for mundane or even useless activities but seems unwilling to channel similar support for that which uplifts as well as entertains.

And yet when a cultural institution such as the BSO has been allowed to develop to the highest levels of excellence, we must not let the fluctuating whims of society in general cut this back. (After building Camden Yards, would anyone even think of returning the Orioles to AAA baseball?)

All world-class major orchestras perform large-scale repertoire with 60 strings, 35 winds, brass and percussion, and have contracts based upon 52 weeks. Any cutback in either personnel or season removes an orchestra from major-league status. If one compares the salary schedule of the BSO with orchestras of comparable quality, there is no question that the community is getting a substantial bargain.

Acton Ostling Jr.


The writer is professor of music at the University of Louisville.

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