Medication and bias

There’s drugs that reduce risk for chronic disease by

1. reducing the harms caused by certain dietary choices

2. reducing the impact of certain genetic pre-dispositions

3. changing single, discrete and measurable biological parameters that are only one risk factor for disease.

4. supporting changes that might occur with diet and lifestyle interventions, but not as easily or quickly.

5. change physiology by changing feedback loops in the body

Celebrities use them.

You’ve probably got friends & family using them and you don‘t even realise.

What drugs am I talking about? Maybe not the ones you think...

Antihypertensives

They lower blood pressure by altering heart, blood vessel and kidney functioning.

But no one calls them cheating.

No one questions who is “allowed” to use them.

No one demands that people must first try exercise, meditation, and celery juice for five years before being eligible. Drs often describe them as a tool to protect health while other efforts begin, or because genetics makes it harder for some people to achieve the necessary outcomes.

For Every 10 mmHg Reduction in Systolic Blood Pressure risk of stroke, heart attack, heart failure and overall risk of cardiovascular disease related death drops by 20-50%. So, these drugs are life-savers.

The DASH diet can lower blood pressure by 8-14 mmHg. Increasing potassium intake and decreasing sodium intake could each lower blood pressure by 5 mmHg. Increasing exercise can lower blood pressure up to 9 mmHg, limiting alcohol by a further 4 mmHg. \

But we accept the diversity of this toolkit. Why have we accepted the complexity of blood pressure regulation, but not the complexity of weight regulation?

I suspect it’s down to weight being visible & linked to societal status, discrimination and privilege.

We can’t see blood pressure, so we haven’t created diet culture narratives or the narratives of effort and worthiness around it. It’s not linked to virtue, status, or self-worth. But weight? We’ve made it a moral measurement. We've built a whole culture around “earning” a smaller body.

When we reduce our blood pressure, we don’t assume a more privileged space in society like we do when we reduce our weight.

This tells us something: our discomfort with weight-regulating drugs isn’t really about health or science. It’s about bias.