Man concerned about brother
I am over 70 years old and in failing health. My stepbrother, “Tom,” is 58. Although he is still working, I am sure that he will soon have to stop because over the past few years, he has become steadily more obese, and the doctors seem unable to find a cause or remedy, nor do they really seem to care. He now weighs almost 700 pounds. I love my brother and am worried about what will happen to him when I am gone. I have always been reasonably slender, and my brother doesn’t seem to eat much more than I do, and he certainly doesn’t eat cake, pies or other junk food, nor does he eat large portions.
I can’t understand why the medical profession doesn’t assign a higher priority to the treatment of obesity in this country. Why can’t more people understand that it isn’t just a problem of overeating?
Dear Annie: Dear Concerned: — Concerned Brother
It’s great you’re still looking out for your little brother. I’m not a doctor, but it sounds to me as if Tom could have hypothyroidism. The most important thing you can do for your brother is encourage him to seek the opinion of another doctor. Offer to take him to the appointment yourself. Finally, be sure to take care of yourself, too. I’m sure Tom is as worried about his elder brother as you are about him.
I’m a psychiatrist. For several decades, I’ve treated patients for attention deficit hyperactivity disorder. You recently ran a letter from “Missing My Space Cadet.” He was concerned about his wife, who, after being prescribed an “amphetamine medication” for ADHD, became laser-focused on work and was no longer fun-loving. She was also described as sleeping and eating lots more on days when she didn’t take it.
As you said, she may be abusing her medication, but another possibility (more likely, in my opinion) is that the prescribed dose is simply too high for her. Most patients — and more than a few prescribers — do not realize that with ADHD medications, there is usually a fairly small difference between the dose that does nothing and the dose that has unwelcome side effects or that the correct dosage can vary quite widely from person to person. Thus, rather than simply prescribe a standard dosage, doctors must conduct a singlecase experiment for every patient.
For this reason, I think your advice that the husband and wife should go together to the next appointment was very much on target.
Dear Annie: — A Psychiatrist in New York
Input from medical professionals such as you is always helpful. You’ve raised a great point. I’ve passed this information along to “Missing My Space Cadet.” Thank you.
Dear Psychiatrist: