Clint Witchalls, newscientist.com, 1 February 2011:
Today, people don't just have diseases, they have pre-diseases: pre-diabetes, pre-hypertension, pre-obesity. In the face of pre-disease, otherwise healthy people seek treatment for potential ailments that show no symptoms, and maybe never will.
The book makes it clear that if a person has symptoms, they should get a diagnosis from their doctor. And, certainly, it recognises the benefit in diagnosing the silent conditions that often show no symptoms, such as hypertension.
But it argues against the constant changes to disease thresholds, which define more and more people as patients in need of medication or treatment. When, in 1997, the definition of diabetes changed from a fasting blood sugar level of 140 milligrams per decilitre to 126 milligrams per decilitre, 1.6 million Americans became diabetic at the stroke of a pen. Being classified as ill creates anxiety, and being treated with drugs, operations or other therapies can create unnecessary risk.
H. Gilbert Welch, the lead author, is no cheap contrarian, though. As a primary care physician in Vermont, he has seen the ill effects that come with treating patients too early ... Read more>>