Message from the editor.

A Plea for Submissions

Welcome to our Winter 2004-2005 issue of the AMAA Journal. On the following page is a timely and very important article on NSAID use and endurance running, written by Running & FitNews Editor Jeff Venables following his attendance at the panel discussion on this topic at AMAA's Sports Medicine Symposium in October. Because of the continued turbulent nature of the topic through the tail-end of 2004, Jeff did further research to include the latest updates and recommendations from experts. This is a must-read for AMAA members!

To fill the pages of the AMAA Journal, we often draw from presentations made at the AMAA symposiums held at the Marine Corps and Boston marathons; however, I know that among you there is a good deal of work and intellectual thinking going on in the area that our Journal focuses on--sports medicine, athletic training and health. I, therefore, respectfully ask that you consider preparing a submission for our Journal. Because submissions are peer-reviewed, I recommend that you allow me a preliminary review of your topic (send to: [e-mail]) before you spend an extensive amount of time on something that may not fit well. That said, however, we are especially interested in having our membership broadly represented on the pages of our publication so I tend to be flexible when AMAA members send us submissions.

As to subject matter, papers can be on sports/athletics-related basic science; the clinical aspects of taking care of athletes; sports injury prevention, treatment and rehabilitation; and various aspects of promoting exercise and training programs in the broad range of sports that we deal with (although endurance sports would receive the most attention). You can also address controversies, such as the utility of stretching or how much is enough training when training for a marathon. These are just some suggestions of topics that could easily grace our pages--do let us hear from you!

To view the "Guidelines for Submitting Articles to the AMAA Journal," go to www.amaasportsmed.org and choose "AMAA Journal" from the menu. These guidelines include word counts for sections represented in the Journal, as well as other details such as formatting references and submission requirements. If you don't have access to the Internet, call Barbara Baldwin at 800-776-2732, ext. 12--she'll be happy to mail or fax those guidelines to you.

How to Deal with Obesity: Not!

An article by Gina Kolata published in The New York Times on September 30, 2004, told us that "Weight Loss Surgery May Soon Be Paid by Medicare." (And people wonder why health services are so expensive in the United States. The development of this type of surgery and its widespread promotion is surely one of them.) "Bariatric surgery" goes for $30,000 to $40,000 a pop. Millions for treatment, not too many pennies for prevention. This treatment is not only very expensive, it is also of questionable value and carries with it the risk of serious side effects. In one of the studies cited as supporting the utility of the intervention, the average weight loss was 68 pounds in the first year and 44 pounds after eight years. In the 350 to 400 pound folks for whom this procedure is usually done, that is not a lot. Furthermore, the potential positive effect on diabetes and hypertension--one of the reasons why the Medicare program is looking into funding the surgery--is questionable.

Further, one should ask why Medicare is thinking of paying for the procedure at all. Aren't we talking about folks over age 65 (and I am one), folks who most likely have been heavy for a very long time? The justification given for the proposed benefit is the amelioration of some of the negative outcomes of obesity, as noted above; however, the damage caused by obesity has already been done by the time one is Medicare-eligible. The potential negative side effects of the surgery range from bowel obstruction and malnutrition to anemia and bone loss. In the face of continually rising Medicare costs, one can think of many more productive uses for these dollars.

Turning from surgery for obesity to drugs for obesity, we come to an item that appeared on my AOL screen on November 17, 2004. It was a report on an article that appeared on WebMD Medical News on November 9: Experimental Drug Has Staying Power. "Acomplia," so we are told, "takes off weight and reduces waist size" and "keeps the weight off for two years." It also raises serum HDL, reduces triglyceride levels and improves "the body's ability to handle blood sugar." The drug was developed under the leadership of the well-known obesity researcher, Dr. Xavier Pi-Sunyer, of Columbia University and St. Luke's-Roosevelt Medical Center in New York City.

Golly gee, here's a pill that is just as good for achieving weight loss as healthy eating and regular exercise ... and it can make up for all the extra high-fat, high-calorie food that we Americans have been barraged with for the past 50 years. Why, that's magic! In reality, it looks like it'll end up being just another crutch to lean on, another quick fix that will help overweight individuals avoid changing unhealthy behaviors. As far as the potential side effects of the drug are concerned, they seem to be very limited and mild. But every "magic bullet" obesity drug that has preceded it onto the market, and it may be on the market in the not-too-distant future, has eventually shown the potential for serious side effects. Just think Fen-Fen.

I have yet to be convinced that there is truly a magic bullet drug--no work, no pain, no struggle, no "give-ups" and no need for personal health-promoting behavior change--that can deal broadly with the obesity epidemic. Until our nation begins to devote even a tenth of the time spent looking for that magic bullet to looking for more effective ways people can activate the motivational process for managing weight loss, we, as a nation, will simply continue to get heavier and heavier.

I welcome your comments on this topic, or any other that you think is worthy of discussion for the AMAA Journal.

Respectfully yours,

Steven Jonas