Tuesday, April 29, 2014

Don't Fall Prey to The Licensing Effect

Although I cannot find the original source of this term, the 'licensing effect' is commonly referred to as the subconscious phenomenon whereby increased confidence and security due to one action tends to lead that same individual to worry less about the consequences of a counter-productive action.  In other words, they think that one action gives them a license to perform a different action.

For example, suppose a person is prescribed a statin, a cholesterol lowering drug, because his physician is concerned that the patient's cholesterol is too high thereby increasing the risk of heart disease.  The reason for high cholesterol can range from hereditary factors to a diet high in fats, such as fried foods, that are capable of raising cholesterol levels.  So following the advice of his physician, the patient fills the prescription and begins to take the statin confident that his cholesterol will be lowered and his risk for heart disease decreased.

Over the ensuing days, weeks, and months as the patient uses the drug, he feels like his cholesterol is no longer a concern.  So when he comes across french fries, pizza, cake creams made with trans-fats, etc., he doesn't think twice of the potential harms of eating such foods.

You may say that's ridiculous. No one could be that foolish to not realize the consequences of eating these unhealthy foods known to cause long term heart issues for many. (I say many, because of the lucky few who seem to get away with eating anything and everything like my friend Steve.)

If you are one of those naysayers, you may have trouble with a new study that showed
that people who took statins in 2009-2010 consumed more fat and calories than those who took the drugs 10 years earlier.

That's right, they experienced a "licensing effect" to eat more.

And in case, you thought everyone ate more, that was not the case. There was no similar increase in fat and calorie intake among people who didn't take statins, according to the University of California, Los Angeles (UCLA) researchers.  Furthermore, their analysis of U.S. National Health and Nutrition Examination Survey (not always perfect nor reliable, but pretty good) data showed that statin users in 2009-2010 consumed 9.6 percent more calories and 14.4 percent more fat than statin users in 1999-2000.

The clever ones among you may think that people who need statins probably always consumed more calories and fat and that's why they needed the statin in the first place. You would be wrong as statin users in 1999-2000 consumed fewer calories and fat than people who didn't take the cholesterol-lowering medications.

That has clearly changed per the study that was published online April 24 in JAMA Internal Medicine and simultaneously presented at the Society of General Internal Medicine annual meeting in Denver.

This licensing effect is far more ubiquitous than just the statin example.

Many people are under the illusion that taking prescription medications and supplements will somehow protect them from eating too much, especially of foods that are unhealthy for most humans.I saw this with patient after patient.  They thought everything was okay because their blood pressure  was within normal range on blood pressure medication, their blood sugar was within normal range because they took metformin, their cholesterol was within normal range because they took a statin, etc.  They thought that if the tests are normal then everything was okay. They didn't realizing that simply lowering cholesterol doesn't prevent heart attacks. In fact, statins typically prevent one heart attack among every 100 users. That's right, 1 out of 100. That shouldn't give anyone a real sense of protection. (However, don't stop your statin without consulting your physician.)

So please don't make the mistake of thinking you can eat whatever you want, and sit around all day and and do nothing simply because you take some pills and supplements..

Consider this a friendly warning. Your license has been revoked.

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