So annoying, in fact, that I googled it, and found out that there’s a whole culture of people out there who find the ad equally repellent. Many, unfortunately, have commented on the size of the main actress, and the backlash against the backlash against the commercial (isn’t everything in America these days a backlash against a backlash?) is that the haters of the commercial are simply “fat shaming” the actress. So let me state right off the bat that indeed, fat shaming is a horrible thing, and my objection to the commercial has nothing to do with the fact that the lead actress is overweight.
Rather, what really irritates me about the commercial (other than the cloyingly obnoxious jingle) is that it perpetuates the great pharmaceutical lie about type 2 diabetes: namely, that it’s an incurable disease that is best controlled with medication. Nothing could be further from the truth. The fact is that type 2 diabetes is often curable, and almost always manageable, with lifestyle modification, and – provided they make the correct changes – many type 2 diabetics don’t require any medication at all.
For example, I once had a patient who was taking five different medications, including insulin, for her type 2 diabetes. Despite this, her a1c (a 3 month average of blood sugar) was 9.2%. To put that into perspective, most diabetes associations suggest targeting diabetic patients to an a1c of 7% or less. A healthy person without diabetes or pre-diabetes will typically have an a1c of 5.5% or less. So 9.2% represents very, very, elevated average blood glucoses.
And yet, just a few months later, her a1c was 5.7%, off of ALL medications. She achieved this “miracle” after following my advice to go on a strict low-carbohydrate Atkins/keto style diet and to take a daily 20 minute walk.
Lest you think this is a fluke case, Virta health has built an entire business model by basically applying the same advice, and they have cured hundreds of thousands of type 2 diabetics at this point.
This is part of why I left corporate medicine and started my own direct primary care practice. When you are free to treat patients with what you know works, rather than what the insurance and pharma companies tell you is the “standard of care,” you are free to get better results for your patients.
Returning to the commercial, none of this of course is mentioned. That would be bad for business. Instead, our happily singing actress is seen dancing as she accepts a delivery of fast food. Had the commercial shown her exercising and eating a salad, I’d be more accepting of her ode to Jardiance – after all, medication can be a PART of the treatment of type 2 diabetes. But the message couldn’t be clearer: change nothing in your life dear patient, and enjoy your junk food. Jardiance will take care of it for you.
For what it’s worth, I actually have a reasonably favorable opinion of Jardiance as a medication. Amongst the medications we have for type 2 diabetes, it’s one of the more effective ones, and unlike a lot of other diabetes medications which are shown to lower glucose but not to actually improve life expectancy or reduce the risk for bad things happening to our patients (e.g. heart attacks, kidney failure, leg amputations), there’s actually some data that Jardiance does reduce the risk for these dreaded complications. On those occasions when one of my diabetic patients does need to take medication, it’s one of the agents that I consider using, and I have written more than a few prescriptions for it in my career.
But the message of the commercial is just dreadful, and encapsulates so much of what is wrong in our current healthcare system. Patients need to be educated and supported on how to take their health back. They don’t need more pills.
