That’s the refrain swirling in Civis’ mind when reading about proposals for wide-scale funding of "miracle" weight-loss drugs.
It’s so much like the approach to vaping. Remember how vaping was touted as a much safer alternative to smoking? Remember the enthusiasm and the backing it received?
The plethora of toxins that accompany vapes is being recognised as more dangerous than first thought.
It usually takes years — even many years — before the grievous effects of tobacco smoking become apparent.
Yet, without sufficient time, evidence or studies, vaping was encouraged and embraced.
This wasn’t a case of being wise after the event. There were warnings, and they were ignored.
Vaping might still have a place in the quit-smoking arsenal.
A prescription-only model, as now used in Australia, would have been a wiser approach.
But the stable door was opened and the galloping horses entrenched vaping. Later attempts to rein it in proved too little, too late.
Last week, the Otago Daily Times reported that leading health academic Prof Sir Jim Mann said Pharmac should not consider wide-scale funding until New Zealand had a solid approach to treating obesity.
Sir Jim, co-director of the University of Otago’s Edgar Diabetes and Obesity Research Centre, said some people would almost certainly benefit.
Pharmac should consider funding for those with heart disease, heart failure and some with diabetes.
But drug use should occur within an overall national strategy for tackling obesity, one of this country’s biggest health issues, Sir Jim said.
The weight-loss drugs might be seen as "miracles", he said. But it is still early days in understanding their potential and long-term effects.
Nutritional support needed to be built in because as soon as someone stopped taking the drug, they regained weight if they hadn’t learned better eating habits. Nothing in obesity was a "magic bullet".
At present, Wegovy costs $459.99 a month in New Zealand.
Sir Jim called for healthy scepticism. He noted that years of experience were lacking compared with commonly prescribed drugs for blood pressure, diabetes, heart disease and cholesterol.
We rushed into vaping without sufficient knowledge of long-term effects and social impacts and we are paying the price. There is still a long way to go before we understand the weight-loss drug downsides.
The University of Otago, Dunedin and New Zealand are fortunate to have someone of Sir Jim’s ability, experience and wisdom in our midst.
Take heed.
It’s acknowledged that these weight-loss drugs suppress appetite and that weight falls off relatively quickly.
They are likely to have a place.
We should, however, be careful.
* * *
There are all sorts of speculations about the possible impacts of the drugs. Might they decimate hospitality industries as people eat and drink less? What will happen to food producers? Will there be more focus on quality food?
What about social norms around weight and body positivity?
Will there be two tiers of people — those who can afford the drugs and those who can’t — reinforcing inequities? And what if Australians receive the drug subsidised while New Zealanders don’t?
What about the side effects that already prevent some people from staying on the drugs at current doses?
These include nausea, fatigue and gastrointestinal issues. And what about muscle and bone-density loss if people don’t eat properly?
Civis was intrigued by one report suggesting United States airlines could increase profits because planes would be carrying lighter payloads.
* * *
Civis had to look up where "when will they ever learn" came from.
It is most famous as the recurring refrain in the anti-war folk song Where Have All the Flowers Gone, written in 1955 by Pete Seeger.
Artists such as The Kingston Trio and Peter, Paul and Mary popularised the song.
