Lowering the Bar: Medicine in the 21st Century

Does diagnosis always mean disease, or does it sometimes mean opportunity?

As many as 16 million Americans are prone to screaming and pounding on the dashboard when someone cuts them off in traffic. Another 7 million are fully capable of devouring a whole box of cookies in front of the TV. There are 14 million men with low testosterone, 9 million women with low sexual desire -- and tens of millions of people with bladders that are too active and blood sugar that's a little too high.

The common thread: All have non-life-threatening conditions that for most of the 20th century were not considered a part of mainstream medicine. Some did not exist at all as formal disorders. Each of the conditions, from intermittent explosive disorder to overactive bladder disorder, is the product of a new or expanded definition. These definitions come from medical societies or researchers who get money from drug companies.

And those companies stand to profit when millions of people -- often overnight -- are labeled as ailing. What's more, the drugs involved can be costly, can carry serious health risks, and often do not work well, a Milwaukee Journal Sentinel/MedPage Today investigation has found. In 2003 and again in 2010, the American Diabetes Association tinkered with the definition of a condition known as prediabetes, which independent doctors say is an unneeded label that has led to overtreatment with drugs, exposing patients to risks without proof of real benefit...