Pam Belluck’s outstanding story on the science of the morning after pill and the politics of its labelling sits at the nexus of investigative and science reporting and embodies the best of both traditions:

But an examination by The New York Times has found that the federally approved labels and medical Web sites do not reflect what the science shows. Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents’ definition of abortion-inducing drugs. In contrast, RU-486, a medication prescribed for terminating pregnancies, destroys implanted embryos. [NYT]

Back in October, I reviewed the research on the workings of the morning after pill to settle an argument with some friends. I came to the same conclusions as Belluck. A body of elegant in vitro and in vivo experiments in tissues, animals, and humans show that the morning after pill (aka high-dose birth control) works like birth control, namely, by preventing ovulation.

One minor quibble: Belluck frames the story as part of the abortion debate, which is certainly how the anti-choice faction is approaching the issue. But even if emergency contraception did prevent implantation, EC would be no more an abortifacient than an IUD, a popular form of birth control that does prevent implantation. According to medicine, and common sense, abortion presupposes pregnancy, and pregnancy presupposes implantation. If you’re not pregnant, it’s not an abortion. But once again, anti-choicers are trying to redefine medical terminology for partisan ends.

At a time when science journalists are pressured to hedge, defer to authority, and give equal time to opposing sides regardless of their intellectual merit, Belluck bucked the trend, assessed the evidence, and stated her conclusion for the record.

Then Belluck went on to hold powerful institutions accountable by asking pointed questions. If the science says that the morning after pill is birth control, why do government-approved labels and health information resources raise the specter that the emergency contraception is an abortifacient? As you might expect, conservative pressure groups like the anti-choice Family Research Council are very interested in FDA labelling because these descriptors shape medical and policy conversations. Belluck reviewed the records on FDA approval for emergency contraception and found that the caveat about preventing implantation was grandfathered in from earlier labelling discussions about birth control pills. There is some question about whether daily birth control pills might discourage implantation by thinning the lining of the uterus. This conjecture remains unproven for regular birth control, but follow-up studies have shown the question to be a moot point for emergency contraception. One large dose of hormones doesn’t have time to alter the lining of the uterus the way daily birth control pills do.

The labels were written in a period of genuine uncertainty. Today, the scientific consensus is clear, but anti-choice groups are campaigning to keep the misleading labels intact. With any luck Belluck’s outstanding reporting will spur citizens to demand that scientific accuracy prevail over ideology.

[Photo credit: Grasshopperkm, Creative Commons.]

HBO joined forces with the Institute of Medicine, the CDC, the NIH, and Kaiser Permanente to create “The Weight of the Nation,” a four-part documentary about obesity in America. All four full-length films can be viewed online for free. The first episode, “Consequences,” examines the health impact of obesity in America. The second installment, “Choices,” attempts to explain why lasting weight loss is so difficult and what the average person can do to take control of his or her weight. “Children in Crisis,” documents the effects of childhood obesity. The final episode, “Challenges,” explores the economic, cultural, and political factors that make it so difficult, even for highly motivated people, to eat well and maintain a healthy weight in the U.S. today.

After watching the first two episodes, I’m impressed. Experts present the mainstream consensus on overweight and health in accessible language. They explain the connection between obesity and diabetes, the link between excess fat and cardiovascular disease, the distinctive health risks of abdominal adiposity, the role of a fatty liver in producing the metabolic abormalities associated with obesity, and how stress hormones predispose us to overeating and weight gain.

The documentary pulls no punches about the dangers of overweight, but it presents fat people as compelling and relatable subjects, not as objects of repulsion or pity. We don’t see any clicheed “headless fatties” shuffling along. The fat subjects are charismatic, funny, and self-aware. They come from all walks of life, some are call center employees, one is a judge. The message is clear: Their predicament is our predicament.

The Romney campaign has released a new ad about how the Romneys’ strong marriage helps them cope with Ann Romney’s multiple sclerosis. About 400,000 Americans are living with this progressive, debilitating, and as-yet incurable neurological condition. Jonathan Cohn of the New Republic has mixed feelings about the ad because, as touching as the Romneys’ personal story may be, the fact remains that Mitt Romney’s policy platform would make life a lot worse for ordinary people with MS and other chronic diseases. Cohn explains: 

But if you have MS, or any other serious chronic illness, you need more than a devoted spouse. You need a way to pay your medical bills. And, historically, many people with MS have struggled with that. MS is a long-term, progressively debilitating disease, requiring ever more costly treatments and equipment. The bills are high enough that even patients with private insurance have struggled with out-of-pocket expenses or run up against annual or lifetime limits on payments. And those patients have been, in some respects, the lucky ones. People who buy coverage on their own or through small businesses frequently end up with exorbitant rates or skimpy benefits, or can’t get coverage at all. Those are just some of the reasons the MS Society has long supported reforms that would, among other things, provide “comprehensive, quality health care available to all.” [TNR]

Cohn won the Hillman Prize in 2010 for his outstanding coverage of health care policy.

Consumers might not consider sunscreen a powerhouse industry, but many of its manufacturers, as well as makers of other products that claim to offer some degree of sun protection, are actually part of giant cosmetics or chemical companies – which are heavy-hitters here in Washington (for instance Merck, which owns the popular Coppertone sunscreen brand.) Two trade organizations closely aligned with the cosmetics industry have gone to bat on the labeling rules, demanding the FDA roll them back – the Personal Care Products Council, which has spent about $140,000 on lobbying so far this year, and the Consumer Healthcare Products Association, which has dropped about $210,000 so far in 2012. The Personal Care Products Association spent $890,000 in 2011, and well over $1 million the previous two years, while the Consumer Healthcare Products Association spent $835,000 last year, and $3.2 million in 2010. Both report lobbying the FDA.

 

Turning this into a full-blown beach brawl, a handful of senators are now promoting legislation – the Sunscreen Labeling Protection Act – to force the FDA to speed up the process. But don’t confuse that with the Skin Cancer Prevention, Education, and Consumer Right-To-Know Act, another piece of proposed legislation to begin enforcement of the new rules. Both pieces of legislation are currently stuck in place.

In the best tradition of Big Tobacco, the European chemical giant CIBA created a front group called Citizens for Sun Protection, Choma notes. CIBA is part of an even larger company that claims to manufacture half the world supply of UV-blocking chemicals.

[Photo credit: Amy McTeague, Creative Commons.]