Pain, Dizziness, Insomnia, and Headache

In other instances, however, doctors have actively opposed medicalization. By definition, this is the case with any contested illness: distressing and painful symptoms that affected individuals believe constitute an illness even though many doctors disagree. For example, fibromyalgia is characterized by many common symptoms, including pain, dizziness, insomnia, and headache. Moreover, no blood test or x-ray can identify an individual as having fibromyalgia. As a result, many doctors question whether it really is a disease. The same is true for chronic fatigue syndrome and multiple chemical sensitivity, among others. In these cases, consumers often press for medicalization to get validation for their experiences, stimulate research on treatments and cures, and get health and dis- ability insurance coverage for their problems. The rise of the Internet has made it much easier for such consumers to find each other, reaffirm each other’s sense that they suffer from a real illness, and lobby for medicalization.

Managed care organizations (MCOs) also play a major role in battles over medicalization. MCOs are health insurance providers that restrain costs (and ideally improve quality of care) by monitor- ing closely the health services given to patients. MCOs either support or oppose medicalization, depending on which tactic best protects their interests. For example, in the past, MCOs typically rejected requests for gastric- bypass surgeries to help obese patients lose weight, implicitly arguing that obe- sity was a personal rather than a medical issue. More recently, MCOs have started approving these surgeries in hopes of reducing their long-term costs for obesity-related disease.

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The final major force behind medicalization is the pharmaceutical industry. The industry has a vested economic interest in medicalization when- ever it can sell a drug as a treatment. For example, in 1985, pharmaceutical company Genentech patented a genetically engineered human growth hormone designed to increase height in children with pituitary gland defects. Such defects, however, are rare. To expand the market for its drug, Genentech sponsored in-school screening programs that identified the shortest 3% of students and then informed the students’ parents that the students might benefit from hormone treatment. That treatment, however, carried significant side effects and only increased height in children with pituitary defects.