Medicine doesn't really ignore nutrition, but the problem is:

1. Most people don't believe it anyway. People want to hear they can eat hamburgers and milkshakes and be healthy. Telling them "we know that gives you heart disease and cancer" does nothing.

2. Nutrition is complicated and different for every person, because everyone has different things they can tolerate. The "perfect" diet is actually worthless because it has a 0% success rate. Really, we have to optimize for how miserable people are willing to be.

3. Most people are unhealthy enough that nutrition is the least of their concerns. That sounds crazy, I know, but if you're obese (which most people are!), then priority is being not obese. Not your nutrition. I know those sound related but they're way less related than you think.

You don’t have to wonder. It’s public record that 45% of the FDA’s budget incomes from user fees that companies pay when they apply for approval of a medical device or drug.

In the drug division specifically, the number is about 75%.

Nutrition is run on fads - see whole fitness and healthy food bullshit. Nutrition supplements ended up being a loophole that allows pharmacies and pharma companies to sell all kinds of random stuff that they can't or don't want to, show is safe, or doing anything at all.

Medicine doesn't ignore nutrition, you just don't like the answers.

And it shows on the research: e.g. does creatine help muscle building? No.[1] But cue some anecdote from someone where they also changed a dozen other things at the same time but are sure it was that.

[1] https://www.unsw.edu.au/newsroom/news/2025/03/sports-supplem...

But there's a core problem with this, in many states doctors are legally forbidden to give nutrition advice. The academy of nutrition and dietetics has worked very hard to make it so that only dietitians can provide nutrition advice. Take Ohio for example, a medical doctor in Ohio is legally forbidden and actually in jeopardy of losing their license and going to jail if they were to provide nutrition advice without a dietetics license. Dietitians are not doctors, but the academy of nutrition and dietetics wants you to think they are.

So you are stating that there has been no change in how clinical trials are required to be run, and the associated costs, since the changes immediately following the thalidomide catastrophe?

I'll give you a case in point. This article was discussed the other day:

> https://www.nytimes.com/2026/04/02/technology/ai-billion-dol...

People want GLP-1 drugs. They can't get them without a prescription. They pay $$$ to a "telemedicine" "doctor", recite a list of well-known symptoms, and buy the prescription.

The system is that you can't buy these drugs without the piece of paper, and the piece of paper is basically something that anybody can buy regardless of whether or not they actually need the drug. Wanting it is usually enough.

The "perscription system" used to be that you'd have to go see a doctor, the doctor knew who you were, and would make decisions on what prescriptions/medications you should be given.

Due to drug advertising rules, the prescription system has been turned on its head, and the patient now goes to their doctor asking for a specific prescription.

Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you.

Go to doctor, get prescription for restricted medicine, pick up prescription.

If you can call up a teledoc and they give you a prescription based on your description why could you not just go buy the meds yourself without a prescription. You have essentially diagnosed yourself and just asked the doctor for permission to buy the drug you want.

I take certain medications--nothing interesting, nothing controlled, nothing abusable. I have to deal with a whole thing just to get refills, because my PCP forces me to come in every time--and even that is now just a telehealth call that is annoying.

In Mexico, for meds like mine, you can just buy them at the pharmacy. There's no reason for all this nonsense.

(Edit: same PCP refused to prescribe GLP-1s early, without any scientific or medical reason not to. Delayed my weightloss by months until I found a place that would.)

> I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically.

They basically operate as a "pay for a prescription" service.

Figure out what drug you want, google the drug name and telehealth. You will be marketed in a wink wink sort of manner over how easy it is to get them, just hours away! Then if you are not a total idiot, you answer certain questions in the right manner on the intake form, the doctor (usually NP/PA or similar for most things) will quickly run through that and expect you to answer correctly - perhaps guide you a bit if you don't.

5 minutes later you have a prescription in the web portal and it's sent to your pharmacy of choice.

It really shows how the whole "permission slip" program is BS. I've used these services a couple times vs. my normal doctor just to save time and expense of an office visit. If I can click some buttons, have a call 30 minutes later, and be on my way to the pharmacy for $50 it's sometimes the path I take now vs. traditional route.

Someone used to the traditional doctor/patient relationship thing and prescriptions being "holy" would be shocked at how easy and gamed it all is.

Many of us would appreciate if you could share one of those reputable vendors with such cheap prices