By Val Willingham
CNN Medical Producer

I don't smoke. But I have a good friend who does. For years, she's been trying to quit, using patches, gum, group therapy, even exercise programs designed to help you "lose your cravings." She's gone cold turkey, smoked fake cigarettes and many times begged buddies to take her cigarettes and throw them in the trash if they saw packs in her home or car. And although she's had a few smoke-free periods in her life, she's never really quit the habit. She says it's just too hard.

Of course she's not alone. Drug experts say nicotine is more difficult to kick than heroin. Of the 44 million people in the U.S. who smoke, the American Cancer Society says, 70 percent of those smokers confess they want to quit and about 40 percent do quit each year. Yet only 4 percent to 7 percent actually give up smoking, without help, for good.

But now there may be hope. The National Institute on Drug Abuse, a division of the National Institutes of Health, has awarded Nabi Biopharmaceuticals a $10 million grant to take its anti-nicotine vaccine into phase 3 human research trials over the next few months. Called the NicVAX, the vaccine is designed to stimulate the immune system to generate antibodies that would latch on to nicotine in a smoker's body and actually prevent nicotine from ever entering the brain.

When a smoker inhales a cigarette, nicotine is absorbed through the lung tissue, into the bloodstream and carried through the body. Because nicotine is a small molecule, it easily crosses the blood brain barrier into the brain. The nicotine then binds to receptors in the brain, which release dopamine, which is a stimulant that gives the smoker a pleasurable sensation, known as a "smoker's high."

This process occurs very rapidly in the body, less than one minute after tobacco smoke is inhaled, so the nicotine fix is quick. That's what causes the addiction.

The NicVAX vaccine creates antibodies that bind to nicotine in the bloodstream, blocking it from crossing into the brain, through the brain-blood barrier. That's because these nicotine-specific antibodies are large molecules and are too big to cross into the brain. So the bound nicotine is trapped in the blood and can't reach the receptors that trigger that release of dopamine, which is what causes the pleasure response.

It's believed that the addiction of the smoker to nicotine will gradually diminish because as the antibodies created by NicVAX continue to bind the nicotine, the amount of nicotine reaching the brain will gradually decrease.

According to Nabi, these phase 3 trials could begin by the end of the year. The companys says that so far, the results have been promising with few side effects. In the phase 2 trials reports, Nabi says "a statistically significant number of participants treated with the NicVAX optimal dose were able to quit smoking and remain abstinent over the long term at rate of nearly three times that of those receiving the placebo. In addition, those participants that continued to smoke and but showed a high antibody response to NicVAX significantly reduced the number of cigarettes smoked over the full 12-month period from a baseline of 20 cigarettes per day to 10 cigarettes per day."

The vaccine will be tested over a six-month period with participants receiving a vaccine every four weeks. .The antibodies should remain in the body for a long period of time. Just how long, researchers don't know yet. Trial sites will be located across the country. You can check on clinicaltrials.gov if you're interested in becoming a participant.

I am sure my friend will be waiting to sign up.

But here's the question. Would you be willing to take a vaccine periodically to help you quit the habit? Or do you have a method that has helped you to remain smoke free? We'd like to hear.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Caitlin Hagan
CNN Medical Associate Producer

On a hot sunny day, eight men play street soccer on the hard top of a local basketball court. They high-five and laugh while running drills and scrimmaging. Their dynamic is unique because despite their competition, they are also extremely supportive of one another. Friendly trash talk is intermixed with calls of praise that continue when it's time for a break and the men move off the court, into the shade. To an outsider, this group of friends is happy and healthy, enjoying an afternoon in the sunshine.

Street Soccer USA tries to give hope and restore self-worth to homeless men around the country.

No one would ever suspect these men are homeless. In fact, being homeless is what brings them together.
Welcome to the Atlanta Street Soccer team. One of 16 in the country, the team is part of the national program, Street Soccer USA. The program, open to men who are homeless, addicts in a rehabilitation program, or refugees, seeks to use sports, specifically street soccer, to help the players turn their lives around.

When someone is homeless, “you stop thinking about your health and things that make you happy, things that make you want to live, that make you want to be a productive member of society, that make you want to get up and go to work.” Participating in soccer and sports “makes you want to take that next step. It motivates you to want to do better,” says Jeremy Wisham, an AmeriCorps volunteer who coaches the Atlanta team.

Calvin Riley had a job and an apartment before his company went bankrupt and he was laid off. Eventually he lost everything and became one of the more than 2 million Americans who are homeless. “I was depressed…I never thought I’d be homeless. I never thought I’d be down in the homeless shelter.”

A chance encounter with Wisham brought Riley out on the court. Since then, he says, everything has changed. “Playing soccer got me back focused. Being around positive people…helped me to go out and do something.” Riley is now enrolled in college classes with a job lined up for when he graduates in a few months. He has lost weight and he quit smoking. “You know, there’s a lot of running in soccer. When I first came…I was running constantly. I didn’t like the way it made me feel…so after three practices I said, I’m giving it up, man. I am giving it up.”

“Street Soccer is about redefining yourself and setting goals,” says Lawrence Cann, founder and CEO of Street Soccer USA. “The homeless are usually locked out of normal life so a chance to get in and play and be a part of the team…it’s something they can be proud of at the end of the day.”

The 16 teams will meet at the end of July in Washington, D.C., for the U.S. Homeless Cup. From there, about a dozen players will travel to Milan to compete in this year’s World Homeless Cup. “Soccer is the world’s game. It’s the people’s game, and when you’re homeless, you’re so alone…but you become part of a community, the soccer community, probably the biggest community in the world,” says Cann.

Riley believes that support has been key to his success. “When you join this team, it’s like a family. If you need anything, we’ll be there for you.”

Do you think sports could be a solution to homelessness? Has sports ever helped you overcome an obstacle?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a regular feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta:

From Jolene: 
"I have a friend who needs to have his wisdom teeth pulled and will need pain medication. The problem is, he is a recovering addict. Any suggestions?"

Answer:

Jolene, first of all, congratulations to your friend for making it to and staying in recovery. More than 23 million Americans struggle with substance abuse problems every day, according to a recent government survey, but only about 4 million of them actually receive some kind of treatment for their addiction to alcohol or illicit drugs.

That being said, it’s true that since he’s a recovering addict, your friend faces a greater challenge than many when it comes to any type of surgical procedure that’s going to require pain management.

But his pain definitely needs to be treated, regardless. The reason: Studies have shown that if a patient does not receive adequate pain treatment in surgical recovery, his tissues don’t tend to heal as well. Pain that goes untreated can also lead to what pain experts refer to as “wind-up,” meaning the spinal cord gets so bombarded with continuous pain signals that it can lead to a longer, more chronic pain situation. So it’s important to “quiet” the spinal cord by bringing the pain under control.

While the vast majority of patients who undergo oral surgery do take some type of narcotic drug afterward for relief, some people are able to successfully treat their pain with anti-inflammatory drugs such as prescription-strength ibuprofen. These non-habit-forming drugs might be the first step for your friend to try. He will need to discuss this option with his doctor, because there is a greater concern about bleeding with this class of drugs, although usually they are safe especially if taken only for a few days.

If the anti-inflammatory drugs don’t work, however, there are some narcotic drugs that are thought to be less addictive than others. Tramadol is one option. It’s a chemical that works as an antidepressant but also has a weak effect on your brain’s opiate receptors, meaning it can provide pain relief but it doesn’t work as assertively on the brain’s reward system (which can lead to addiction). It’s thought to be safer for people who struggle with addiction. Your friend will need to work with his physician to weigh the risks and benefits of trying a narcotic drug before going down this path.

The critical part of keeping a recovering addict from falling back into a cycle of substance abuse with painkillers is making sure that both the doctor and patient vigilantly monitor the course of pain management. For a procedure like wisdom teeth removal, a patient should start feeling better after a few days, maybe a week max. The doctor should follow up with the patient so that if he still complains of pain, the doctor can re-evaluate what could be causing the pain to continue.

By Elizabeth Landau
CNN.com Health Writer/Producer

The general anesthetic Diprivan (propofol) has been making headlines as questions about Michael Jackson's death abound. A nurse who had worked for the singer told CNN that Jackson requested the drug because he had trouble sleeping, and The Associated Press reported that it had been found in his home. Diprivan is not approved as a sleep aid by the Food and Drug Administration. Read more about propofol.

It turns out that propofol, used routinely for surgeries and procedures such as colonoscopies, has been a point of concern among some anesthesiologists because of the potential for abuse by health care workers. A 2007 study published by the International Anesthesia Research Society found that about 18 percent of the 126 academic anesthesia programs in the United States had at least one reported instance of propofol abuse within the previous 10 years.

Researchers also found that six out of 16 residents (about 38 percent) who abused propofol died from it. While these are small numbers, lead author Dr. Paul Wischmeyer, professor of anesthesiology at the University of Colorado, believes this is indicative of a larger problem.

People who abuse propofol tend to have had trauma earlier in life, and take the drug to escape it, Wischmeyer said. These people also tend to be impulsive and risk-taking, he said.

Wischmeyer became passionate about the issue because one of his classmates in residency died from using the drug.

"I know physicians that have reached their hands into sharps boxes, where all of the needles are disposed of, to pull out old, used syringes of this stuff that have been used in other patients, and then use it on themselves," he said.

The drug affects two important brain receptors, one of which is associated with marijuana, and the other is targeted by anti-anxiety drugs such as Valium, he said.

"Once someone has tried this drug in a way that they remember it, they very much always choose to try it again," he said.

Some people may die from propofol abuse because the drug itself becomes contaminated when it sits out for too long, like "spoiled milk," he said. There is also a risk of overdose.

"The difference between being high and being dead is a cc or two," Wischmeyer said.

If propofol is the direct cause of death, it should show up in an autopsy in urine, blood, and possibly hair, he said. But it does depend on how long before death the drug was injected.

Should propofol be considered a controlled substance that needs to be "scheduled," with tight distribution and strict accounting of its use? Anesthesiologists are still debating this.

On the down side, stricter pharmacy control of Diprivan would involve increased costs and administrative oversight, the study authors noted. Although there have been documented cases of propofol abuse, it is still much less frequent than abuse of opioids and benzodiazepines, which are governed by strict federal laws and local pharmacy control, they wrote.

But Wischmeyer advocates that it should be a controlled substance because of how lethal it is. He argues that having an extra layer of accounting, as there is with many painkillers and sedatives in hospitals, would not delay the supply of drug for the patients who need them. It was only with Wischmeyer's group's study that the anesthesiology community became more aware of the growing abuse problem, he said.

Most anesthesia programs do not keep track or control of propofol stocks, the authors wrote.

The drug does not produce a "high" per se, but does give the person who takes it a euphoric feeling upon waking up, said Dr. Hector Vila, chairman of the Ambulatory Surgery Committee for the American Society of Anesthesiologists.

For more information about the propofol issue among anesthesiologists, read the study and check out Anesthesiology News.

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Danielle Dellorto
CNN Medical Producer

They say the first step in breaking any addiction is admitting you have a problem. For years I’ve brushed off my husband’s “intervention” attempts. But lately I’ve begun to experience the physical side effects of my addiction (more on that later) and it’s forced me to think about how often I get my “fix.’”

Turns out, my husband was right all along.
My name is Danielle and I’m addicted to my Blackberry.

It’s the last thing I look at before I go to bed; it even sleeps next to me on the nightstand. I set my alarm 20 minutes early so I can read and respond to e-mails before I get in the shower each morning. I’ve pulled over while driving to answer an e-mail and, yes, my whole day feels out of whack if I’ve forgotten my trusty device at home.

I know I’m not alone. Look around at the mall, at a restaurant, at a baseball game and you’ll see most adults with their devices out.

It's not always work related. As technology advances, our phones have become personal computers – we’re tweeting (follow me: @daniellecnn),updating our Facebook status, looking up movie times, and refreshing our favorite Web sites to see what’s happening while we’re out and about.

Wireless devices aren’t the Antichrist of course, but too much of any good thing can take a toll both mentally and physically.

It may sound silly to say out loud, but my thumb really hurts! My left thumb aches more than the right. Sometimes I feel a shooting pain at the base; other times it just throbs. These are classic symptoms of tendinitis and arthritis, and doctors say they’re a side effect of my addiction.

The overuse of motion from typing for hours primarily with your thumb causes a lot of undo stress and inflammation. The thumb has one less joint than the rest of the fingers so that may explain why it’s more sensitive to injury than our other three-jointed digits. Experts say the easy cure for mild pain caused by overuse is simple – don’t use it as much! “I usually find that if a patient was to just reduce the workload or reduce the repetitive nature of this condition, their symptoms will resolve,” said hand surgeon Dr. Keith Raskin of New York University Medical Center.

Being a pain in the thumb is one thing, but what about the toll wireless devices may be taking on our social lives?

I use to think of myself as a master juggler. Pretty proud I could balance my role as the ultimate wife and employee flawlessly around-the-clock via my Blackberry! But then my one day my husband started to literally thank me for leaving my Blackberry in the room during our vacation. A day of my full, undistracted attention was a treat for him.

What a reality check. Guess I’m not so great at “juggling” as I thought. But I am getting better. I no longer jump to check my device every time it buzzes at night and I don’t bring it to the dinner table anymore either (baby steps!). I did ask him why he never flat out told me how much my antics bothered him. He said he had told me several times. Apparently, I was typing away at the time and only half-listening. Yikes! Sorry about that, honey.

So now I want to hear your story! Is your thumb achy too? What works to relieve your pain? Is being connected to your wireless device 24/7 taking a toll on your social life? What’s your advice?

By Caleb Hellerman
CNN Medical Senior Producer

It’s only been three weeks but it feels like a lifetime since we aired our documentary, Addiction/Life on the Edge. That’s how it goes in the news business, especially when a global swine flu outbreak grabs the headlines.

But I can’t ignore the fascinating calls and emails we got in response to “Addiction” – including doctors who watched with colleagues, and a man who said he watched in the rec room of a rehab program, with 90 percent of the other residents.

I found it especially heartbreaking to read notes from people whose children are struggling with drugs or alcohol. Linda Frisciaro wrote about her 25-year-son, who beat an addiction to crack (“I thought we conquered the world when he stopped, and there was no better feeling than that…”) but soon was battling an addiction to alcohol and prescription painkillers. (“He called me about a year ago, crying and weeping, saying ‘Mom, please help me.’ It took him about 45 minutes to get out those couple words….”)

My heart goes out to Frisciaro and anyone in her position; I can only hope their stories have happy endings and the addicts come to realize how fortunate they are to have someone who didn’t quit on them.

A number of people wrote to emphasize the link between addiction and disorders like depression and bipolar illness. We mentioned this briefly in the documentary, but it might have been worth making a stronger point.

I also got an earful from people who read my article about medications that might be used to treat addiction. A sample:

Joan: “I agree that the disease is complicated, and a pill won't solve every problem. There are many reasons and life situations for a person to drink, but if this can help, why not make it available?”

Fred: “I give this guy about a year of working in this bar and he'll be blackout drunk once again. Trust me. I know. Naltrexone is not the silver bullet.”

I’d like to re-emphasize: no one particular treatment will work for everyone. And the research on medication is clear: it works best when used in combination with therapy, not when you just take a pill and plop down in front of the TV.

One of the most interesting emails came from Dr. Howard Wetsman, a psychiatrist in New Orleans, who wrote, “I can’t agree with your theory about the medications profiled not fitting in with current treatment. In fact I know of many residential settings that use both naltrexone and topiramate in the context of stopping drug or alcohol use.” Some colleagues fear that use of medication ignores an addict’s underlying suffering, but it’s not a business consideration, says Wetsman. “Far from having a profit motive to be against medication, they would actually bring more people into their programs if they offered medication as part of the treatment. These are caring professionals that want to provide good treatment. While I disagree with their stance, I can’t find fault with their motives.”

You can read all the posted comments here and here.

We’d like to report more stories about addiction and possible treatments. What would you like to hear more about?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Caleb Hellerman
CNN Medical Senior Producer

We’ve spent close to a year exploring the twists and turns of addiction and rehab. It stirs up strong emotions – a lot of us have friends or family members who have wrestled with addictions, so it touches close to home. I think that’s why many people see addiction as an issue of morality or basic decency – who are these people to wreak havoc in our lives?

That said, on at least some level addiction is a disease of the brain. I was fascinated to learn about anti-addiction medications and what they might mean for the future of treatment. It was the most e-mailed story on CNN for two days running, and we got hundreds of comments on this report. What many people wanted to know is why these medications are not widely known.

This isn’t an answer, but I’ll lay out a theory: Medications like naltrexone or topiramate don’t fit the current models for treating addiction. This is true, for different reasons, on the high end and the low end, too. The issue in high-end rehabilitation centers is obvious: Why would people or insurers pay tens of thousands of dollars a month, when they could stay home, see their family doctor or therapist and pick up a monthly prescription at the pharmacy? Of course it’s not that simple; even the biggest advocates of medication say that inpatient treatment can be helpful for some addicts, and most inpatient centers do sometimes prescribe these drugs. Still, the business angle can’t be overlooked.

Less obvious but probably bigger is the impact medication could have on outpatient therapy. That’s because a lot more people get treatment in small community centers, or clinics, than go to hospitals like Betty Ford. Even more just go to AA or another 12-step program. In all these settings, many counselors have little or no medical training. Sometimes they just have whatever wisdom they’ve gleaned from their own addiction.

If “medical” outpatient treatment is a lot less expensive than spending a month in rehab, it’s a lot more expensive than hiring lay counselors and organizing AA meetings. Dr. Robert Swift of Brown University and the Providence Veterans Affairs Medical Center, who helped run the federally funded COMBINE study that compared medication with other types of therapy, told me “A lot of these programs go to the lowest bidder. If you can provide, quote, ‘services,’ and one program uses the lowest level of acceptable counselors, and the other provides medical treatment and pharmacotherapy, one of those is going to be substantially more expensive.”

There’s no doubt the struggle over the best addiction treatment has a big component of philosophy: is this a brain disease, or a character flaw? But the issue of cost makes it that much easier to stick with the status quo. In a country of 23 million addicts, where close to 20 million don’t get treatment, that’s not really acceptable.

Has addiction touched your life? What treatment(s) have you seen work?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By David S. Martin
CNN Medical Senior Producer

Planted along the wooded road leading to Hazelden’s main campus in Center City, Minnesota, are three wooden signs, each bearing a single word: Easy. Does. It. Treating addiction is seldom easy, though.

Angela Puckett came here after an overdose of alcohol and painkillers nearly killed her. She had spent her life as a self-proclaimed party girl. She arrived at Hazelden hoping 28 days there would begin her road to recovery.

In “Addiction: Life on the Edge”, which airs Saturday and Sunday, April 18 and 19 at 8 p.m. ET and 11 p.m. ET, CNN Chief Medical Correspondent Dr. Sanjay Gupta profiles Puckett and three other addicts trying to rebuild their lives. During the year CNN followed them, one relapsed, showing just how difficult recovery can be.

On a campus that resembles a small college, patients at Hazelden go to individual and group therapy, attend lectures, and reflect. Puckett was lucky. Her insurance covered Hazelden, where the typical stay costs $26,000. Only half of insurance plans pay for residential rehab.

Four years after she arrived at Hazelden, Puckett is back at work and back as a devoted mother to her son. “I know I’d be dead if it wasn’t for Hazelden,” Puckett told CNN. “Hazelden gave me my life back.”

“Addiction: Life on the Edge” also profiles:

* Lucy Gross, a 17-year-old who attends one of a growing number of high schools specially designed for addicts in recovery.

* Walter Kent, a retiree who ended four decades of addiction to alcohol by taking a pill.

* Nic Sheff, a young writer who chronicled his addiction to methamphetamine and other drugs and the toll it took on his family in the book, “Tweak.”

The federal government estimates there are 23 million Americans who abuse drugs or alcohol, costing more than $500 billion in healthcare, criminal justice and lost productivity.

Do you think insurance companies should be required to cover drug or alcohol treatment? How about residential treatment like Puckett’s?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Danielle Dellorto
CNN Medical Producer

“What was he thinking?” That seems to be the common reaction when fans hear the news that Olympic superstar Michael Phelps got caught smoking pot. What’s interesting is, as I dug deeper, I realized people weren’t too concerned that his behavior may harm his health, but more appalled that his getting caught could cost him millions of dollars in endorsement money.

This got me thinking that a lot people look at marijuana as having very limited impact on our health. One friend made his case to me with absolute certainty in his tone, “In the big scheme of things, smoking pot is not going to hurt me.” He added, “At least I don’t smoke cigarettes.”

But is that really true? Are cigarettes worse for your health than marijuana? An overwhelming amount of research says not so fast.

Smoking one marijuana cigarette sends the same amount of tar into the lungs as four tobacco cigarettes. Turns out pot contains about 400 chemicals and 50 percent more carcinogens than a tobacco cigarette. Carcinogens cause damage to the DNA in our cells, increasing your risk for lung infections, heart disease and even cancer.

Pot is becoming as addictive as tobacco too. What’s being sold today is not your parents’ generation of marijuana. A study released last summer compared pot being smoked today with what was smoked back before 1992 and concluded it is 175 percent more potent, resulting in more frequent use and increasing it's addictive properties.

The short-term health effects probably won’t surprise you: impaired judgment, forgetfulness, difficulty focusing. But the long-term effects are physical. Marijuana smoking causes asthma, chest colds, lung infections and increased heart rate. Experts believe marijuana causes more damage to the respiratory system than cigarettes because pot smokers hold the smoke in their lungs longer than a person inhaling tobacco.

People may not realize their chronic chest cold could be the result of smoking pot and quite frankly for some people it may not even matter. But for a professional athlete, a swimmer no less, who relies on the strength of his lungs to win gold medals — the health ramifications just don’t seem worth it.

So here are my questions for you: Why is it so common for people to believe smoking pot doesn’t impact your health? Were you surprised by what you read? And don’t forget to sound off on Phelps. I want to know what YOU think he was thinking!

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Jennifer Pifer-Bixler
CNN Medical Senior Producer

One of my favorite television shows is “Intervention.” On the show, people with harrowing addictions are confronted by loved ones with the help of a trained interventionist. Typically, the episodes end with the addicts going to rehab. It's my idea of “must see TV”: trauma, drama and redemption all wrapped into an hour. Most of the time, the people on the show are addicted to drugs or alcohol. But there was one addict with a different story. Josh was a compulsive overeater. In his early 20s, Josh spent his days gorging on fast food and sweets. He weighed nearly 550 pounds and was miserable. Every time Josh walked up the stairs, he felt as if he were going to have a heart attack. Something about Josh really struck me. He had a gentle demeanor. His passion was singing and he had a beautiful voice. When he went away to the rehab, I was really rooting for him. The other night, I caught a follow-up episode on Josh. It's hard to believe what's happened to him.

Josh's story came to mind as I read an unsettling statistic. For the first time, obese Americans now outnumber the merely overweight. According to the Centers for Disease Control, 32 percent of Americans are overweight, 34 percent obese and 6 percent are extremely obese. To put that into perspective, if you are 5 feet 5 and weigh 150 lbs, that's considered overweight. If you weigh 180, that's considered obese. Statistically, women as a whole tend to be a tad more obese then men. As we've pointed out many times, America has an obesity epidemic. Over the years, we've seen a number of carrots and sticks offered as ways to combat to this major U.S. health issue. Some health insurance policies offer discounted gym memberships to help people watch their weight. In New York City, certain restaurants have to post calorie information on menu and menu boards. In Mississippi, lawmakers even discussed proposing a bill that would make it illegal for restaurants to serve obese people. That idea was shot down pretty quickly. Ideas abound. But still the numbers go up. Why? I decided to ask an unconventional expert.

I tracked down Josh. He is doing great. In the past year and a half, he has lost close to 249 pounds. He's now around 300 pounds and is working hard to lose 100 more pounds. I asked him why he thought the number of obese Americans is growing. While he doesn't claim to speak for all obese people, Josh thinks for most of them food is an addiction. "It's a cheap way to stuff down emotions," says Josh. "I used food as a drug so I didn't have to feel." Josh says food for him is like booze for an alcoholic. "I don't think it's a matter of willpower. I could not control the power of food," he says. He couldn't just have one sliver of cake. "I'd eat the whole thing," he says. Like an addict looking for his next fix, Josh says, he use to plan his days around when he was going to eat and what. When he went into rehab, Josh says he had to come to terms with some things about who he is and what he wants. "The number on the scale is just one small part of the story," he says. "The real miracle has come through my spiritual and emotional growth. My goal is to help other people who have been where I was."

I love Josh's story and hope he continues to lose the weight and grow into the man he wants to become. His confidence is soaring. He plans to audition for “American Idol” and “America’s Got Talent.” Josh has become a success story in America’s obesity epidemic. I am curious. Do you think obesity is the result of addiction? Do you think health insurance companies should pay for compulsive eating rehab?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.