If you havent seen the prescription drugs ads on television, you must not have a television. Theyre everywhere, and theyre convincing millions of people who may not need medication to "talk to their doctor" about getting fixed up with free samples.

The mark of a drug ad seems to be the overt caution they seem to be recommending for anyone using their products. Fill in the blank here: if you have an _________ for more than four hours, please seek immediate medical attention.

But these overt warnings are not the most important distinguishing features of the ads. What truly sets them apart is the subtle manipulation they use to make you think you need to take them.

Look at the ads for Lipitor, an effective cholesterol lowering drug offered by Pfizer. In their ads, you see a very good looking man getting ready for a swim, or a glamorous woman emerging from a limousine to the flashbulbs of the adoring paparazzi.

Youre notified that these are people who have it all. Not only do they take care of themselves and have the adoration of opposite sex well into middle age, but theyre likely also rich and famous.

Then, whoops, they belly flop into the pool or trip onto the red carpet in front of all their fans. We learn theyre not perfect after all. They cant dive or walk in high heels, and oh yes, they have high cholesterol.

Isnt that just a comical way of introducing a drug? Well, yes, but thats not all that the ad is trying to accomplish.

The subtle message here is that even if you were to live the perfect life, you would probably still need their drug to lower your cholesterol.

The viewer is left thinking, "Ill never get myself to look that good no matter how hard I exercise and watch my diet, so why should I even try? Isnt it better just to quit trying and take the drug?"

This, of course, is the wrong message to send to Americans, who dont need any more excuses to sit around and wait for terrible diseases to succumb to.

High levels of low-density cholesterol are a problem. And everyone who has this should be making every effort to get it down. (If your doctor tells you to take statins like Lipitor, take his or her advice straight to the pharmacy counter.)

People with a genetic predisposition to overly high cholesterol are the minority, though, not the majority. In fact, a web site sponsored by the University of Medicine and Dentistry of New Jersey estimates that familial hypercholesterolemia (genetically high cholesterol) affects only 1 in 500 people: http://www.umdnj.edu/genesatwork/topics/adult_medicine/10_adult.htm

But the simple fact is that cholesterol can almost always be lowered with a combination of exercise and a diet that is lower in saturated fats.

The drugs companies do pay lip service to this, but they do so in a way thats almost a throwaway line--"exercise, eat better, yada, yada, yada"--knowing full well that Americans wont be changing those habits anytime soon. (Similarly, cigarette manufacturers know they can run all the anti-smoking ads the government wants them to with very little effect on sales.)

There will be people who need to take cholesterol-lowering drugs, and we should be thankful that companies like Pfizer are around to help out in those situations. (The author takes a prescription Pfizer product and would have a much lower quality of life without it.)

However, statins are powerful drugs, and powerful drugs often have quite malicious side effects that one might want to avoid. With all statins, there is a danger of permanent nerve damage known as neuropathy. Neuropathy causes pain and tingling in the legs, as well as a loss of sensation, when the nerves stop functioning. Amputations are common with this condition.

A study in Sweden showed that two years of statin use raised the risk of developing peripheral neuropathy by 26%.

Given that statistic alone, it would be better to emphasize that most people will be able to control their cholesterol through a sensible diet and exercise program. We may never look like the models and actors who supposedly have cholesterol problems, but perhaps we can have better health without drug interventions.