Have We Become Too Dependent on Medications?

Updated July 2026

We have become a nation of pill takers, and the trend is accelerating. Around 65% of American adults take a prescription drug in a given year, and among people 65 and older, the vast majority do. More striking is how many take several at once. The share of adults on five or more prescriptions has roughly doubled over the past two decades, from about 8% to 17%, and among older adults, more than four in ten now take at least five medications, while nearly one in five takes ten or more.

Some of this is genuinely lifesaving. Many medications are real advances, and the point here is not to demonize them. But it is worth asking an honest question: do we really need this many pills, and are they actually making us healthier?

Why are we taking so many medications?

Because we are treating the results of how we live rather than… fixing how we live.

Look at what tops the list of the most-prescribed drugs in America, and a theme jumps out. The single most prescribed drug is a statin, for high cholesterol. Round out the top ten and you find four blood pressure drugs, a diabetes medication, and a drug for acid reflux. These all treat the downstream effects of our diets.

But if these conditions are caused in part or in whole by what we eat, shouldn't the first step be to change the food rather than taking a bunch of drugs? Is it just me, or is there something backwards here?

But don't the medications work?

They control the numbers. Whether they make us healthier is a different question. Consider a striking paradox. When you look at how Americans actually eat, only a tiny fraction consume what anyone would call an ideal diet. And yet cholesterol, blood pressure, and blood sugar look relatively well controlled in the population.

How can both be true at once? Because doctors are very good at prescribing. We have gotten expert at using medications to push the numbers into normal range, even as the underlying habits driving those numbers never change.

But normalizing a lab value is not the same as curing the problem. Putting someone on a drug to lower cholesterol or blood pressure without addressing what they eat does not fix the disease. It masks it, and it quietly enables the very lifestyle patterns that caused it, creating a cycle that tends to grow, one prescription at a time. It is a bit like ignoring someone's smoking and focusing all our energy on giving them an inhaler.

Wallpaper over crumbling walls

The analogy I use with my own patients is wallpaper. If I put you on a medication to control a nutrition-related condition, but you are not doing your part to improve what you eat, all I have really done is hang very pretty, and often very expensive, wallpaper over crumbling walls. It looks better. But the structure underneath is no stronger than the day we started. That is not healing. That is decorating.

This is how we arrive at a scene I see far too often: patients on medication lists so long they fill an entire page. Those patients do not feel well. They do not look well. But their numbers, on paper, are perfect. That is not health. That is a well-decorated wall.

It is also why going on a medication is never a license to stop caring about your diet. What you eat affects far more than the one number a given pill is managing. The same poor dietary patterns feeding high cholesterol also feed high blood pressure, diabetes, and obesity, and are linked to dementia, depression, and cancer. Meanwhile, a statin only lowers LDL. It does nothing for anything else.

How do I know if I actually need all my medications?

The simple answer: you ask. The single most useful thing you can do is become an active participant in your own prescribing. Whether you are talking to your doctor or your pharmacist, here are five questions worth asking about any medication:

1. What is this medication for?
2. How long will I need to take it?
3. Is there anything I can do to reduce my need for it?
4. What are the side effects?
5. Are there any concerns about combining it with my other medications and supplements?

Question three is the one most people never ask, and it is the one that matters most if you want to reduce your reliance on medication. For many conditions, especially diet-driven ones, your doctor can point you toward changes that lower your dose or your need for a drug altogether. Even if you can't completely get off a medication, cutting the dose required to get you to your treatment goal reduces your risk of side effects.

Question five matters enormously once you are taking more than three or four medications, because drug lists have a way of growing as one medication gets added to treat the side effects of another. Your pharmacist is an excellent and underused resource here. And if you are already on a long list of prescriptions, it is worth reading how to safely untangle polypharmacy with your care team.

The bottom line

Medications should be an adjunct to care, not the whole plan. The goal should be to need fewer of them, not more, and the most reliable way to get there is to fix what is driving the problem in the first place. When food is a major part of the cause, food has to be a major part of the solution.

That is the entire reason Step One Foods exists: to help people get off the prescription merry-go-round by addressing the actual driver of so many of these conditions. If you are ready to take something off your medication list rather than add to it, the place to start is by changing what's on your plate.

If you're new to this site and found this useful, I write one of these evidence-based articles every week. You can get them in your inbox by joining my email list at the bottom of this page. No spam, no requirement to buy anything, just practical knowledge.