New Drugs to Combat Obesity
Until recently, obesity was seen by most to be vanity issue, but today more and more physicians recognize it as a serious medical condition linked to diabetes, stroke, heart disease, and certain types of cancer.
And it’s a condition that’s increasing in the United States: By 2030, some estimate, the national obesity rate will be at nearly 50 percent.
Good diet and exercise are central to effectively managing obesity, but those regimens can be hard for patients to stick with, and doctors have been eager for new tools to help improve outcomes--doctors like Sangeeta Kashyap, an endocrinologist at the Cleveland Clinic.
KASHYAP: People who come to see me, you know they've tried various diets and they haven't worked for them. They want something more.
This summer, two new drugs came on the scene that Kashyap says can help many of those patients.
Qsymia and Belviq, just approved by the FDA, help control cravings for food, Kashyap says, and when paired with diet and exercise, can result in modest weight loss.
In clinical trials, patients taking Belviq for one to two years lost an average of about 3 percent more weight than those on a placebo.
For Qsymia, the average weight loss over one year versus placebo was a bit higher, around nine percent.
So for a person who weighs 300 pounds, that’s about 10 to 30 additional pounds lost, which physicians say is medically beneficial.
Both drugs have possible side effects, like insomnia or constipation, and Qsymia can't be used by pregnant women because of the increased risk of certain birth defects.
Still, many clinicians, including Sangeeta Kashyap, have been waiting for new drugs to combat obesity.
GLAUSSER: I mean it's 13 years. Before we had lifestyle--diet and lifestyle--or bariatric surgery. There was nothing in between.
Dr. Caroline Apovian, who runs the weight management program at Boston Medical Center, says about half of her nearly 500 obese patients will be put on one of the new meds.
APOVIAN: It's not going to be for cosmetic weight loss. It's going to be for clinically relevant medical weight loss.
In other words, weight loss that improves chronic conditions that are associated with obesity, like diabetes.
APOVIAN: The environment's not going to change--there's too much food out there, too much bad food, our brain is are geared to seeing food and eating it and not doing enough exercise so we need some help, and this is the help that we need. Finally.
The FDA has been under pressure to help Americans lose weight but also to screen out drugs that could prove dangerous in the long-term.
They've pulled several diet drugs off the market—you may remember fen-phen back in the 1990s which was found to damage heart valves, or more recently the drug sibutramine which reportedly increased the risk of heart attack and stroke.
Primary care doctor Stan Anderson from Canton Ohio is familiar with the benefits and risks of the new meds, and intends to use them where it makes sense:
ANDERSON: I've always felt that people get to a place where they feel so frustrated with what they're doing and their failures, and so I think this is going to be a huge advance in helping people to stay down, to stay with a goal.
But as with all new drugs, it’s not clear how the safety records of Qsymia and Belviq will hold up over time. The drug manufacturers are required to monitor their use to identify any long-term risks they may pose.