A Glut of Obesity Drugs?

On June 27, the FDA approved the first new weight-loss drug in 13 years, Arenas lorcaserin (Belviq). The track record for anti-obesity drugs has not been very goodeach has been withdrawn from the market, after approval, due to safety concerns. Why was this drug approved? How long will this one last before being yanked for adverse events?

Lets look at the background and track record of lorcaserins predecessors.

Perspective on the need for weight loss drugs

Why the brouhaha over Arenas new drug?

According to the Centers for Disease Control and Prevention, more than one-third of adults in the United States are obese, defined as having a Body-Mass Index (BMI) of > 35. In the U.S. alone, 78 million U.S. adults are obese; another 34% of adults are overweight > 30. So 70% of U.S. adults have a problem with weight. Worldwide, CDC estimates 500 million are currently affected. Overweight and obesity constitute the second leading cause of preventable death, after smoking, resulting in an estimated 300,000 deaths per year. The number of obese is expected to rise to 42% by 2030, with an additional 11% prevalence of severe obesity (BMI >40, or ~80+ lbs overweight).

In 2000, consumers spent approximately $35 billion on weight-reduction products and services; it is undoubtedly more now. There is enormously aggressiveand misleadingadvertising for these products. The Federal Trade Commission noted that about half of these ads were false.

Annual health-care costs for patients with BMIs of 20 to 24.9 were 20% lower than costs for overweight patients with BMIs from 30 to 34.9 and almost 33% lower than for obese patients who had BMIs of 35 or more. There has been a steady increase in obesity over the past several decades, though this appears to be tapering off a bit. Finkelstein et al. estimate that costs of obesity may be as high as $147 billion per year, or roughly 9% of U.S. annual medical expenditures. If obesity were to remain at 2010 levels, the combined savings in medical expenditures over the next 2 decades would be $549.5 billion.

With such a huge health problem comes a correspondingly large business opportunity. According to Ernest Trent, cited in Bloomberg News, sales for Arenas new drug may hit $2 billion by 2020.

Even modest weight loss, of 5-10%, is enormously difficult to achieve with diet, exercise, and behavior modification. Yet even that is enough to demonstrate significant health benefitsa reduction in diabetes or cardiovascular disease. Unfortunately, as many of us know all too well, such weight loss is often like a flash in the pan, enticing but all too transient.

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A Glut of Obesity Drugs?