Quest for safe, effective diet drug continues
By Nanci Hellmich
USA Today
As Americans continue to pack on the pounds, drug companies and obesity researchers are racing to develop the next prescription diet drug.
An estimated 50 to 100 obesity medications are in the early stages of development, pharmaceutical insiders say. Some are designed to burn calories, others tinker with brain chemistry to control appetite, still others promote a feeling of fullness in other ways. Some may one day be used to treat people who have only 10 or 20 pounds to lose.
Gannett News Service
Companies are investigating new compounds despite a recent spate of bad press about a possible link between the appetite suppressant Meridia and some patient deaths from cardiovascular problems, and the 1997 withdrawal of two diet pills, including fenfluramine, half of the popular fen-phen combination.
Most of the drugs in the pipeline probably will never make it to the market, and the few that look the most promising are still at least two years away from being prescribed to obese Americans. But for drug makers, it's worth the gamble: The company that comes up with the next safe and really effective diet drug will probably hit pay dirt, possibly making billions of dollars, obesity researchers say.
In the United States alone, potential patients include 54 million people who are obese, which is roughly 30 pounds over a healthy weight. Add to that a growing number of overweight children and an increasing number of heavyset people around the world.
"We think obesity represents what is unquestionably the largest future market for pharmaceuticals," says John Maraganore, senior vice president for strategic product development for Millennium Pharmaceuticals, which is working with Abbott Laboratories to develop obesity and diabetes drugs.
There are only a few prescription drugs on the market used to treat obesity, including Meridia, which works on brain chemicals to control appetite, and Xenical, which blocks some fat from being absorbed by the body. Weight loss from these drugs usually amounts to about 5 percent to 10 percent in four to six months.
Many experts say safe and effective diet drugs could save lives by curbing the incidence of weight-related diseases such as diabetes, heart disease and arthritis.
Although the current drugs are prescribed to obese people, some experts believe that future diet drugs may be more widely prescribed, possibly treating patients who have 10 to 20 pounds to lose. Other weight-loss researchers aren't so sure. They say an overhaul of the way Americans live, not diet drugs, will be needed to fix the nation's spiraling weight problem.
The cost of developing a prescription medication is an estimated $802 million, according to the Tufts (University) Center for the Study of Drug Development.
Consumer advocate Sidney Wolfe, director of Public Citizen's Health Research Group, is skeptical of diet drugs and has been monitoring the risks of the current medications. Public Citizen petitioned the FDA to ban Meridia, which the group charged is associated with 29 deaths, including 19 from cardiovascular causes such as heart attacks.
Abbott Laboratories maintains that Meridia is safe, and obesity experts say it's difficult to determine whether people died because of the medication or because they were obese, which put them at increased risk for several diseases, including heart problems.
Wolfe says of obesity medications in general: "You have to believe in magic to think there is a simple solution like a diet drug or a crash-diet book for this complicated problem called obesity."
He says the answer is a long-term one that involves reducing calories by several hundred a day and walking a few miles or doing another form of daily exercise.
"That's safe and effective, but history is teaching us that one diet drug after another is not turning out to be safe and effective in the long term," Wolfe says.
Thomas Wadden, director of the Weight and Eating Disorders Program at the University of Pennsylvania School of Medicine, says medications have an important place, but they are not the only answer to the obesity epidemic.
"I can't imagine that we're going to treat 25 percent to 30 percent of the American population with weight-loss medication," Wadden says.
Drugs probably will end up being most beneficial to people who have a genetic propensity to being overweight, Wadden says.
"They are a minority of the people who are overweight or obese. Most people are now overweight as a direct consequence of our lifestyle. For them, the best advice is to start walking and start eating more fruits and vegetables," he says.
