Rethinking Healthcare

Why does the diet pill market keep producing lemons?

Why does the diet pill market keep producing lemons?

Posting in Food

Two new prescription diet pills are set for approval by the FDA this summer. Anti-obesity drugs have a poor track record with life-threatening side effects, and doctors have similar concerns about the two new medications.

Few solutions hold more promise than a pill. In pain? Yeast infection? Can't sleep? Swallow and forget about it.

With two-thirds of Americans overweight or obese, walking habits waning and portion sizes growing, the idea of weight loss from a pill gleams brightly. This summer the U.S. Food and Drug Administration (FDA) is posed to approve new prescription anti-obesity medications for the first time in 13 years, the New York Times reports.

This Thursday an advisory comittee for the FDA voted in favor of lorcaserin, developed by Arena Pharmaceuticals. The FDA will announce its final decision on the drug on June 27th. In February the same committee endorsed Qnexa, developed by Vivus, and the FDA will give its final answer on it by July 17th.

Weight loss drugs carry with them an unsavory history. Physician Danielle Ofri writes in another article for the Times:

Fen-phen, ephedra, sibutramine and phenylpropanolamine all had to be pulled from the market for safety concerns. A drug popular in Europe, rimonabant, was denied approval in the United States because of side effects. The lone prescription drug currently available in America for weight loss, orlistat, offers only minor weight loss with the trade-off of major stomach problems in the form of oily, greasy stools.

Why the bad rap? Michael Lauer recently wrote an article for the Annals of Internal Medicine comparing the diet pill market to used car sales. Consumers are too eager to fall for lemons, he says. Lauer was one of twoo members of the 22 person FDA panel to vote against acceptance of Qnexa, citing concerns about cardiovascular risks. He explains:

We know that prior obesity medications reduced weight at the price of unacceptable side effects. Taking history into account, we should be concerned about a proposed obesity medication that increases heart rate, especially considering that it may be used in tens of millions of people, many of whom are already burdened with cardiovascular risk factors.

Most diet pills are intrinsically hard on your body. A number of diet medications work as appetite suppressants by stimulating the sympathetic nervous system, hence the cardiovascular concerns with raised blood pressure and heart rate. Others work as fat blockers (orlistat) removing excess fat from the intestines at the cost of stomach problems.

Some would argue that such side effects are worthwhile if it means cutting back life-threatening obesity.

Today Sharon Begley of Reuters offered another interesting view on America's so-called obesity epidemic. She cites fat hatred as a culprit in the country's issues with weight.

It may be the nation's last, accepted form of prejudice. But the stigmatization of obesity has repercussions beyond the pain it inflicts on its targets: It threatens to impede efforts to fight the obesity epidemic.

Begley says prejudice against overweight people promotes some Americans to be too self-conscious to excericise, socially withdrawn so they're more prone to binge eating, and less likely to seek medical treatment.

Obesity prejudice could also be driving our over-willingness to accept the harmful side effects of diet pills. Such heavy stigma against obese people overvalues the possible weight loss power of these drugs, regardless of their impact on the rest of your body.

Photo: Joanne Escober/Flickr

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Audrey Quinn

Contributing Writer

Audrey Quinn is a Brooklyn-based multimedia journalist focused on health, tech and the economy. Her radio stories can be heard on Marketplace, Studio 360, PRI's The World, NPR's Latino USA, Deutsche Welle Radio and The Believer Magazine podcast. In addition to her work with CBS Interactive she produces multimedia science stories for online publications and is a teaching assistant at the Transom Story Workshop. Her investigative work has been awarded by the Fund for Investigative Journalism and The Nation Institute’s Investigative Fund. Follow her on Twitter. Disclosure