Weight-loss pills. Miracle solution or just more confusion?


I’m betting on the latter. Now that we have two new weight-loss drugs after a 13-year hiatus, what is the medical community saying about who should take them, for how long, at what cost, what results can be expected and what are the risks?

Deborah Kotz of The Boston Globe, in search of answers to the above questions, interviewed Dr. Richard Siegel, co-director of the Diabetes Center at Tufts Medical Center about the new medications. The 7-23-12 article (See link below) began:

The approval last week of a new weight loss pill called Qsymia means that doctors will soon be able to prescribe two new drugs to help overweight people shed pounds. Last month, the US Food and Drug Administration approved the pill Belviq, the first drug approved for obesity in 13 years. Both drugs will hit pharmacies later this year and their cost, yet to be determined, will probably be about $100 to $200 a month.

My summary of the article. In short, the two new drugs yield an expected weight-loss of 5% for one and 10% for the other. That means a 250 pound woman can expect to lose between 12 and 25 pounds, but may have to take the drugs for up to two years to achieve those modest results. With an expected price tag of $100 to $200 per month for this regimen, we’re talking about an cash outlay of $1200 to $4800—for an opportunity to lose between 12 and 25 pounds.

That works out to a price per pound lost of somewhere between $100 and $400. So, if an obese woman of 250 pounds loses 25 pounds, she is still obese. What’s the point? Is it worth the risk and the cost? Here’s what Dr. Siegel had to say about that?

Q. What side effects are associated with these new drugs?

A. Belviq (lorcaserin hydrochloride) has been associated with attention and memory problems, according to the FDA, and may cause low blood sugar in diabetics. Qsymia (a combination of phentermine and another older drug, the anticonvulsant topirimate) can increase a patient’s heart rate, and the FDA said it is not known whether this has any detrimental effect on those at high risk of having a heart attack and stroke. Qsymia can also cause tingling in the hands and feet and shouldn’t be taken during pregnancy because it increases the risk of birth defects.

Both drugs, like many others, can cause headaches, dizziness, fatigue, and nausea, and the FDA is requiring both manufacturers to conduct longer-term studies to assess heart and stroke risks.

To his credit, Dr. Siegel points out that he would encourage his patients to not just take the pills but to also  “join a support group, meet with a nutritionist to map out a new eating plan, and start exercising.”

Do you think a 5 to 10% weight-loss would make much of a difference in the lives of these two women?

The Bottom Line. Obesity pills are not the answer to our obesity epidemic. Neither are support groups or “mapping out a new eating plan with a nutritionist.” How many nutritionists do you need to tell your patients directly that they’re now eating the wrong food? How long does it take–and how much does it cost to tell them the two-word solution—whole plants?

The nutritionist or dietitian would likely tell them to eat a balanced diet with lean cuts of meat and low-fat dairy and to watch the portion sizes, don’t snack between meals and keep their total daily calories under a certain level. Then, of course, they have to keep track of their risk factors for a plethora of diseases. None of this is going to work.

We’re never going to solve the obesity epidemic until we face the cold hard fact that we’re eating the wrong food for our species. These two new drugs will bring us no closer to the solution—they simply add to the confusion.

This reminds me of the old joke about change. How many psychologists does it take to change a lightbulb? Answer: Only one, but the light bulb has to “want to change.”

For your convenience, I have provided the Boston Globe source article below, along with a few of my earlier posts on the topic of obesity.

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Blogging daily at hpjmh.com…from the seaside village of Stonington, Connecticut – Be well and have a great day.

—J. Morris Hicks, board member, T. Colin Campbell Foundation

About J. Morris Hicks

A former strategic management consultant and senior corporate executive with Ralph Lauren in New York, J. Morris Hicks has always focused on the "big picture" when analyzing any issue. In 2002, after becoming curious about our "optimal diet," he began a study of what we eat from a global perspective ---- discovering many startling issues and opportunities along the way. In addition to an MBA and a BS in Industrial Engineering, he holds a certificate in plant-based nutrition from the T. Colin Campbell Center for Nutrition Studies, where he has also been a member of the board of directors since 2012. Having concluded that our food choices hold the key to the sustainability of our civilization, he has made this his #1 priority---exploring all avenues for influencing humans everywhere to move back to the natural plant-based diet for our species.
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