Ready to bloat

The World Obesity Congress and Expo held in Washington dc, usa on July 12-13 this year was all about anti-obesity drugs: educating industry about new research on it, and finding ways to enhance business in this area. The Expo's focus was extremely timely: two days later, the us department of health and human services announced that obesity was now officially considered an illness, and would be brought under the umbrella of Medicare coverage.
Wow As an Expo promo put it, anti-obesity drugs are "almost certainly the biggest windfall in the history of modern pharmaceuticals". According to industry pundits attending the Expo in the next ten years, the industry was likely to be worth us $50 billion.

In 2003, sales for anti-obesity drug Meridia came close to us $200 million. And companies are busily researching on drugs that could affect satiety or modify behaviour by working through the gastro-intestinal system or the brain. There's Acomplia, for instance, likely to be introduced into the market in 2006 by its maker, Sanofi-Aventis SA. It is a cannabinoid cb1 receptor antagonist and treats obesity by blocking brain signals that control cravings (cb1 receptors, found in the brain and in fat cells, play a crucial role in a complex signalling system that urges the body to eat more than it needs). The company estimates the drug's peak annual sales to exceed us $3.6 billion.
Worrying The anti-obesity drug market is a large one because obesity itself is a global pandemic. But does its cure necessarily require drugs? Aren't diet control, or plain physical activity, effective enough? Wisely, the new medicare policy the us government has announced will also cover weight-loss therapies such as stomach surgery, diet programs, and behavioural and psychological counselling. But such a way to treat the disease might just get swept away under a drug blitz financed by the world's largest pharmaceuticals.
Equally worrying As Joel Lexchin of the University of Toronto, Canada, puts it "The copious side effects of anti-obesity drugs cause no change in morbidity and mortality and sometimes end up causing more negative effects." Some experts say Meridia is effective and safe, but between February 1998 and September 2001 the us Federal Drug Association (fda) received reports of 397 serious adverse reactions to it, including 152 hospitalisations and 29 deaths. Public interest organisations have petitioned fda for Meridia's immediate removal, without any satisfactory response.

"I think the very development and existence of anti-obesity drugs are premised on a number of myths that exist about weight and health and that the drugs do little to aid weight loss and nothing to improve health," says Maree Burns of the University of Exeter.

Could the companies promote, instead, healthier lifestyles? If wishes were horses...