New drugs for obesity treatment. A good thing?

The newest is Qsymia. How it works. (Basically it hits on the brain’s reward circuits involved in appetite, which are known to be dysfunctional in many prone to obesity.)

I think IMHO is appropriate for this but if a mod feels GD is better then I’ve no objection.

For the sake of discussion let us assume it is safer than it likely is, that no women will use it who are unaware that they are pregnant and that no birth defects result … so on. That it costs about the same as the newer diabetes drugs, something like $5 a day. Modest weight loss - about 10%, maybe a bit less - which can be maintained if the med is continued but assume that the weight comes back if the med is stopped to the degree that weight lost by “diets” tend to be regained. Potential market? Well a third of American adults hit the indication of “obese” and another sizable percent are “overweight” with a confounding factor such as hypertension or diabetes. Plus those who may be prescribed outside of those official indications. So 33% of American adults is a solid base market potential.

If you are in that third, do you want to use this med? Whether you are or not what do you think the ramifications are?

I don’t trust diet pills. My grandma had to file suit due to heart issues caused by fen-phen. She won some obscene amount of money, but I’d rather not risk it.

I think new obesity drugs are, in general, a good thing, although I’m concerned about abuse. (And unforeseen side effects).

I wouldn’t use it, at this time, because I think that one ought to make a more good faith effort to lose weight through diet and exercise (or at least products with a longer history on the shelf like Slim Fast) than I have yet been inspired to do.

Alternately, one should be more seriously overweight than I am.

I think it’ll sell like hotcakes, particularly among women … and eventually get pulled off the market for some danger probably already known to the company hawking it.

There’s just too damn much money in a drug like this for there NOT to be something hidden somewhere. I don’t trust pharmaceutical companies to tell the truth, the whole truth and nothing but the truth and I certainly don’t trust the FDA to be above bribery.

I just had weight loss surgery … but if I were still pre-op … no, I would not take this drug. I never took Fen-Phen but seeing what happened scared me away from diet pills.

My theory is why can’t they reproduce/create the drug in our brains that tells the body that we are full…so we stop eating…then again, they have yet to cure the common cold, so…

I’d give it a go. Why not? I’ve tried most everything else. Unless it’s an appetite suppressant, in which case I wouldn’t bother because I can easily continue to eat when I’m full. I want something which suppresses the desire to eat.

I am rather confused - it contains phenteramine, one of the drugs in fen-phen … so how are they assuring that it will not cause heart issues? In a quick read of the article it seems that it affects the heart rate upwards, yet they claim it reduces hypertension. I know when my pulse rate is up my BP is up … :dubious::confused:

I have taken the other drug in the combo, a few years back for migraines. It didn’t work on my migraines, and I didn’t notice anything else happening with me from the drug. Makes me wonder if this one would work on me to supress the appetite or whatever it claims to do.

The ‘common cold’ is a virus. If we could cure that it would represent a huge advancement in the medical field. I don’t pretend to understand everything in medicine, but I’d be willing to bet that curing the common cold would be one of the biggest breakthroughs we’ve seen in a very very long time. OTOH, I’m also going to guess that based on where research dollars go, we won’t cure it directly, but rather indirectly. I would assume that we’d cure something like HIV or Herpes first which will teach us how to cure viruses in general and we’ll take it from there to cure other viruses once we have the ‘keys’.

In theory I have no problem with fixing obesity by drugs; dieting and exercise are both unpleasant and in practical terms don’t work very well (an obesity fix that’s so inconvenient, unpleasant and difficult that most people won’t keep it up is badly flawed). The question as others have brought up is if the stuff is safe and actually works, or if it’ll be another fraud.

In fact, it’s over 200 different viruses; so yeah, that’s why we don’t even have a vaccine.

It’s two very old drugs formulated together - must be some synergistic effects to get approval I guess but hard to get excited about it shedding much light on obesity pharmacology, or representing a major step forward in obesity treatment.

tbf it is very hard to get approval for a fat drug - given the natural remedy of eating less and exercising is ultra ‘safe’, if that’s even the right term, then the slightest unpleasant side effect could derail the drug.

I think you’re looking for something medicine couldn’t possibly cure.

Except monstro that is likely what these drugs do. They act, at least primarily, in the brain impacting food reward circuitry, the drive to eat the hyper-rewarding foods (which can ethologicaly be considered superstimuli) which surround us in the modern world, and which some are wired to respond to more than others. Some may be genetically wired that way, some may have acquired it by way of inflammation triggered by foods and some may have epigenetic effects. These central issues are likely the prime player in obesity. This brain effect is not simply where the full marker is (satiety). Indeed abnormally high reward signaling can and does overcome satiety signals and these meds do seem to work at that “desire” level rather than the “fullness” one.

I understand the concerns over safety, which is why my op requested we, for the sake of the discussion, just assume safety, perhaps beyond a justified level. I still have trepidation. The main thing is that these drugs have been shown to cause modest weight loss and that is it. The assumption is that modest weight loss will result in improved health outcomes and lowered mortality but even without side effects I am not sure that that is a reasonable assumption. Yes, 5 to 10% weight loss in the obese, maintained long term with a reasonable nutrition and exercise plan, leads to improved health outcomes. But it does not automatically follow that the same level of weight loss achieved without those behavior changes will have the same results. In fact, there are some studies that suggest that it is the behaviors that matter much more than the weight. These drugs may be cosmetic items, not ones significantly impacting health, and spending perhaps $5 a day, $1800 or so a year, ongoing, to perhaps a third of the American population, without solid evidence of improved health, gives me … pause.

If it does take-off, then off-label use is also a possibility. When accomplia was launched (before it was withdrawn), there was speculation that it could find use in tackling all sorts of addictive behaviours - smoking, gambling, boozing etc.

Yea, that’s what I don’t get. Drugs should only be taken for conditions where there are no safe alternatives. Anyone can lose any amount of weight healthily and without drugs. Ergo, there’s no need for a weight loss drug.

Side effects aside (heh) a pill doesn’t resolve the basic physical and psychological issues that result in obesity.

A new ‘wonder drug’ may even prove to encourage the lack of lifestyle change, since you can always swallow that prescription down with a litre of Coke.

Assuming the drugs actually worked, then so what? The ideal would be some treatment that let you eat as you pleased, never exercise, and still have the body of an athlete. There’s nothing noble about exercise and eating food you hate to stay thin; that’s just an unpleasant regimen for dealing with how badly built our bodies are for living in a modern society.

The human body is complex thing, Der Trihs - no medication could possibly produce the results of what you propose.

You say “…there’s nothing noble about exercise and eating food you hate to stay thin”, but there is no honour in being dysfunctionally fat with a lesser quality of life either.

It’s not about being thin. It’s about being healthy. And nobody says you have to eat “food you hate.” More likely you don’t want to eat food that ‘hates’ you.

The body is complex, but it isn’t magic. It’s a complex machine that with sufficient knowledge should be quite possible to heavily modify. And there’s gene-modification treatments that have done pretty what I described in lab animals actually; I wouldn’t recommend trying that on humans yet given how primitive such technology is at present, but I see no reason to think that it can’t be done.

And at any rate I said “ideal”, not “realistic” or “soon to come”.

Yes, they do. Good tasting food is notorious for being unhealthy.

Our hunter-gatherer brain tells us we must eat all of the fat, salt and sugar we can get, because these substances are both necessary and very hard to get. That’s why, as Der Trihs says, we love things like ice cream.

Also, a lot of the time we eat not because we are actually hungry, but for comfort or other psychological need, or just because that bowl of ice cream looks so dam good.

I might be in the group that they are targeting. I don’t have so much to lose that I might get steered to weight loss surgery or so little to lose that diet and exercise is the easy option.

I don’t have any pre-diabetic or blood pressure issues so far, though.

I don’t think I’d want to take it, although I’d love to be thinner. The reason is that I think I got a taste of what it might be like to be on it while taking another medication last year. This other med made me lose my motivation to eat. Not in the sense of feeling satisfied sooner, but in the sense that eating at all became a chore devoid of all pleasure.

Not worth it.