# New drugs for obesity treatment. A good thing? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [July 18, 2012, 1:33am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583 "2012-07-18T01:33:29Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Thudlow\_Boink](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thudlow_boink/32/320_2.png) [@Thudlow\_Boink](https://boards.straightdope.com/u/Thudlow_Boink)\ **Post date:** [July 18, 2012, 4:54pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/21 "2012-07-18T16:54:52Z")
> [@Crafter\_Man](#): > > 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. Do you feel the same way about drugs for depression, anxiety, ADHD, etc.? ---
**Author:** ![Rachellelogram](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rachellelogram/32/8689_2.png) [@Rachellelogram](https://boards.straightdope.com/u/Rachellelogram)\ **Post date:** [July 18, 2012, 5:02pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/22 "2012-07-18T17:02:53Z")
> [@Crafter\_Man](#): > > 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. This argument is just silly. Because didn’t you know, people can avoid any manner of accidents, injuries, and medical conditions by simply staying in their homes all day? It’s safe and minimizes the amount of drugs required to treat preventable conditions, so of course we should recommend it. Right!? :smack: ---
**Author:** ![Ponch8](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ponch8/32/9883_2.png) [@Ponch8](https://boards.straightdope.com/u/Ponch8)\ **Post date:** [July 18, 2012, 6:11pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/23 "2012-07-18T18:11:37Z")
> [@highrollinwooded](#): > > 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… They can. Making it in a form that can withstand your digestive enzymes (if taken in pill form), and can then actually get through the blood-brain barrier into the brain, and doesn’t cause all sorts of toxicities, is a whole other matter. ---
**Author:** ![Gestalt](https://avatars.discourse-cdn.com/v4/letter/g/90ced4/32.png) [@Gestalt](https://boards.straightdope.com/u/Gestalt)\ **Post date:** [July 18, 2012, 6:14pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/24 "2012-07-18T18:14:21Z")
> [@6ImpossibleThingsB4Breakfast](#): > > 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. Why would you have a decreased quality of life? I am all for this drug. Exercise/diet do work but it is very hard for most people to achieve lasting weight loss with this method; if we can find a med which allows us to eat happily and still be lean, and which would also have associated morbidities less than those associated with obesity/overweight, I think it would be a godsend. I don’t get the whole, “you can lose weight through diet and exercise so no other options should be allowed” school of thought. The thing is, we already treat a lot of obesity-associated conditions with medications. We have medications for high blood pressure, cardiac artery disease, and diabetes, and machines for obstructive sleep apnea. For the most part people aren’t telling people who are overweight and on those meds that really they should just try to lose weight, because the other medications wouldn’t be unnecessary. For the most part, society accepts people taking blood pressure meds, diabetes meds, and heart disease meds. All of which do have side effects, btw. So why do so many people think poorly of people who have bariatric surgery or take weight loss medications? ---
**Author:** ![ZipperJJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zipperjj/32/211_2.png) [@ZipperJJ](https://boards.straightdope.com/u/ZipperJJ)\ **Post date:** [July 18, 2012, 6:39pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/25 "2012-07-18T18:39:27Z")
> [@cher3](#): > > 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. Same here. I fall in to depression every year or so where I don’t want to eat. I get tired, I get sick, I get moody and when I DO manage to eat it’s not a salad or a piece of lean meat, it’s Pop Tarts or gas station pizza. I never lose weight when I go through periods like this even though I’m eating less. I’m eating crap when I do eat. If there’s a pill that causes your body to not hold on to fat and melts the fat you do have, and it’s all safe, I’m in. I’ll take pills for weight loss. If a pill says “You stuff your face all day long, and I can fix it!” I’ll pass, because it’s not true - I don’t stuff my face all day long and I know for a fact that appetite suppressants aren’t the answer for me. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 18, 2012, 7:01pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/26 "2012-07-18T19:01:18Z")
> [@6ImpossibleThingsB4Breakfast](#): > > Side effects aside (heh) a pill doesn’t resolve the basic physical and psychological issues that result in obesity. But it actually does. The maladaptive brain food reward systems are the main physical issue that results in obesity and these meds target that. But for other reasons already stated I am still not convinced. ---
**Author:** ![drewtwo99](https://avatars.discourse-cdn.com/v4/letter/d/d07c76/32.png) [@drewtwo99](https://boards.straightdope.com/u/drewtwo99)\ **Post date:** [July 18, 2012, 7:14pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/27 "2012-07-18T19:14:01Z")
What good is losing the weight if it doesn’t actually solve any problems? Are there any studies to show that people who lose weight by using this pill are actually any healthier? Obesity is only correlated with certain diseases, it hasn’t been shown to be a cause, has it? ---
**Author:** ![fluiddruid](https://avatars.discourse-cdn.com/v4/letter/f/c2a13f/32.png) [@fluiddruid](https://boards.straightdope.com/u/fluiddruid)\ **Post date:** [July 18, 2012, 7:23pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/28 "2012-07-18T19:23:28Z")
I’ve always been overweight, but lately I’ve had some health problems that have affected my sense of hunger and desire to eat. It’s like night and day for me. I have to remind myself to eat regularly – I have even fallen so low on calories inadvertently (under 1000/day for decent periods) it’s affected my energy level without feeling strong hunger or cravings. I also have little to no desire for emotional eating anymore. The thing is, though, I still enjoy the actual taste of food, things taste good to me, I have no nausea or anything like that – I just don’t want to eat when I don’t need to eat. I mean, I’d enjoy the taste of grabbing a peanut butter cup, but I’m not hungry, so I can’t be arsed – whereas before, even if I’d never eat one, I’d be thinking about them. I imagine this is how a lot of people feel about food, the ‘naturally thin’ types who eat what they like. I’d say these new drugs, barring unknown side effects, are a good thing. Weight loss doesn’t need to be an ordeal, and making it a constant battle of willpower to overcome your body’s signals is clearly not working all that well for our population. Why not take some of the suffering out of weight loss? It’s clear certain individuals struggle far more with the desire to eat excessively than others, or who have addiction-like issues with food. It’s far less invasive than surgery, too. And yes, losing weight in obese individuals generally improves health. Even if you never are going to get diabetes either way, the physical toll of extra fat weight is going to affect you – e.g. your knee joints, your back, whatever. ---
**Author:** ![ZipperJJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zipperjj/32/211_2.png) [@ZipperJJ](https://boards.straightdope.com/u/ZipperJJ)\ **Post date:** [July 18, 2012, 7:23pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/29 "2012-07-18T19:23:49Z")
> [@drewtwo99](#): > > What good is losing the weight if it doesn’t actually solve any problems? I agree. Don’t obesity surgeries do the same thing except one (the pill) makes you not want to eat too much and the other (surgery) makes you unable to eat too much? Plenty of people are able to “overcome” their obesity surgery and get right back to where they started. If you’re not committed to the changing of mind, body and soul you’re not going to succeed. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [July 18, 2012, 11:00pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/30 "2012-07-18T23:00:38Z")
> [@DSeid](#): > > 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 appreciate the explanation, but it only confuses me. Every time we have a discussion about obesity, people offer different hypotheses. It seems like one day it’s “Weight loss makes people hungrier!” Another day it’s “Certain foods make us hungrier!” And now you’re saying that certain genetic propensities and/or environmental triggers could be making people addicted to food–regardless of whether they feel physiological sensations of hunger. I’m not saying that all of these hypotheses couldn’t be co-existing, even within the same individual. It’s just a bit confusing. I can’t imagine how a person can overeat in the absence of an appetite. When I have no appetite, the idea of eating makes me sick. And I can’t imagine how a drug would be able to fix this problem without having horrible side effects, like amotivation and anhedonia. I have a feeling I’m wrong and oversimplifying an uber complex issue. Yet again. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [July 18, 2012, 11:13pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/31 "2012-07-18T23:13:24Z")
I don’t know if it is a good thing, but that is because the drug manipulates reward circuitry. They tried a drug that blocked the cannaboid receptor and people ended up committing suicide on it. Weight loss drugs nowadays seem like they are either amphetamines (which can increase CVD risk) or change the brain reward circuitry. But for the sake of argument assume that isn’t the case, there are no health risks like you said. It is up to people to decide what they want to do to change their appearance. If people want to lose weight, then go for it. Would I use it? Probably not. ---
**Author:** ![MrDurden](https://avatars.discourse-cdn.com/v4/letter/m/ed655f/32.png) [@MrDurden](https://boards.straightdope.com/u/MrDurden)\ **Post date:** [July 18, 2012, 11:19pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/32 "2012-07-18T23:19:31Z")
> [@aruvqan](#): > > 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:😕 Phentermine is a pretty safe drug, it was the interaction of taking it with fenfluramine that cause heart valve problems. It certainly will cause any effects a mild stimulant does, such as raising heart rate… but raising heart rate actually lowers your blood pressure in the long run. Your body works on a negative feedback system always trying to get back to normal. Basically heart rate and blood pressure are sort of opposites and when one goes out of wack the other tries to compensate. Of course when you exercise or something, both go up. But that’s just temporary and not cause for alarm. ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [July 19, 2012, 12:25am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/33 "2012-07-19T00:25:22Z")
> [@jabiru](#): > > 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. This. It would be nice to pop a pill, and no longer want to eat when I’ve had enough . . . even before I’m actually full. ---
**Author:** ![SpoilerVirgin](https://avatars.discourse-cdn.com/v4/letter/s/4491bb/32.png) [@SpoilerVirgin](https://boards.straightdope.com/u/SpoilerVirgin)\ **Post date:** [July 19, 2012, 12:34am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/34 "2012-07-19T00:34:05Z")
This part of the article is the red flag for me: > [@](#): > > The FDA has required Vivus to do a study on the drug’s cardiovascular effects. Vivus said it would be done after the drug’s approval. I’m not a candidate for a weight loss drug at the moment, but if I were, I think I would wait until _after_ the cardiovascular study is completed. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 19, 2012, 1:01am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/35 "2012-07-19T01:01:15Z")
> [@monstro](#): > > I appreciate the explanation, but it only confuses me. Every time we have a discussion about obesity, people offer different hypotheses. … I can’t imagine how a person can overeat in the absence of an appetite. When I have no appetite, the idea of eating makes me sick. And I can’t imagine how a drug would be able to fix this problem without having horrible side effects, like amotivation and anhedonia. > … All I can state is my understanding of the state of the art of the science. There are a lot of media hyped theories out there but to me the evidence is pretty convincing that a (I think “the”) central player in obesity is the brain. Your circumstance makes a great counterpoint to the circumstance of those prone to obesity. For whatever reason your brain food reward circuits do not fire very strongly. Eating enough is therefore a battle for you. Both you and **Wesley** below make the same very realistic point. Hitting on reward circuits by adjusting acetylcholine, dopamine and serotonin levels is a pretty big deal. It is reasonable to be suspicious that unintended effects may show up as it used more widely. > [@Wesley\_Clark](#): > > I don’t know if it is a good thing, but that is because the drug manipulates reward circuitry. They tried a drug that blocked the cannaboid receptor and people ended up committing suicide on it. Weight loss drugs nowadays seem like they are either amphetamines (which can increase CVD risk) or change the brain reward circuitry. > > But for the sake of argument assume that isn’t the case, there are no health risks like you said. It is up to people to decide what they want to do to change their appearance. If people want to lose weight, then go for it. Would I use it? Probably not. Should it be a covered benefit? Oh, **Zipper**. At least for bariatric surgery there is documented evidence of improved health outcomes. And its indicated use is not as broad. ---
**Author:** ![grude](https://avatars.discourse-cdn.com/v4/letter/g/e47774/32.png) [@grude](https://boards.straightdope.com/u/grude)\ **Post date:** [July 19, 2012, 4:51am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/36 "2012-07-19T04:51:00Z")
We already have perfectly fine diet drugs, they are called amphetamines. Are they safe for people with cardiac issues or other problems? No of course not. The only reason physicians and the FDA is against them are drug war scare mongering. Bit like saying you are searching for a pill for pain, it exists already. ---
**Author:** ![6ImpossibleThingsB4Breakfast](https://avatars.discourse-cdn.com/v4/letter/6/e19adc/32.png) [@6ImpossibleThingsB4Breakfast](https://boards.straightdope.com/u/6ImpossibleThingsB4Breakfast)\ **Post date:** [July 19, 2012, 7:26am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/37 "2012-07-19T07:26:11Z")
> [@Der\_Trihs](#): > > 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. I think it would be simpler to heavily modify basic calorific intake. Heavy modification of this complex machine has come in the way of evolution, and it seems to have worked pretty well. It just can’t adapt so quickly to the last 50 years of available, excessive food consumption with a sedentary life that has been an adopted way of life for some people. > [@Der\_Trihs](#): > > 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”. Agree that the technology is primitive, and that it could be an ideal future solution. However the original question was whether or not I agree with yet another drug being available as the answer to obesity. I am yet to be convinced that it is. > [@Der\_Trihs](#): > > Yes, they do. Good tasting food is notorious for being unhealthy. On this, I vehemently disagree. Unhealthy food is notorious for unbalancing your palate. Thus good, healthy food does taste really good. You just have to re-educate your tastebuds. > [@Gestalt](#): > > Why would you have a decreased quality of life? Probably because you are morbidly obese with any, all, or additional, to the following that you have mentioned: high blood pressure, cardiac artery disease, diabetes, and sleep apnea As well as limited mobility. To me there’s quantifiably less quality of life when you can’t sleep, stay awake, eat, or move without some type of medical intervention. > [@DSeid](#): > > But it actually does. The maladaptive brain food reward systems are the main physical issue that results in obesity and these meds target that. > > But for other reasons already stated I am still not convinced. Yes, I agree that current meds target that; but it doesn’t alter the type of foods chosen to satisfy the brain demand. So generally, it seems that the end user ultimately changes the amount of food they eat, but not the quality of it. Still helpful, but not very useful. ---
**Author:** ![Johnny\_Bravo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_bravo/32/493_2.png) [@Johnny\_Bravo](https://boards.straightdope.com/u/Johnny_Bravo)\ **Post date:** [July 19, 2012, 8:57am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/38 "2012-07-19T08:57:47Z")
I’m not going to lie; I’m intrigued about diet medication in a general sense. I’ve lost about 25 pounds so far this year (just broke 300 pounds) with a combination of exercise and a shift in diet, but I still have major self-control issues when it comes to food and I feel like getting some medical assistance could be really helpful. I’ve been planning on seeing a doctor and discussing my options. ---
**Author:** ![SurrenderDorothy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/surrenderdorothy/32/1221_2.png) [@SurrenderDorothy](https://boards.straightdope.com/u/SurrenderDorothy)\ **Post date:** [July 19, 2012, 9:20am UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/39 "2012-07-19T09:20:15Z")
> [@Wesley\_Clark](#): > > I don’t know if it is a good thing, but that is because the drug manipulates reward circuitry. They tried a drug that blocked the cannaboid receptor and people ended up committing suicide on it. Weight loss drugs nowadays seem like they are either amphetamines (which can increase CVD risk) or change the brain reward circuitry. > > But for the sake of argument assume that isn’t the case, there are no health risks like you said. It is up to people to decide what they want to do to change their appearance. If people want to lose weight, then go for it. Would I use it? Probably not. I’m on a drug (Naltrexone) that manipulates reward circuitry. It’s supposed to help with cravings with opiate addicts and alcoholics. I take it because I pick and scratch at myself compulsively and my doctor thought it might help with that. I don’t think it’s a super super common drug like celexa or trazodone, but it’s not crazy experimental or anything. I’m not sure it does much for me, but at least it doesn’t fuck up my brain/life so far. And it doesn’t do anything positive for my eating habits in any way. But it would be cool if it did. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [July 19, 2012, 12:27pm UTC](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583/40 "2012-07-19T12:27:05Z")
> [@6ImpossibleThingsB4Breakfast](#): > > I think it would be simpler to heavily modify basic calorific intake. Simpler, but undesirable. Food is one of the pleasures of life, and people shouldn’t be stripped of most of the capacity to enjoy it in the name of efficiency. > [@6ImpossibleThingsB4Breakfast](#): > > On this, I vehemently disagree. Unhealthy food is notorious for unbalancing your palate. Thus good, healthy food does taste really good. You just have to re-educate your tastebuds. I’ve never bought that; too many people try for _years_ to change their diet and hate it the whole time. Claims like that have always struck me as being usually just part of the superior attitude indulged in by many of the physical fitness types. Perhaps it actually works for some people, but I doubt it works for many. [Previous page](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583.md?page=1) [Next page](https://boards.straightdope.com/t/new-drugs-for-obesity-treatment-a-good-thing/628583.md?page=3)