The media has raised the alarm of an obesity epidemic in the United States. From young children to seniors, the news tells of the "crisis" of expanding waistlines. This emphasis, however hyperbolic, is not without warrant.
In 2009, the Centers for Disease Control and Prevention released the staggering statistic that 26.7 percent of the adult population was obese as defined by having a body mass index higher than 30. Only Colorado and Washington, D.C. boasted rates lower than 20 percent. The study found that more than 25 percent of Virginians are obese.
Waistlines aside, the rise in obesity has correlated to a greater occurrence of a range of diseases that includes type II diabetes, heart disease, stroke, high cholesterol, hypertension and certain types of cancer. Moreover, the estimated medical costs associated with treating obesity total about $147 billion annually.
Not surprisingly, the weight loss industry is booming. A release from IBISWorld, an independent publisher of U.S. industry research, reported that between $33-55 billion is spent annually on weight loss products and services, which include pharmaceuticals and medical procedures. Pharmaceuticals in particular have recently garnered attention with the news that Abbott Laboratories will voluntarily withdraw its popular weight loss drug, Meridia (sibutramine) in the United States.
Meridia, which had initially been tested for its antidepressant activity, entered the market in 1997 following the withdrawal of two other weight loss drugs, Pondimin and Redux. Similar to its predecessors, Meridia was known as a monamine re-uptake inhibitor, which prevents the reabsorption of seratonin. This is believed to prolong the feeling of fullness after eating, thus promoting appetite suppression. The Food and Drug Administration approved the drug because close to 60 percent of Meridia-treated subjects lost more than 5 percent of their baseline body weight compared to the 30 percent of placebo-treated subjects.
Questions about Meridia's safety stemmed largely from the six-year Sibutramine Cardiovascular Outcomes Trial study, which showed a 16 percent increase in the risk of a primary outcome event - defined as non-fatal heart attack, non-fatal stroke, resuscitated cardiac arrest and death.
The FDA's public hearing saw debate about the relative risks and benefits of continued use of Meridia. Dr. Diana Zuckerman, president for the National Research Center for Women and Families, stressed that "the weight loss [from using Meridia] is modest, usually temporary, and there's no evidence that it's saving lives. In fact, quite the opposite."
Others, however, argued that Meridia was never an appropriate treatment for persons at high risk for a cardiovascular event and that it should remain a viable option for certain patients. As Gary Deverman, chief executive officer of Building Healthier America, put it, Meridia "can be a safe and effective treatment for patients without cardiovascular disease. By providing physicians with a range of options, we can ensure that patients who need treatment receive effective treatment."
In the end, the FDA's Advisory Committee voted in favor of recommending the withdrawal of Meridia. This decision comes on the heels of the FDA's review of three new drugs aimed at treating obesity - Qnexa, Lorcaserin and Contrave. It remains to be seen whether these drugs will be approved, and if so, whether they will fill the space left in the market by Meridia.
Andrew Matz is a University Medical student. He can be reached at a.matz@cavalierdaily.com.
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