The business of reducing obesity

The effort to reduce obesity (and to profit from that effort) isn’t anything new, but based on my email inbox recently, perhaps we’re about to enter into an era of blockbuster weight-management medications. For the moment, however, we’re at the early stages of any such race, and it looks like Novo Nordisk and Orexigen are fighting for the strong start out of the gate.

Jeffrey Bouley
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Obesity is, dare I say, big business. It has been for a long time, with all kinds of sketchy “exercise” devices and often sketchier diet fads touted by innumerable entrepreneurs and companies across the decades. All kinds of nutritional supplements, “fat burners” and other ingestible obesity-killers that often don’t have a shred of science behind them and might even do more harm than good. All kinds of advice on what foods to eat and which to avoid, which at times can change as capriciously as the wind filling a ship’s sails.
And, of course, the obesity remedies in the world of pharmaceuticals.
Sometimes, these trial-tested therapeutics for the ailment of obesity arise out of a specific effort to deal with obesity directly, while others are more indirect, such as attacking high cholesterol levels, and still others are accidental discoveries coming out of other therapeutic efforts, such as treating diabetes.
Although this issue of DDNews has no obesity-related coverage of note, I thought the topic of obesity-fighting drugs was pertinent given that I received several emails about such compounds in September—two entirely different compounds from two companies, in fact, that were both being touted to me within two days of one another.
One of these was Novo Nordisk’s diabetes drug Victoza, which a panel of U.S. Food and Drug Administration (FDA) advisers voted 14-to-1 should be approved for a new use in treating obesity, feeling that the injectable drug’s benefits outweigh its risks for patients who are obese or dangerously overweight. According to the company’s research, 60 percent of patients taking Victoza for over a year lost at least 5 percent of their body weight, and 31 percent of patients lost more than 10 percent.
“Victoza is familiar to physicians for its use in type 2 diabetes, where it has proven real-world efficacy in weight loss,” noted Christina Vasiliou, a healthcare analyst at Datamonitor Healthcare. “This, combined with Novo Nordisk’s strength in global marketing, means it has huge potential. Victoza’s only limitation is its subcutaneous administration route.”
Assuming the FDA gives the nod for this obesity indication, Novo Nordisk plans to market the drug under the brand name Saxenda, to be used in adults with a body mass index (BMI) of at least 30 kilograms per square meter, or a BMI of at least 27 kilograms per square meter in those with at least one weight-related health issue.
The other contender for being a hot new obesity treatment—and this one an oral drug rather than injectable—as well as one that, unlike Saxenda, has actually just received full FDA approval—is Orexigen’s product Contrave, which is a combination of bupropion, the active pharmaceutical ingredient in the antidepressant Wellbutrin, and naltrexone, an opioid blocker intended to fight alcohol and opioid addiction.
Yet another one of the flurry of emails I received about these two drugs was on behalf of weight-loss specialist and physician Dr. Sue Decotis, who warmly welcomed Contrave as “an important addition to the arsenal of treatment options available,” saying, “Obesity was finally designated as a disease just last year—and it’s taken that long for us to understand it as a complicated condition that has to be treated on many levels. It's much more than just saying ‘eat less and exercise more.’ Of course controlling appetite is an important step in controlling weight, but it is just the first step. Medication can also help in the fight against obesity.”
Both of these drugs are coming on the heels of two other weight-loss drugs approved in the past couple years: Qsymia from Vivus and Belviq from Arena Pharmaceuticals. Whether this portends a flood of other obesity-fighting drugs in the next few years or not remains to be seen, but in an industry where blockbuster drugs are still a goal and with no shortage of people in need of obesity treatment, I wouldn’t be surprised if it does.

Jeffrey Bouley

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