The obesity epidemic is a serious health threat for both adults and children alike, and the prognosis for the nation is getting worse. In America alone, a staggering 35% of the population is obese.
Yesterday the US FDA approved a new prescription anti-obesity drug Belviq – the first to be approved in 13 years. This is the latest “quick fix” solution for our pill-popping society, attempting to fight the astronomical rise of preventable diseases associated with obesity. It appears to be another treatment for the symptoms of an emerging crisis.
But what approach is necessary and most effective in combating this fast growing epidemic?
First of all, more chemicals are not what people need. Creating and marketing drugs like this is failing our society, promoting and re-enforcing the unhealthy behaviors and furthering the economic burden.
Why has no such drug been approved in over a decade? Safety reasons. This was the second attempt for Belviq to win approval – the FDA turned down the first in 2010 as scientists discovered it was causing tumors in rats. (1)
In the two main clinical trials, those who took the drug lost an average of 5.8 percent of their weight after a year, while those using a placebo lost 2.5 percent. That’s around 17.4 lbs weight loss in a year for a person who weighs 300 lbs now. Modest to say the least, but the only hard work involved is taking a pill.
Every anti-obesity pill approved by the FDA also gets recalled by the same organization, usually due to safety concerns. I think the lack of safety surrounding this pill has already been made blatantly obvious.
Next consider the side effects of Belviq. Scary. One includes serotonin syndrome – a potentially life-threatening drug reaction that causes the body to produce too much serotonin and causes symptoms of agitation, diarrhea, heavy sweating, fever, muscle spasms, tremors or mental health changes. The drug may also cause “disturbances in attention or memory,” the FDA said. Still, it was approved as these potential risks were outweighed by the benefits.
Does anyone really want to suffer any of these side effects for an average 5.8 percent reduction in body weight over one year? Drastic times call for drastic measures.
The major unanswered question is this: What happens when you stop taking the pill?
If you haven’t changed your lifestyle, I can tell you straight out what’s going to happen. Rebounding from taking pills will not only make you regain weight, but your metabolism will be altered. Go back to your old ways and sooner or later, you’ll get your old body back plus extra. Simple.
For only modest weight loss results and unpleasant side effects, is Belviq the magic pill answer to the obesity crisis? No.
As a healthcare professional, I see the limitations in the alternate – the treatment of obesity with a general diet/exercise approach is not working. Too much food, not enough exercise. More willpower. Ban all starches. No carbs after 7pm. They have heard it all before. Clearly, ‘telling’ people what to do is not the answer. Going to a high intensity interval class at the gym won’t do the trick either. If it were really that simple, I’m sure we’d have no obesity epidemic in the first place.
It comes down to more than just calories in versus calories out. Being overwhelmed by too much information, and frustrated by unrealistic expectations creates failure after failure. No wonder people find this approach to weight loss so difficult.
We must recognize obesity is a powerful addiction. It has an underlying emotional attachment – there is a food solution for every emotion you have. That’s why you’ll see a morbidly obese diabetic individual with two feet amputated still eating a huge tub of Haagen Dazs ice-cream washed down with Coke.
The key to combating the obesity epidemic is individual behavior change. Creating and implementing programs that break the addiction and empower the individual to long-term behavior modification has potential for success.
Doctors’ calling on the FDA to approve new anti-obesity pills to combat the growing rate is giving way to further issues. The doctor has a highly influential role in determining success in patient’s weight loss journey. For obese populations in low socio-economic neighborhoods, who can’t afford personal trainers or dietitians, the doctor is the most influential figure. To reach for a prescription pad is the lazy way out. The solution is to get moving. Walking 20 minutes a day. Doctors should be proficient in modification counseling for obese patients, and be skilled in effective communication for behavior change.
More professionals in both the healthcare and fitness industry need to work in collaboration to address the underlying emotional issues and needs of obese clients. Being made accountable and taking responsibility for one’s actions is essential.
During my university internships, I met and counseled hundreds of clients who would be potential candidates for taking this pill. Treating morbidly obese clients with exercise prescription is a difficult task. It’s heartbreaking. There is a whole strategic behavior change approach necessary for success, and it starts with meeting the client at their level and setting small achievable goals. It does work, but it’s hard work.
Small changes can make a difference, such as:
– Take small steps to empowering individual changes that promote a life long adaption of healthy behaviors.
– Create healthy support networks, with people who lead by example.
– Re-learn the basics and not assuming people ‘know’ what healthy food is, let alone how to cook it.
– Establish clear expectations for weight loss. You will not lose 25 lbs in 25 seconds. Every single person is different, so creating unrealistic expectations and making comparisons to others is again a major set up for failure.
The obesity crisis may not be the Black Death, but it is a severe public health crisis. The cost will affect all of us eventually. Adopting healthy behaviors and leading by example is just the beginning.
One thing I’m sure of: A pill will not fix a person’s lifestyle.
1. September 2010 FDA Advisory Board Committee presentation: