Just when I thought obesity was moving off the national radar screen, it lit up recently with a shocking new forecast, the mainstreaming of the term “obesogenic” and the promise of a new obesity drug.
Last week, a new report was released by the Institute of Medicine at the three-day Weight of the Nation conference, hosted by the Centers for Disease Control and Prevention.
The report says that 42 percent of American adults will be obese, including 11 percent defined as “severely obese,” by 2030.
By comparison to today's stats, the CDC says 34 percent are obese and 6 percent are severely obese.
The Institute of Medicine also called for the government to embrace multiple policy strategies, from changing farm policy to taxing soft drinks, to make the eating environment less obesogenic, which is defined as having conditions that lead people to become excessively overweight.
The institute's report came on the heels of news that the Federal Transit Administration is going to start testing the breaking and steering capabilities of buses due to heavier riders and months after the Coast Guard lowered certain ferry boat capacity limits because of heavier riders.
The national conversation continues this week with the airing of HBO's four-part documentary, “Weight of the Nation.” The first two parts, “Consequences” and “Choices,” premiered Monday. The second two parts, “Children in Crisis” and “Challenges,” air tonight starting at 8 p.m.
For those who don't subscribe to HBO, the cable channel has developed a website and Facebook page designed to help people get involved in the solution, underscored by the subtitle: “To win, we have to lose.”
Dr. Patrick O'Neil, director of the Medical University of South Carolina Weight Management Center, agrees that news and debate about obesity comes in waves, in part because it usually revolves around regular government data reports, and that the wave is high right now.
O'Neil, who doesn't subscribe to HBO, ordered a kit from the “Weight of the Nation” website and described it as well-done.
“They didn't dumb it down to any extent. While some of the experts (interviewed) talk very scientifically, they make it readily understandable,” says O'Neil.
His hope is that more startling statistics and public involvement may encourage the Food and Drug Administration to be more open to drugs to help patients lose weight. O'Neil, who has helped conduct clinical trials and author studies, describes the FDA's position on obesity drugs as “risk averse and benefit-blind.”
The only FDA-approved drug for weight loss is Orlistat, marketed as a prescription under the trade name Xenical or over-the-counter as Alli, which works by blocking some fat absorption.
“Up until now, it (drug approvals) has been dismal and very discouraging for people working on obesity drugs,” says O'Neil.
But hope may be on the horizon for the chronically obese.
FDA advisory panels have given the OK to other drugs, such as Contrave and Qnexa. The FDA declined to approve Contrave in 2011 without a long-term study proving that it doesn't raise the risk of heart attacks. It will rule on Qnexa on July 17.
Last Thursday, the panel approved lorcaserin, which MUSC has conducted three trials on. It is set for a vote June 27.
O'Neil, a co-author of a study on the drug, says it works by targeting a serotonin receptor that controls appetite. In the study, those using lorcaserin saw an average of 5.8 percent weight loss versus 2.2 percent on a placebo.
O'Neil is quick to add, however, that lorcaserin and other tested obesity drugs are not a magic pill.
“I don't know any medications that don't involve lifestyle changes,” says O'Neil.