Pundits and Their Misguided Messages

A perfect example of a pundit claiming their approach is better than any other raised its ugly head yesterday. In a Forbes.com piece here, author Melanie Haiken highlighted what she thought were the five deadliest diet trends. I don’t disagree with four of her five entries but entry number four focused on QNEXA and its successors, the current drugs being evaluated by the FDA, being included on this list is a perfect example of bias against those affected by obesity needing help rearing its ugly head.

First of all, the blurb is inaccurate when saying all of the drugs are combination therapies of existing medications. They are not. Locaserin (by Arena Pharmaceuticals) is a novel (new) drug. More importantly though is that the big difference between “QNEXA and its successors” is that they are all going through the FDA approval process at this time after having gone through multiple clinical trials including thousands of patients. They will ultimately be judged on the merits of the data by experts both from the FDA and the FDA recruited Advisory Committees (in fact, one such committee has recommended approval of QNEXA by a 20 – 2 in favor vote). This is obviously different then the “Brazilian Diet Pill” and the other so called “pills” listed that get released with no regulatory body reviewing their safety or effectiveness.

I find it curious that Ms. Haiken has already decided that the next batch of obesity drugs “kill.” What’s her expertise to make this assumption? Her background doesn’t indicate medical training. She obviously believes she is more qualified than the recent FDA panel made up of some of the leading experts on diabetes and cardiovascular disease who voted 20 – 2 in favor of approving QNEXA. Plus, does she not recognize that “obesity” itself “kills”? She has softened her comments somewhat with an addition to the article in the comments, but that too shows her bias. Basically, she says everyone should just diet and exercise and we’ll solve the obesity epidemic. If it were that simple, we wouldn’t be in the situation we are in when it comes to obesity.

The next batch of obesity drugs are not “magic” or “silver” bullets. If approved, they will cause very modest (5 – 10 percent total body weight-loss) in the right patients when they are prescribed as part of a comprehensive medical weight management program by a skilled practitioner. They do have risks, so the decision to take such drugs should be made carefully; however, placing them in the same categories as “miracle” supplements and other hogwash is a true disservice. Forbes and Ms. Haiken should be ashamed in my opinion.

Check out the post by Ms. Haiken and let me know if you feel the same way.

Making a Difference Together,

Joe



3 Comments for this Post
  • Cari De La Cruz
    April 20, 2012 at 8:26 pm

    I think the chief problem here is the association with the “TrimSpa” type drugs…people immediately think of Anna Nicole Smith, and the discussion is over. BUT — I was prescribed Meridia prior to having my weight loss surgery and, for 6 months, it worked — or, should I say, I was able to work it. Something about the medication altered my brain chemistry (?) enough to allow me to focus on making healthy life choices in my diet and exercise routine and I saw 50 pounds of success.

    However, the efficacy was limited, and like being cut loose from the “climbing chain” on a roller coaster, I hit the top of the hill and began a rapid decent back into my obese world. It was extremely frustrating (and scary) and the pounds threatened to come roaring back. Fortunately, my doctors interceded with WLS and, 4-1/2 years later, I am able to use my surgical tool to wage (and win) a daily battle against a killer disease.

    I think there is, indeed a place for meds in the obesity arena. I believe they can be beneficial – but they are only part of a temporary answer (at least for now). I liken them to meds for managing Type II diabetes: When taken with a managed diet, they can help keep a deadly disease in check.

    Perhaps science will find a cure for both diabetes AND obesity, but in the meantime, why rule out treatments that can save lives? I suppose it’s just another way of blaming the patient, but that’s why we’re all fighting the good fight…


  • Walter Medlin
    April 21, 2012 at 4:31 am

    I’m very happy to see the OAC use its voice to call foul. Joe does such a great job of respectfully disagreeing – and education is the answer to well intended ignorance. Way to go!

    Ms Haiken does perform a service as a consumer watchdog, but enough already with the media’s habit of portraying things in an overly dramatic way. She crossed the line from skeptic to cynic with QNEXA. Evidence is not to be dismissed so lightly. If you disagree with medically treating obesity, then you aren’t helping.

    No medication, no intervention is for everyone. A very few are just plain bad (mostly the unregulated), but even the best interventions have side effects and failures, and are easy to disparage. Those of us without the comfort of the bleachers have got to make real world decisions with the tools and knowledge at hand. I could well be dead or disabled right now if not for intervention (sleeve gastrectomy). As a surgeon, I have to help others make a similar call for themselves every day. If you were over my shoulder you would likely criticize me as too cautious, when you see the effects of these diseases.


  • Dr Martin Binks
    April 23, 2012 at 6:59 pm

    Thank you Joe for these well thought out comments. Several folks have shared their concern on the site. Also, if you are interested I added my 2 cents in my blog. (feel free to delete this if your policy discourages sharing of private company blogs here – don’t want to inadvertently cross any lines of ‘self-promotion’)
    http://www.drbinks.com/blog/2012/04/response-to-forbes-article-disparaging-obesity-drugs/



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