Archive for May, 2011

Severe Obesity’s Personal, Financial Toll

May 31st, 2011

Persons with severe or morbid obesity are hardly the lazy, indifferent people as they are often portrayed. Instead, as we see from this survey by the Canadian Obesity Network, they repeatedly try to lose weight in spite of frustrating disappointments, at great personal costs to themselves. They do not live in a bubble but realize the serious effects excess weight is causing in their careers, interpersonal relationships and self-esteem. Impact of Severe Obesity Felt Far Beyond Physical – Financial Burden and Emotional Implications Also Significant | Canadian Obesity Network

Texas pol caught exaggerating obesity death figures

May 31st, 2011

Texas Rep overstates obesity mortality rates. PoliticFacts gives updated figures PolitiFact Texas | State Rep. Rob Eissler says 34 children die from obesity every hour

DOL Reports on Essential Benefits

May 31st, 2011

The future of health care reform relies on the development of state exchanges whereby individuals can go and select among health insurance plans. But the plans must meet certain minimum requirements. One of them is that they provide “essential benefits.” The Department of Labor was instructed to conduct a survey of employer-sponsored health plans to determine the benefits typically covered by employers. The Department of  Labor (DOL)just sent its report to the Department of Health and Human Services (DHHS).  Essential Health Benefits: Overview of the Department of Labor Report on Benefits Offered Under a “Typical” Employer Health Plan – Health Reform GPS: Navigating the Implementation Process

No mention was made of obesity treatments or obesity preventive services. So the prospects of inclusion of obesity treatments in the final essential benefit package looks unlikely without a huge lobbying campaign. It is interesting that even diabetes care management was one of the least mentioned benefits with 73% of plans not mentioning it.

Understanding Bariatric Surgery

May 28th, 2011

If you or a loved one or colleague are considering bariatric surgery, you owe it to yourself to click on Dr. Sharma’s Obesity Notes. Go to his five-part series, Why I support Bariatric Surgery. It is an excellent description not only of how the surgery works but also how to assess the risks and benefits of surgery and why sustaining weight loss is so difficult. Check it out.

Trends in Global Health and Wealth

May 24th, 2011

Professor Hans Roling has done a fantastic job of depicting the changes in global health and income for the last two hundred years. While it doe not address obesity specifically, most of the countries showing increases in income and longevity also show increases in obesity.  For global changes since 1980, see National, regional, and global trends in body-mass… [Lancet. 2011] – PubMed result

Normal Weight but Metabolically Obese

May 24th, 2011

It’s worth remembering that one can be metabolically obese but have a normal weight. This is due to the distribution of body fat, not its amount. Too much visceral fat can lead to the same metabolic conditions for a normal weight person as for a person who is obese, according to a study from the Mayo Clinic. Body fat distribution, adipocyte size, and metabol… [J Clin Endocrinol Metab. 2010] – PubMed result

Pharma Companies Hang in There

May 15th, 2011

Drug companies battered by the FDA earlier this year are not taking no for an answer. Vivus Inc. is in discussion regarding Qnexa to make it available for men and women who are not of childbearing age.  UPDATE 1-Vivus to submit Qnexa application as limited indication, shares up | Reuters  Arena Pharmaceuticals  is looking at a three month study of breast tumors in rats rather than the 12 month study the FDA wanted.   Arena pushing shorter study of rejected diet pill – SignOnSanDiego.com  while Orexigen is examining cardiac function effects of its drug, Contrave, see Orexigen submits diet-pill test plan to FDA – SignOnSanDiego.com

What’s Up with the FDA? – Part 2

May 15th, 2011

I’m sorry are we bothering you with all this obesity stuff?

As you know the FDA was quite busy this last 12 months or so with reviews of Meridia, Qnexa, lorcaserin and Contrave. Meridia is off the market now while the other three are holding on for dear life. It came as no shock to those closely watching the meetings of the Endocrinologic and Metabolic  Advisory Committee that the FDA really doesn’t much like dealing with obesity. Now, we know why. They are not curing hypertension or diabetes. That’s what the head of the FDA drug center, Janet Woodcock, right,  wanted to see. And that’s what she told Reuters in this interview. FDA official sees drug approvals rising | Reuters

So, think about this for a moment, the top FDA drug official casually tosses off the FDA’s own guidances for developers of obesity drugs regarding efficacy and says, well, she wishes they were other drugs entirely. Imagine if she said, well, we have turned down this drug for breast cancer because it didn’t  improve Alzheimer’s disease or  cure multiple sclerosis. Or if she said of a drug rejected  for HIV/AIDs, that she would like to have seen it cure Parkinson’s disease?  Would she stay in office the rest of the day? Would it not be a huge embarrassment to the FDA, the HHS, the medical community, the Administration? Why is it  ok for obesity? Is is any less intellectually vapid?  Is that why one of people who works for her, running the Endocrinologic and Metabolic Advisory Committee process this year, apologized, APOLOGIZED! to the panel for “putting them through this unpleasantness.” The “unpleasantness” Dr. Coleman was referring to was the Committee’s job, namely, reviewing new drug applications for obesity. Dr. Coleman, went on to add, “I guess you should be thankful you don’t have to do this everyday for your living.” (See http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/EndocrinologicandMetabolicDrugsAdvisoryCommittee/UCM232443.pdf at page  304) Is this a cry for an intervention, a plea for a new job? Or a sign of an institution so biased against all this obesity that no obesity drug will ever be approved no way, no how? Can these people give obesity drugs a fair hearing? The FDA has rules on Conflicts of Interest. How about rules on Lack of Interest?