Sunday, May 15, 2005

When will we ever learn?


As reported by Reuters:

CHICAGO - May 11, 2005 - Arena Pharmaceuticals Inc. Wednesday said its experimental obesity drug was effective in helping patients lose weight in a 28-day, mid-stage trial. Patients taking a 15-milligram dose of Arena’s oral drug, known as APD356, lost an average of 2.9 pounds after 28 days of treatment, compared with a loss of 0.7 pounds by obese patients taking a placebo. Diet drugs have a checkered history, with few resulting in lasting weight loss. At the same time, doctors are eager for a safe and effective treatment for obesity, a major risk factor for conditions such as diabetes and heart disease. The San Diego-based biotechnology company said the results were highly statistically significant and that no serious side effects occurred.

There they go again! Yet another diet drug trumpeted in the press. The folks taking the drugs lost a whopping 2.9 pounds in 28 days and those taking the placebo only lost 0.7 pounds. Three pounds in twenty-eight days!! Four short weeks! WOW! Are you as underwhelmed as I am?

As this new miracle cure gets some ink, nudging up in the race to your drug store shelves with rimonabant (Acomplia), no one seems to get the big(ger) message. To whit: quit looking for healthy lifestyles in pill format! It just has not been invented nor is it likely to come out any time soon in a patch, topical gel, time-release, or enteric-coated gelcap. People, a pill is not the solution.

I won't even get into the whole "Fen-Phen" fiasco and how many hearts were damaged (and lives lost) by that ill-fated combination again. Nor will I get into another rant about how worthless and overpriced the most recent "diet drug" brought out for weight loss (sibutramine, Meridia) is. And don't get me started about the whole Relacort and CortiSlim green tea nonsense. But, for pity's sake, it is high time that the pharmaceutical industry climbed off this tired horse and started putting resources into something more important. Maybe, I don't know, just off the top of my head, perhaps - more thorough drug testing? With longer drug trials we will avoid the current travesty of bringing drugs to market with either insufficient testing or the ability to cover anything that is actually negative about the drug.

I am refering, of course, to the recent withdrawals of the COX II inhibitor class of antiarthritis drugs - Vioxx, Bextra, etc. With the rush to market and multimillion dollar rollouts of new prescription drugs, the pharmaceutical industry is, of coursem just doing what comes naturally. Profits over safety. But, that's just business. Even if I don't like it, I can understand it. Capitalism, the American Way, apple pie and all that. It's the "solution in a pill" metality, actively promoted by the drug industry, that I take issue with.

When will we, as the consumer, finally wake up to the truth? We are never going to have what we all dream of, namely, health by pill. Sure, there will be plenty of new, over-priced "cures for obesity" like this APD356 (Arena Pharmaceuticals). We should have Acomplia (Sanofi-Aventis, of France) - drum roll, please - next year. But with the best of the studies of Acomplia, patients lost 16 pounds on average over two years, compared with 5.5 pounds for those who took dummy pills. Now, by my calculations that is about 2.5 ounces per week over 2 years. Does this sound like a miracle to anyone? It certainly does not to me. For someone with 50 pounds to lose, that will "only" take slightly more than 3 years of Acomplia "therapy." Of course, on a cost per ounce basis, based souly on what I expect Acomplia to cost, it will probably work out to be about $5.00 per ounce of weight loss (calculation, purely hypothetical, are shown below). This is progress? I think not.

Somewhere in the reams of doctor and patient information that will be published in newspapers, magazine, professional journals, and by the crack team of Sanofi-Aventis representatives will be an asterisk which points to a discretely buried and barely readable subscript passgae at the bottom of every page. It will read, to the effect, that:

"Weight loss should only be expected to be accomplished in patients who follow a fat-restricted, reduced-calorie diet and participate in a regular program of moderately-vigorous aerobic exericse."

And there, my friends, will lie the real truth. There is no cure for inactivity, work and family demands on our time, meals in the car, on the run and out of a sack, Whoppers or 64 ounce Big Gulps, or reality television. There is no pill to cut down on dietary fat grams or sugar. There is no patch that will make you walk, jog, crawl, swim, or cycle for 30-60 minutes a day, 5 days a week. There is no time-release capsule that will reverse the "thrifty gene" passed on to you by your ancestors from hundreds of years of selection and stop your body from storing fat every chance it gets. And there has never been and will never be a drug that you put into your body that does not have side effects, some possibly lethal.

So, as we sit on our sofa or easy chair and watch the news and advertisements for the "next big thing" to lose weight while we sleep, remember this: where the rubber meets the road, there is only one thing that can improve your health - you. It is you - and you alone - that has the ultimate control of your health. How you choose to live, when all is said and done, is all we have. And the decision you have to make, despite the thousands of books and "experts" that tell you differently, is a simple one. You can choose to live as healthy a life as you can or not. You can swear off the absolute "garbage-as-food" sold out of drive-thru windows or not. You can park your car a half-mile farther from work and walk or not. You can take the stairs or the elevator. You can carry your golf clubs 18 holes or ride in a cart. You can break a sweat, raise your pulse and exercise or not. You can turn off American Idol, Survivor, The Great Race, The Newlyweds and Chasing Farah and all the other mindless dribble that passes for television, or not. When will the idiotic chatter of who's going to win a meaningless reality show change to "what I did to improve my health (or my mind or my family life or my profession or my hobby) last night?" Sadly, I answer myself, never. What type underwear Bo Bice wears or what Paris Hilton said was "hot" seemingly is the only thing on our minds these days.

I am not just talking about weight loss. I am talking about being as healthy as you can, in mind and body. About spending quality time with your children before it is too late. Learning something new - knowledge or a skill - that makes your mind expand beyond it's current boundaries. Discussing a real issue - like war, famine, genocide, the hereafter, your faith - with friends or family.

And, just on the off chance you might be interested to know, health does not come in a pill.
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Calculations: Based on the best study published to date, patients taking Acomplia lost an average of 16 pounds over 2 years. There are 52 weeks per year and 104 weeks over two years. There are 16 ounces in a pound. So, 16 pounds is 256 ounces. 256 ounces over 104 weeks is 2.509 ounces per week. Thus, if we (very, very conservatively) estimate the cost of a months therapy of Acomplia is $100 per month and we have 50 pounds to lose, we will need a little over 3 years to lose 50 pounds with Acomplia. Three years of therapy at $1200 per year (12 months X $100 per month) to lose 800 ounces (50 pounds X 16 ounces per pound) works out to about $5.00 per ounce.

7 Comments:

Anonymous morbid obesity said...

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Anonymous morbid obesity said...

Hello DietDoctor, been looking for the latest info on over weight obese and found When will we ever learn?. Though not exactly what I was searching for, it did get my attention. Interesting post, thanks for a great read.

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Anonymous Meridia Prescription Information said...

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