Three Drugs Enter, One Remains

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This year saw three weight loss drugs come before the FDA. Two have already been axed, one will get ruled on in December.

The news is interesting, not just because pharmaceutical research is still hunting for the holy grail of a "magic weight loss pill" but because the one remaining treats obesity more like an addiction than a metabolic problem.

The first two drugs already disallowed acted to promote the feeling of satiation -- as if you had already eaten a meal. The second that got the ax was a mix of an anti-convulsant and an amphetamine. Neither met the dual standards of the FDA; a drug that works (5 to 10% weight lost and kept off for a year) and that doesn't have harmful side effects. "Harmful" in this sense means more harm to the patient than the good they would get from the weight loss.

The third drug, still in contention, is called Contrave. It uses a drug combination that has been found useful in treating addiction by lessening cravings. In phase III trials, it is said to have met the standard of weight loss over a year, but whether or not the FDA will approve it remains to be seen.

The interesting thing is that treating obesity as an addiction is a relatively new idea. Previous treatments focused on either blocking the absorption of food or increasing metabolism.

So called "food addicts" suffer weight gain as a result of their pursuit of the feelings they get by overeating. It isn't about metabolism or amount of food, or even calories directly -- it's about self-treatment of depression or other problems by way of eating.

Contrave is manufactured by Orexigen Therapeutics and they claim on their website that the drug combination works by, "Addressing the reward system in the brain that causes food cravings."

That's just how the same drugs in combination are thought to help people overcome opioid addiction. Let's hope Contrave is approved as safe and effective. And then, let's hope that those who need it for food addiction get it.

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