For a long time, obesity was seen and treated as the result of the wrong lifestyle choices of an individual. The only treatment options were:
- Diet
- Physical activity
- Surgery
The latter is called vertical banded gastroplasty, an operation that involves removing about 75-85% of the stomach. Because of this reduction in size, the patient feels full much more quickly and consumes less food than they would usually eat, resulting in weight loss.
The big absentee from this list is drug treatment. After the failure of fen-phen, an anti-obesity treatment based on fenfluramine and phentermine that was later linked to the onset of heart disease, the development of obesity drugs came to a halt. Now that seems to be changing.
Obesity drugs: a growing market
It is estimated that obesity afflicts more than 680 million people worldwide and is responsible for 5% of all global deaths. This situation has enormous costs not only health-wise, but also socially and economically. Despite this, only 7% of people suffering from obesity receive any form of medical treatment.
Something is changing in recent years, starting with the growing acceptance of obesity as a chronic disease and not as a consequence of laziness or poor eating habits. This awareness has prompted more and more doctors to address the issue directly and has revitalised pharmacological research for the treatment of obesity and weight control.
This shift in perception has led analysts at Morgan Stanley to believe that pharmacological treatment of obesity is on the verge of becoming one of the top 12 global therapies, growing from a $2.4bn market in 2022 to a $54bn market by 2030.
The market estimates were made in part because of the experience with a similar disease: hypertension. From a condition related to an improper lifestyle, hypertension has managed over the years to make its way into public perception as a real disease that requires treatment. Analysts believe that obesity is about to make this leap as well.
Opportunities and challenges of the obesity drug market
Newer drugs for the treatment of obesity have excellent safety profiles and high efficacy rates, enabling weight loss equivalent to that of bariatric surgery. Market growth is estimated to be driven by:
- A higher awareness of the life-saving potential of these drugs
- An increased focus on weight loss in the treatment of diabetes
- The use of social media in drug promotion
To reach the expected numbers, anti-obesity drugs must overcome some challenges. The first will be to prove the safety and efficacy of the treatments, which at the moment seem to be ensured. The second step will be convincing doctors to prescribe them: especially in those who have been practicing for several years, distrust and concern about possible side effects remain, mindful of the cases of fenfluramine and dexfenfluramine.
Another possible problem arises from social media and the use that pharmaceutical companies are making of influencers to promote their products. When a drug gets a particular media hype, the risk of misuse also increases accordingly. In this case, the misperception of these drugs as miraculous weight-loss remedies could lead to disproportionate and incorrect use, impacting the people who need to use them for health reasons and are at risk of not finding them available anymore.
The biggest question mark revolves around insurance companies, which will have to decide whether or not to cover these new drugs. To avoid gaining weight again, the patient must continue taking the therapy for life. The knowledge that the cost of the drugs will be covered, either partially or fully, by one’s insurance could make the difference for many people. In the United States, at the moment, Medicare does not include treatments for obesity, but according to practitioners, it is only a matter of time before the change in perception around the disease prompts consideration of its treatment as a basic requirement for any insurance plan.