Some Aspects of Anti-Obesity Drugs

In 2013, speaking of anti-obesity drugs in general, journalist Esha Dey remarked that sales had “fallen far short of expectations.” According to some analysts, doctors were reluctant to prescribe them due to wariness about safety concerns that had caused earlier products to be withdrawn from the market. For instance,

Vivus’s Qsymia and Arena’s Belviq have serious side effects, ranging from depression and anxiety to heart risks and potential harm to fetuses.

Dey spoke with an investor named Kevin Starr, who explained,

A lot of the obesity drugs historically focus on working signals in a little area on the hypothalamus. That is very close to the happy signals and sad signals. Suicidality and depression are all co-regulated by that same area of hypothalamus.

Dey quoted another expert who felt that the big pharmaceutical corporations were dropping out, in what he described as “a bit of an exodus from the obesity space.”

But only a few short years later, an investor report claimed that “With the presence of a considerable number of companies, this market appears to be fragmented” — which seems to be a disguised complaint about the presence of too many little guys, rather than the preferred state — which would be consolidation and monopolization by the mega-corporations.

But why would the existence of numerous companies be a drawback, especially when nobody had really come up with anything good yet? Possibly because every smaller enterprise that exists threatens the bottom line of the industry giants. What if a little guy comes up with the answer first? Who knows, the customer might even get a better deal.

This document, in the same genre as the hyper-pricey investor guides we spoke of yesterday, predicts that by 2023, “the anti-obesity drugs market will register a CAGR [Compound Annual Growth Rate] of almost 8%.” It touts the huge opportunities for drug vendors to manufacture “innovative and highly effective drugs.” However, a caveat is issued:

Limited reimbursement for anti-obesity drugs… Although US is the major market for anti-obesity drugs, the challenges associated with the reimbursement of these drugs is more in the US.

In explanation, the copywriter speaks of bariatric surgery, which is, reimbursement-wise, in the same unfortunate boat:

People are unwilling to pay for this surgery as they believe that obesity is a cosmetic or lifestyle issue, which led player limit coverage.

The company’s literature apparently refers to the institutions we entrust with our lives as “players,” which seem a bit cavalier. Aside from being written in sub-professional English, it makes some unusual statements, for instance:

The prevalence and incidence rate of obesity is very high because of the limited efficacy of currently available drugs.

Dr. Pretlow has for many years considered the causes of the worldwide obesity epidemic, without once attributing it to a paucity of effective anti-obesity drugs. That is the trouble with giant corporations. They think they hold the keys to the kingdom, in this case, the promised land of the formerly fat; without granting the possibility that people would much prefer to inhabit the land of the never fat.

In other words, the highest aspiration should not be to sell the most user-friendly weight-loss potion, but to help people start out fit and stay fit.

Your responses and feedback are welcome!

Source: “CORRECTED — New entrant in obesity drug race targets body, not the mind,”, 08/26/13
Source: “Anti-obesity Drugs Market 2018-2022,”, 07/15/19
Photo credit: Mike Licht, on Visualhunt/CC BY

One Response

  1. Hi Pat,

    Seeing today’s article made me think you might be interested in attending the Obesity Medicine Association’s Fall Summit in October. There will be a first-ever pediatric track, with sessions and panels on topoics such as childhood obesity’s effect across the lifespan, mental health in pediatric obesity patients, and how obesity changes pharmacokinetics of pediatric patients.

    I’d love to send you more info and offer you free access, but the email listed on this site for you bounced back. If you’re interested, please reach out and we can talk more!

    Thank you,

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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