- The brave new world of weight-loss drugs has grown considerably in the last few years and changed since the days of fen-phen and Meridia (sibutramine). But clinicians and patients are still wary of cardiovascular (CVD) risk, according to the Wall Street Journal.
- There is a new generation of weight-loss drugs that have been approved by the FDA, including Saxenda (liraglutide), Qsymia (phentermine topiramate ER), Belviq (locaserin), and Contrave (naltrexone).
- In addition to concerns about CVD and other risk factors, there are also challenges with insurance reimbursement issues and patients are finding that their out-of-pocket costs can be as high as $200 per month.
The approval and launch of Saxenda, which Novo Nordisk is planning to start selling mid-year, is big news as it represents reformulation of an already accepted medication, liraglutide. Nonetheless, Saxenda comes with a warning that it caused thyroid tumors in rodent studies and that patients with a history of medulallary thyroid cancer—either personal or familial—should not take it.
In fact, all of the new weight-loss drugs have been subjected to a more rigorous approval process and review period than drugs that were approved 10 to 20 years ago and earlier. The prescribing instructions have extensive safety information, as well as the proviso that the drug is to be taken in conjunction with a healthy diet and an exercise regimen.
Regardless of the safety concerns, the problem of obesity in the U.S., and increasingly in the rest of the world, is formidable. According to the CDC, more than one-third of Americans are obese. For these individuals, having numerous weight-loss treatment option is positive—as long as they are aware of the risks, while not underestimating the risk of the excess weight they carry.