Since other MDs are weighing in, I decided I should offer my thoughts as well. I'll refrain from commenting specifically on articles others have written but would like to offer my perspective as a physician and as a psychiatrist.
It is true that the typical physician does not prescribe drugs explicitly for weight loss. However, it is very possible, that a paradigm shift is occurring. I expect that there will come a time when discussing pharmacological remedies for obesity will be part of a physician's due diligence when caring for an obese patient. Physicians are busy. Most have a routine they follow, and divergences from that routine mean they fall behind schedule. Every physician and practice is different, but I think it is fair to say that, at present, a typical scenario at a PCP office for an obese patient involves the PCP saying a few words about diet and exercise, perhaps giving some handouts. Some of the more thorough physicians will discuss more details about diet and perhaps refer to a nutritionist. Talking about weight loss drugs is not part of the routine. However, I believe that time will come, as obesity becomes more recognized as a "disease" to be "medically managed." If we look back in time, we can compare to how depression treatment has evolved. Once upon a time, a PCP visit for a depressed patient might have involved some kind words and a suggestion to see a therapist. Now, it is typical for that patient to be offered an antidepressant by their PCP. The key difference is that PCPs came to see that as part of their responsibility. When talking about weight-loss meds becomes part of the routine, rather than an extra chore, everything will change. And that change is brewing . . .
I posted this as a response to VANMUSICBLUES in the comments buried below, but I thought it was worth reiterating . . .
Belviq is effective with less that 38% of users and the good results erode over time
3 Replies to vanmusicblues
I don't know what your evidence for that is. In the JAMA study, 47.5% responded at 1-year follow up and 68% of those responders who stayed on Belviq maintained results at the 2-year follow-up
The problem is most people quit in about 0 weeks and only 8% stay on a diet drug for a year. Just look at the churn . you forgot to mention over 50% quit that are not included in your numbers. The longs are dump or liars for the most part
Your numbers are incorrect as is your conclusion. 55% of the treatment group was still involved at the 1year follow-up. The study used intention to treat and last observation carried forward in their statistical analysis. What that means, for example, is that if someone drops out at week 1 and hasn't lost any weight, they will be counted as a non-responder at the 1 year follow-up. The 47.5% response rate is based on the original enrolled participants that they "intended to treat." 47.5% of the original treatment group responded despite the fact that only 55% stayed in the study.
Sentiment: Strong Buy
The traditional role of a doctor is changing in my mind. I do not see them as totally set in their ways but willing to listen to patients who do research treatments for their own diseases and try different things than the old method of just referring them to other specialists or innocuous but ineffective drugs that placate the patient. In my case, I have been taking Metformin and a statin for about 15 years. I managed to lost a lot of weight by adding exercise and cutting out in between meal snacks and sweets. So since my blood work has shown stability and lowered cholesterole and blood sugar, suggested maybe we could cut back and see what happens with my blood. We did so and have cut the Metformin by one half and the statins by 75% without adverse changes. My older doctors who have now retired would not have done that, but acted only on their own direct experience.
This same willingness to try something different for obesity weight loss will IMO result in doctors willing to go beyond nutrition counseling and depression management, by prescribing weight loss drugs like Belviq. I don't see the doctors as the current roadblock, but the health insurers who are not convinced that drugs will help reduce obesity and reducing obesity will help their overall payouts.
Sentiment: Strong Buy
You bring up a good point, which is that the doctor's of today are much more concerned about "patient satisfaction" than those of the past. Bringing up medications that you want to try does matter. Going into the doctor's office armed with the NEJM article wouldn't hurt, either.
Important for sure and thank you for sharing. Of more importance, and what will really drive this drugs sales will be consumer/patient demand. The tremendous size of the current weight loss market (products and services) speaks to the pent up demand for a safe and effective treatment. If you live in suburbia you know the minute the soccer mom crowd gets wind of this product...I feel for any PCP who stands in their way:) Take Care!
Excellent! Now, how is the topic of obesity going to become a topic at future Medical conferences to inform the medical community of the value of adding Belviq to diet and exercise. My experience in the electronic field was to submit papers to conference boards for particular subjects. Obesity is designated a disease so who is the best organization to get the word out? AMA,others?
Sentiment: Strong Buy
Not one mention in your thoughts about diabetes, and weight management as a front line treatment. Late to the party, obesity was recognized as a disease by the AMA last year, and has the full support of the FDA in that regard. The evidence, and data is clear that obesity is a world health problem, medically one of the most damaging problems of serious health concerns costing 100's of millions annually to the health care system treating all known medical issues that follow along with obese people. The tide is turning to manage obesity as a disease to reduce the onset of the related medical issues both in adults, and children. All I can say is open your eyes, look around you and count the obese people you see daily. One of the government required data gathering lines of the 14 or so that must be reported with every doctor visit is BMI.....that was not required two years ago, but now is. There is an obvious reason they are gathering weight and BMI data.....it's to provide obesity data to the health care industry within our population.
No question whatsoever about the importance of weight management for diabetes as well as other health problems! What I intended to convey is that one must overcome a certain degree of resistance (based on routine and what is considered standard of care) before doctors change their prescribing habits. It'll happen, but we need to be patient.
If you are a medical doctor, then you know nothing about medical prescriptions written in the 60's, 70's, and since then. Doctors were prescribing two approved drugs. A drug to curb appetite and a drug to help the patient sleep. I think you are a phony. JMHO.
Sentiment: Strong Buy
How did you manage to get this post stick? If you have a concern about the YMB correspond with them through the link at the bottom of this page: Help/Suggestions
I would agree with you that continuing a long post by replying to your own post is a good way to get a total message out. Perhaps a better way to do that would be a suggestion that Yahoo Finance would consider.
BTW.. I have been writing my posts that have considerable content on a text writer on my computer and saving that so I can cut and paste parts of it to messages and responses to messages. You can create a special folder right on you desktop for these messages making them easy retrieve when needed.
I have also reposted messages that I saw as so important to share after a few days or weeks because unless someone responds with "BUMP IT", it will get buried by the ongoing traffic of posts.
Sentiment: Strong Buy
As a licensed substance abuse counselor, I need to say that there does exist addiction to food/eating, that could be addressed along with belviq. There will always be that food addict that says, if one pill works for weight loss....2 should be even better. There are underlying factors as to why a person would knowingly eat in self destructive manners. These underlying factors must be addressed or else the patient may very well begin to eat again, turn to substitute addictions, or become depressed. Obviously, not every belviq patient will be a bonafide food addict, but those who are will always need the psycho/social aspects of addiction addressed so the treatment is holistic.
Agreed. Absolutely. Obesity is multifactorial with many psychosocial contributors. One should not make light of those factors. At the same time, we should not neglect the biological factors, such as inherently, biologically-driven, higher appetite. That is indeed an issue as well, and one that now can be addressed with Belviq.
Why my kaiser doctor a hard head iv taken belviq for 90 day loss 35 lb my dieibetic blood sugars down stop insulin if he wrote perscription that need it ; it would beed payed for ;he didnt he dosent give a #$%$ that my blood sugars down ;need chane doctor sad ;