Financial Times Editorial Comment: Obesity pill is no silver bullet

Financial Times Editorial Comment: Obesity pill is no silver bullet
Copyright The Financial Times Limited 2009
Published: April 24 2009 19:16 | Last updated: April 24 2009 19:16
http://www.ft.com/cms/s/0/e39d4944-30f9-11de-8196-00144feabdc0.html


Imagine a pill that could solve one of the world’s greatest health problems: the escalating trend of obesity. Despite the launch in European pharmacies this week of a weight-loss drug, already on sale in the US, keep on dreaming for now.

Some drugs provide ground-breaking treatments for diseases that make a real difference; others are little better than snake oil or a placebo. In most cases, prevention remains a necessary accompaniment – if not a far greater driver of good health than any pharmaceutical cure.

Alli, a diet pill long available from physicians, has just been “switched” to allow its sale over the counter in the UK and across the European Union. Where previously patients had to visit a doctor and obtain a prescription, now all consumers can simply have a quick chat with a pharmacist before handing over their money.

Compared with most of the far less evidence-based techniques available in the burgeoning weight-loss industry – from faddish diets and dubious herbal remedies to questionable advice from private “specialist” clinics and pills that went through no regulator – there is at least some medical support for the use of Alli.

Clinical trial data suggest that it can modestly reduce weight, at least over a few months. Unlike some other prescription-only diet pills, already launched or struggling to win approval, it does not bring the risk of psychiatric complications – although it can have some unpleasant side-effects lower down the body.

All sorts of unregulated and unproven weight-loss drugs are available in shops and over the internet without any serious accompanying medical advice, not to mention counterfeit versions of authorised prescription drugs. At least the pharmacists dispensing Alli will have had some training before selling the product to their clients.

The bad news is that even among well-studied medical interventions, only gastric bands and by-passes seem to have much proven significant impact on weight loss.

The small handful of medicines authorised by regulators may bring a modest additional benefit – as long as the drugs are accompanied by exercise and healthy eating.

Tackling obesity should begin with a substantial element of individual responsibility to meet these extra conditions. But, with a growing clash between the traditional dietary demands of humans and their far more sedentary modern lifestyles, it also requires substantial government help.

That includes tougher regulation of junk food labelling, contents and advertising; and policies in education, transport and planning that help healthier lifestyles. No country has so far found a magic bullet against obesity. Encouraging the sale of pills risks simply cashing in on the afflicted.