25 Belt-Busting Obesity Facts

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The Food and Drug Administration approved the weight-loss therapy Belviq from Arena Pharmaceuticals (NASDAQ: ARNA  ) in June 2012. It took nearly one year for the company to gain marketing approval, but Belviq's launch is finally within sight. The drug will join Qsymia from VIVUS (NASDAQ: VVUS  ) in breaking the newly accessible obesity market wide open.

Investors and analysts are already imagining blockbuster potential for Belviq and Qsymia, and while the market is large enough for both drugs to do exceptionally well, I never really gave much thought to the statistics behind the obesity market. After looking into the facts, it is pretty clear that the market opportunity is enormous. Here is what I found.

  1. Approximately 35.7% of adults and 16.9% of children and adolescents in the United States are considered obese, according to the most recent figures. That means more than 90.5 million Americans are at increased risk of serious health conditions -- such as type 2 diabetes, heart attack, and stroke. 
  2. The trend is not our friend, either. The figure for children and adolescent obesity represents an increase of 300% in the last 20 years.  
  3. Obesity strained the nation's health care system to the tune of $190 billion at last count. Average annual medical costs were $1,429 more for obese individuals in 2008, or fully 3% of household income that year. That is also a 50% increase in health care costs compared to non-obese individuals.  
  4. Although it maintains one of the lowest obesity rates in the country, New York ranked second in medical expenditures related to adult obesity in 2010. The state spent nearly $8 billion treating the condition, nearly 81% of which was picked up by Medicaid and Medicare. Just a reminder than obesity affects all of us.  
  5. Every state in the country has obesity levels of at least 20%, or one in every five citizens. In 1996, no state had an obesity level above that threshold.  
  6. Numbers from the last census show that the average household size is 2.83 (with a white picket fence and 0.87 dogs). So if someone in your home isn't battling obesity, then on average, one of your neighbors suffers from the condition.  
  7. Similarly, in 2000, no state had an obesity rate of 30% or higher. Just 10 years later, 12 states -- mostly in the southern United States -- marched past that watermark. 
  8. The slimmest state is Colorado, with an obesity rate of only 20.7%. 
  9. The CDC maintains that only 48% of adults and less than 30% of high school students get the recommended amount of physical activity each day. Not surprisingly, the map for daily physical inactivity strongly correlates to the map for obesity rates.  
  10. Worldwide obesity rates have nearly doubled since 1980, according to the World Health Organization. The international health watchdog also estimates that 500 million people on Earth are obese, or about 7% of the total human population. 
  11. Approximately 65% of the world's population now lives in countries where obesity and overweight health risks kill more people than underweight health risks. That figure includes every high-income nation, most middle-income nations, and -- perhaps more worrisome -- a growing list of developing nations. 
  12. In 1822, Americans consumed 45 grams of sugar every five days, equal to just one 12-ounce can of soda. Today, the average American consumes 765 grams of sugar every five days, or about the same amount found in 17 12-ounce sodas. 
  13. The American Heart Association recommends that the average daily dose of sugar should not exceed 9.5 teaspoons. The average adult consumes 22 teaspoons a day, with the average child consuming 32 teaspoons each day.  
  14. Harvard University has found some interesting correlations between sugar consumption and obesity. A massive 120,000-individual study found that drinking one sugary drink per day adds an extra pound of weight every four years. It may not seem like much, but it's a sneaky way to gain five hard-to-lose pounds over a 25-year period (also, see No. 15 below). Similarly, children who drink one sugary beverage each day are 60% more likely to become obese. 
  15. Researchers tracked 40,000 men for 20 years in one study of sugar consumption and health risks. They concluded that men who averaged one can of sugary beverage daily increased their risk of heart attack by 20%. A similar study in women found that regular consumption of a sugary beverage increased the risk of gout by 75%. 
  16. study by Tufts University found that 19% of restaurant foods tested contained at least 100 more calories than advertised. One item exceeded its menu disclosure by 1,000 calories. 
  17. To better help airlines model fuel costs, the Federal Aviation Administration increased the weight of an average American male from 170 pounds to 184 pounds in 2004. It might be time to adjust that once more.  
  18. A study conducted by Dr. Paul Peppard of the University of Wisconsin-Madison showed that there could be a link between obesity and sleeping disorders. Peppard believes that as many as 5 million people in America could have sleep apnea caused by obesity.  
  19. The key to understanding obesity may lie in our DNA. A recent study featured in the International Journal of Obesity that evaluated 2,269 children found that children who are more genetically similar to each other were also more similar in body weight. Most importantly, the study concluded that additive effects of multiple genes could account for up to 30% of the variance of childhood body weight. Previous studies had only been able to account for 2% of this variance. 
  20. In 2012, Belviq and Qsymia became the first two weight-loss drugs to be approved by the Food and Drug Administration in more than 13 years.  
  21. Half of patients taking Belviq every day for 12 weeks saw body weight drop by at least 5%. For an adult who is 5'11" and weighs 215 pounds, that equates to 11 pounds.   
  22. Despite big expectations for Qsymia, sales have stumbled out of the gate. The drug raked in just more than $4 million in the first quarter. By contrast, VIVUS had to write off $5.8 million in expired inventory.
  23. Fellow Fool Brian Orelli points out several reasons for muted enthusiasm of obesity drugs. Three previous weight-loss drugs -- fen-phen, Meridia, and Acomplia -- were infamously yanked from the market after serious health risks were discovered post-marketing.
  24. In post marketing studies, fenfluramine (the "fen" in "fen-phen") was shown to bind to serotonin 2B receptors and cause potentially fatal heart valve damage. The finding led to the drug's removal from the market, a $13 billion lawsuit, and the current wariness about obesity drugs.  
  25. Luckily for patients, Belviq has been show to selectively bind to serotonin 2C receptors, which are not associated with the same dangerous health concerns of serotonin 2C binders. Long-term data will likely be needed before doctors feel comfortable that the drug does not pose significant danger to patients. 

As you can see, it is always a good idea to investigate the facts behind accepted generalities. This list should help investors realize that obesity is truly a complex health problem that also represents a huge opportunity for Arena and VIVUS. Both companies certainly have their work cut out for them when it comes to successfully marketing their weight-loss therapies -- and true success could take years.

Editor's note: A previous version of this article incorrectly stated that adding one sugary drink per year (instead of one per day) added an extra pound of weight every four years. The Fool regrets the error.

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Read/Post Comments (19) | Recommend This Article (37)

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On May 18, 2013, at 9:17 AM, obobo wrote:

    how about some medical facts from an experienced nurse?

    1. if you have surgery your wounds take way longer to heal and they may open up because it's hard to stitch fat together

    2. you will develop hip, knee, ankle and foot problems from putting to much weight on those joints

    3. very, very high risk of developing stroke, heart attack or diabetes. even if you don't smoke or drink (if you do those things, then shop for a coffin)

    4. 'stomach surgery' is no guarantee you'll be skinny forever. lots of people who have surgery for this end up gaining it all back

    5. you're gonna get stuck on a toilet someday and have to call for help

  • Report this Comment On May 18, 2013, at 10:27 AM, Bubba49 wrote:

    The increase in obesity is directly tied to the ascension of technology increased, so does obesity. But if you prefer to do things the "old fashioned way", you are labeled as out of touch with today's world, and in business, thats not always a good thing.

  • Report this Comment On May 18, 2013, at 11:25 AM, mordowney wrote:

    An important factor that your article overlooked is that primary care physicians know very little about obesity, provide very little obesity counseling and often display very stigmatizing attitudes to patients with obesity. Further, they make very few referrals to obesity medicine specialists or to bariatric surgeons even when their patients would qualifiy for treatment with drugs or surgery. This resistance to pharma treatment by primary care docs will need to be overcome for new products to succeed.

    Morgan Downey, Editor,

  • Report this Comment On May 18, 2013, at 11:38 AM, dsk59 wrote:

    I have asked my doctor for the qsymia but I just get the diet and exercise speech. I believe doctors are very hesitant about giving out these drugs. At least mine is.

  • Report this Comment On May 18, 2013, at 11:47 AM, yermamma wrote:

    Although fenfluramine was shown to bind to serotonin 2B receptors and cause potentially fatal heart valve damage, that is because the 2B receptors are found not only in the brain and spinal cord, but also in heart valves. What many people don't realize about BELVIQ is that not only does it not bind with 2B reeptors, but the 2C receptors for which it has an affinity are only found in the CNS and not in heart valves or tissue. Eisai, the marketer of BELVIQ, as well as AcipHex ($828M in sales) and developer of Aricept $950M) and partner for Humira ($4.3B) and Lyrica ($1.9B) projects at least $200M in sales by the end of March of next year and $9.6B by 2016 (4M users x $200/mo x 12 mos)

  • Report this Comment On May 18, 2013, at 11:52 AM, peggylugray wrote:

    If your doctor is hesitant to prescribe any, repeat, ANY drug, thank them. Diet and exercise, unfortunately, are the safest and most SUSTAINABLE way to lose weight. - please, taking a drug & losing 5lbs at what cost? When you stop the drug, what happens? The body you have today is the only body you are going to get. Love it, learn to live with it in a sustainable way.

  • Report this Comment On May 18, 2013, at 6:52 PM, Chaz13 wrote:

    Peggy, way to get the plug in for your massage therapy business. Every story has a happy ending....

  • Report this Comment On May 20, 2013, at 12:57 PM, maureenaba wrote:

    As the author correctly states, obesity is a complex health issue. It is influenced by many factors, including age, genetics, stress, and physical inactivity). However, assigning blame to one specific product or ingredient (such as soft drinks or sugar) is counterproductive and not based in science. Also, the Institutes of Medicine state that when it comes to the risk for heart disease, there is nothing unique about the calories from added sugars or sugar-sweetened soft drinks.

  • Report this Comment On May 20, 2013, at 6:41 PM, Zombie111 wrote:

    Soft drinks and sugar are not the only factors but they are full of empty calories and also highly profitable for the manufacturers. We really would lose very little (except weight) if we did not drink soft drinks and reduced our sugar consumption dramatically. We build up a tolerance for added sweetness over time, and it takes a while to adjust to what unadulterated food tastes like.

  • Report this Comment On May 20, 2013, at 7:36 PM, luciastern wrote:

    Anti-obesity drugs have more side effects than heart valve problems. They cause diarrhea, and they can irritate the stomach. They may also contribute to poor absorption of nutrients from food, leading to deficiencies in vitamins and minerals. This may compound the overall ill health that an obese person may experience.

    Unfortunately it is not so simple to lose weight if you have a lot to lose. The "diet and exercise" advice neglects recent research that shows how obesity affects energy levels and appetite, and that only makes it harder to exercise and diet.

  • Report this Comment On May 21, 2013, at 9:23 AM, chickajones wrote:

    Interesting article. Might want to re-check your spelling before publishing.

  • Report this Comment On May 21, 2013, at 10:41 PM, nasis wrote:

    <<A massive 120,000-individual study found that drinking one sugary drink per year adds an extra pound of weight every four years.>>

    The correct figure is one sugary drink per day, not per year.

  • Report this Comment On May 21, 2013, at 11:10 PM, KongPL wrote:

    we have a responsibility for our bodies. we are used to delegate - the parents, the family doctor, then the drugs, then our lack of energy when being obese which is the most stupid argument. becoming obese is a process that lasts years. walk more, use the car less, stop drinking sugared soft drinks - it would be so easy with just a little bit willpower.

    And then we expect nurses or home care to deal with our 300 pound bodies when we can't move anymore. a shame!

  • Report this Comment On May 22, 2013, at 2:18 PM, mikecart1 wrote:

    Here are facts from a weightlifter and nutrition guru (along with investor of course):

    1) The problem is not food quantity, it is food quality.

    2) Every single diet expert, fitness celebrity, and nutritionist, doctor, and nurse doesn't understand it isn't how much, but what.

    3) The what I'm talking about is fat, protein, and carbs.

    4) No fat is not bad. No carbs is not bad.

    5) Calories are king so that throws out all these bogus diets you hear about when it comes to losing pure pounds (water, fat, muscles, doesn't matter).

    6) Now that you understand the 1st 5 rules, go figure out how many calories you just consumed... not at your fast food joint, but at your favorite RESTAURANT.

    7) Apparently being 'healthy' doesn't work at an Outback Steakhouse. I had house salad with ranch dressing, 9 oz house steak, sweet potato, 2 slices of quesadilla appetizer, and 3 glasses of water. I wound up eating 1900+ calories in that single meal. BOOM! There goes the 'only fast food is bad' argument.


  • Report this Comment On May 22, 2013, at 5:26 PM, XXF wrote:

    Not that there isn't an obesity problem, but if you've seen my posts you already know where this is going, the data that is used to create scary obesity numbers is intentionally poor to increase the "obesity epidemic." For the sake of an extreme example, when Arnold Schwarzenegger was competing in body building competitions with under 2% body fat he weighed about 235 lbs and stood 6'1", which equates to a BMI of 33, which is not just slightly obese, but he would have to lose 10% of his weight to no longer be considered obese in the statistics above (when he was ~2% body fat!).

    Normal people certainly aren't as muscle bound as Arnold, but when you start considering those are the kinds of inputs that go into these statistics you realize that you're basically being lied to which diminishes the discussion you can really have about the topic (just like pretending someone is getting charged 200 grand for a pacemaker, looking at you Housel). The fact is, there is a cultural problem with weight for a variety of factors, but if we aren't even going to honestly quantify the problem and discuss it like adults, but instead use hyperbole and poor or outright incorrect metrics to induce an emotional response we aren't going to get anywhere.

  • Report this Comment On May 24, 2013, at 12:44 PM, Woof19a wrote:

    I think most of the epidemic is education and (appropriate for the Fool community) the ability to think long term and stay the course.

    Data shows a good enough correlation between obesity and many diseases that I can't imagine anyone with an analytical mind would refute it.

    Once you understand the impact (like not having enough for retirement), then you can start planning. Budget your calories like you budget your retirement savings. Scrimp a little with smaller meals and bank the calories like you'd put away pre-tax dollars into 401k's.

    Once you're able to live within a smaller calorie budget, you'll start to automatically make better choices - less junk food, more nutritious food. Just like spending your leftover discretionary dollars on necessities and things you really enjoy.

    The anologies can go on, but let's face one face for the Fools. What good is a huge retirement nest egg if you're not going to be around long enough to use it?

  • Report this Comment On May 26, 2013, at 8:18 PM, cooncreekcrawler wrote:

    We are not only fat, we are lazy, greedy, entitled, and not real motivated (read stupid). There are some exceptions to this gross exaggeration, of course, and my heart goes out to them. Nothing, and I mean nothing, will take the place of discipline and exercise.

    The picture of the workers removing trees from the TVA project in the 30's that I saw during the Browns Ferry unit 1 restart convinced me. There are few fat hard workers.

  • Report this Comment On May 27, 2013, at 12:19 AM, badnicolez wrote:

    What's happened since we eliminated fat from and added sugar to our diets? We've grown fatter and fatter. Obesity has skyrocketed.

    A low-fat diet is a recipe (pun intended) for hunger, obesity and failure.

    We need to eat more fat and less carbs and sugar. A LCHF (low-carb, high-fat) diet is the way to go for no hunger.

    Eat fat if you want to lose weight. Lots of it. 80% fat, 10% carbs, 10% protein. Eliminate sugar (eat less than 5 grams per day) and starches, and stop eating vegetable oils. Eat lots of coconut oil, full-fat dairy (watch for sugar), nuts, olive oil, avocados, and other saturated fats. Eat as many vegetables grown above ground as you want every day and high-quality meat and seafood. Fat satiates while sugar stimulates the appetite. Exercise or not. Don't bother counting calories. You will lose weight.

    Look up LCHF and keto diet recipes. It's a lifestyle change, not a "diet," but you can actually stick to it the rest of your life because you WON'T BE HUNGRY! You will, however, lose weight and eliminate blood sugar spikes and the deadly fat around your middle. It's the "miracle diet" everybody's been looking for.

    The low-fat myth has been exposed for the fraud that it is. Sugar is deadly, but food and drug companies are sponsoring the organizations that give us dietary advice and big sugar is a huge lobbying group influencing government advice. Stop believing the lies and do your own research.

  • Report this Comment On June 27, 2013, at 8:02 PM, thidmark wrote:

    Doesn't everybody have to shop for a coffin?

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