Although cancer and heart disease may garner a significant portion of researchers' attention, obesity is a growing problem.
According to estimates from the Centers for Disease Control and Prevention, more than one in three people in the United States is considered obese based on body mass index readings. An additional one-third are also considered overweight. A BMI above 30 is considered "obese," while a BMI of 25 to 29.9 is classified as "overweight."
Carrying around extra weight might not seem like a problem, but having a high BMI can lead to a number of complications over a person's lifetime. These include a higher risk of heart disease, cancer, stroke, type 2 diabetes, and a number of other serious diseases. It's for this reason that regulators have taken a proactive approach to educating consumers about the high importance of eating right and exercising, as well as passing along these finer points to America's youth.
Unfortunately, this message appears to still be missing the mark.
Obesity rates take a disappointing turn
According to a Gallup poll released this past week which interviewed more than 167,000 people, 27.7% of respondents are now considered obese, up from 27.1% of respondents in 2013 and 2.2% higher than 2008 when the Gallup-Healthways Well-Being Index for obesity was first introduced. An additional 35.2% of respondents are classified as overweight, down modestly from the 35.7% reported last year.
More concerning is that the number of American adults being categorized as morbidly obese is on the rise. In 2008, when the survey was first conducted, just 3.4% had a BMI of 40 or higher. In 2014, this figure had jumped to 4%, the highest on record for Gallup-Healthways.
When broken down into various demographic groups, the greatest obesity rate increase observed since 2008 was among seniors aged 65 and up (4% increase) and in pre-retirees aged 45 to 64 (3.5% increase). While there's certainly no concrete answers as to why obesity rates rose once again, Gallup proposes that high consumer well-being plays a key role. In other words, as the economy continues to rebound and Americans are left with more money in their pocketbooks, they're able to afford higher-priced and potentially more fattening foods.
An unprecedented number of solutions
Educating the public about the dangers of obesity is one possible solution to lowering obesity rates in America. However, the magnitude of the disease leads to the very real idea that pharmaceutical solutions may be necessary to reverse this worrisome trend.
What's truly remarkable is that we've witnessed the approval of four weight control management drugs and devices just since 2012 after going more than a decade without any new weight control innovations. There's also a fifth solution in development that could revolutionize the way physicians treat obesity by the end of the decade. Consumers have more choices than ever when it comes to adjuvant weight-loss solutions -- the big question is whether or not physicians will prescribe, and consumers will buy, these products.
Five products to battle obesity
In terms of pills, the Food and Drug Administration has approved three since the summer of 2012: VIVUS' (VVUS) Qsymia, Arena Pharmaceuticals' (ARNA) Belviq, and most recently Orexigen Therapeutics' (NASDAQ: OREX) Contrave. As you probably figured, each offers its own unique benefit.
Qsymia, for instance, led to the greatest percentage of weight loss in phase 3 trials of the three. Arena, on the other hand, offered a considerably better safety profile relative to Qsymia. Contrave's weight-loss ranked below Qsymia in clinical studies on a percentage basis, but it's also in the process of completing a long-term cardiovascular outcomes study. This landmark safety study demonstrated in an interim analysis that Contrave is safe, potentially making Orexigen's therapy the go-to weight control management drug when all is said and done.
Although Contrave was recently approved and may wind up being quite successful, the proof has been in the pudding for some time now with Qsymia and Belviq. And by that, I mean consumers and physicians aren't buying these products as much as estimates originally projected they would. After two years on pharmacy shelves, Qsymia's annual sales run rate is just $50 million, while Belviq's annual sales run rate after a little more than a year is a better, but still disappointing, $67 million.
Two additional products that really have an opportunity to make an impact are EnteroMedics VBLOC vagal blocking therapy and Zafgen's (ZFGN) experimental pill beloranib.
Both products are intriguing because they're a clear departure from the treatment pathway of the three aforementioned pills. VBLOC is an implantable device that controls a person's feelings of hunger and fullness by intermittently blocking the vagus nerve. In clinical studies, the device was shown not to interfere with food absorption, and it's completely reversible at a later date. In studies, it led to a 24.4% excess weight loss after just one year.
There are, however, two big hurdles for VBLOC moving forward. First, EnteroMedics is just a microcap company and really doesn't have the cash to quickly launch a new product. Also, it remains to be seen if insurers are going to be willing to cover a device that costs $15,000 to $30,000. If they won't, EnteroMedics' sales will likely be limited to those affluent enough to pay out of pocket.
Now Zafgen's beloranib is really interesting. Instead of controlling your feelings of hunger and fullness, beloranib is designed to regulate your production of fatty acids. It's a completely different pathway that could hold substantial promise in fighting obesity, but it's also three to four years away from pharmacy shelves at the earliest, assuming approval.
Hopeful, but cautious
Personally, I remain hopeful that one or more of these five products can make an impact on people's lives, especially those who are most in danger of complications associated with obesity. But I also remain a realist in that insurers have to be more willing to cover these products, physicians have to be more willing to prescribe them, and consumers have to make a conscientious effort to live a healthy lifestyle. As a consumer, I can see a time in the near future when obesity rates level off or even drop, but as an investor I'm remaining skeptical of the weight control management sector, at least over the next few years.