New Data Shifting Attitudes on Obesity Treatment

The response to new data on obesity treatment — published today in the New England Journal of Medicine — gives us some flicker of hope that attitudes about obesity treatment are shifting. The publication is the 56-week pivotal safety and efficacy study of liraglutide for treating obesity.

Xavier Pi-Sunyer and colleagues found that most (63%) of the people taking liraglutide lost at least 5% of their initial body weight and that a third of them lost at least 10%. And in this study of 3,731 people with obesity, they found a safety profile largely consistent with the safety seen for liraglutide in treating diabetes.

But the real news here is in how this new data is being processed by people at arms length from the study of obesity. The study was published along with an editorial commentary that was shockingly reasonable. Elias Siraj and Kevin Jon Williams, both respected endocrinologists from Temple University, conclude that while “liraglutide is no cure,” this study provides some encouragement that “modest weight loss may now be easier to achieve.”

Why is this news? Just a year ago, in JAMA Internal Medicine, the editorial commentary on the first two new obesity medicines approved by FDA in more than a decade was much more dismissive. “Based on the information that is currently available, the 2 new weight-loss drugs look like slim pickings,” said Steven Woloshin and Lisa Schwartz of Dartmouth. They were speaking of phentermine-topiramate and lorcaserin, the first new obesity drugs approved in more than a decade by FDA.

The study published in NEJM today is clearly of a very high quality. Nonetheless, similar efficacy had been demonstrated for phenteramine-topiramate and lorcaserin. The real difference is the subjective bias evident in last year’s commentary that is absent in the NEJM.

It’s good to see that new data can help to sweep away some old biases.

Click here to read the study and here to read the editorial in NEJM.

Shifting, photograph © Brandon Morse / flickr

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