Thursday, July 22, 2010

Obesity is a Disease


$VVUS is now almost a week away from taking a beating. The share price fell from the $12-13 highs to the $4-5's post the Qnexa thumbs down from the FDA's Endocrinologic and Metabolism Panel. Although the drug is effective is promoting weight loss, the panel deemed the risks too significant to ignore. A special concern was voiced about the usage in pregnancy.

The company, Vivus, remains optimistic. http://ir.vivus.com/releasedetail.cfm?ReleaseID=488784 But what else can the company do? Vivus believes it has a safe and effective product and the biopharmaceutical firm hopes that the FDA sees that Qnexa is a key product. The FDA does not necessarily have to follow its Panel's recommendations, but to not do so is unusual.

If the obesity epidemic is seen for the DISEASE it is, the view for any effective treatment is colored more rosy. Be clear, obesity is a killer and a debilitator. The mortality and morbidity are significant. Heart disease, diabetes, hypertension, hypercholesterolemia and other lipid disorders are but a small window of the over all costs of this disease. Throw in loss of productivity, family losses and disruptions and physical limitations and the Disease becomes all the more compelling.

Obesity is not a sexy disease, it has no panache or attraction. It evokes no empathy. In fact. it is a disease of weakness, a disease of lack of control. People, who don't suffer from obesity, poke fun at and mock the chubby set. Fat people are perceived as losers. To make matters worse, the obese have diminished self esteem. As a group they don't stand up for themselves. For example, the response to the put down of Qnexa was silence. If another disease with the mortality and morbidity stats of obesity were to crop up and a Qnexa like drug, with the same risk benefit profile, went up for review, would the Panel have approved it? You bet.

How many fat people were on the fifteen member FDA Panel? Is there an element of fat people discrimination? Diet and exercise are great treatments for obesity, but if they don't work for most of the obese, are they of real value? Two more fat drugs are coming up for the Panel and the FDA to review this fall. It is hoped that the Panel will change its attitude towards obesity, the DISEASE.

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