With our collective eye on SCOTUS recently, many of us missed news that the FDA approved a new weight-loss drug, Belviq, the first in 13 years. For plan participants struggling with obesity, like myself, is this the magic pill we have waited for? For brokers and employers, will this be a feasible solution to combat obesity costs among employee groups? Time will tell, but the voice in my head is screaming “NO.”  Here’s why.

Observation #1

Results of clinical studies suggest that patients can expect to lose around 3 to 3.7 percent of their body weight after a year on this medication.

Implication: This medication will be recommended for folks with a BMI over 30. Let’s consider a 250-pound woman. She may lose up to 10 pounds after a year. The American Diabetes Society suggests that weight loss of 7 percent coupled with 30 minutes of daily moderate exercise produces a 58 percent reduction in diabetes. I don’t know about you, but I am unlikely to subject myself to potential side effects of medication (in this case: headache, dizziness, fatigue, nausea, dry mouth, and constipation), for a result that is only half of recommended weight loss for health improvement.

Bottom line: Too little pay-off for too much risk. The FDA’s approved labeling for Belviq even recommends that the drug be discontinued in patients who fail to lose 5 percent of their body weight after 12 weeks of treatment, as these patients are unlikely to achieve clinically meaningful weight loss with continued treatment. Given the results of the trial, I wonder what percentage of patients prescribed this medication will have their hopes dashed after 3 months.

Observation #2  

People who continued on the drug for two years were able to maintain their weight loss better than those who switched to placebo after one year.

Implication: This seems to be a “bandage” solution that does not create or support long-term behavioral changes in patients. Back in the 90s I was one of many who took the “Phen” (phentermine) component of the popular weight-loss drug, fen-phen, to lose some weight for my wedding.  I thought this pill was the best thing since sliced bread. My appetite was null, and I had a ton of energy I was eager to work off through exercise. The weight fell off… until I discontinued use after hearing that there was some connection to life-threatening heart valve conditions. I mean, I wanted to look good in my dress, but not THAT badly! Very soon after I stopped taking phentermine the weight came back, and then some. I still regret that yo-yo because it contributed to at least 20 of the extra pounds I still have to lose.

Bottom line: Given the results of clinical study, without connecting to an individual’s trigger to change (see my previous blog), this is a short-term solution, at best, and may actually add to the obesity epidemic long term. Those seriously looking to lose weight should skip the pill and get their mind in the right place to make real change.

What should brokers do?

Brokers, my suggestion is to work with PBMs to identify individuals prescribed this medication to offer additional coaching or lifestyle support to increase effectiveness, and try to develop a long-term solution to an individual’s struggle. Also, continue to educate plan participants in a variety of ways (posters, emails, newsletters, social media, videos, wellness activities, etc.), covering a variety of topics aimed at supporting healthy lifestyle changes. Something will stick and inspire.

A lot of us have spent a long time waiting for medical R&D to produce a panacea, but this is not the answer. Rather, it’s time for us to seize control of our own futures. Adopting a healthy lifestyle and losing weight is not easy, but it can be done. Let’s do it!

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