There Are No Magic Pills

When I heard that the FDA had approved a new diet pill, I was intrigued. Despite the many weight-loss products available at drugstores and over the internet, there are very few drugs that the FDA has approved for weight loss, and some drugs that were approved have been taken off the market because of safety concerns.

Having been through my own process of losing weight and learning how to stay healthy, I know that there is no easy fix. Having friends who have struggled with their weight, I know that there is no one-size-fits-all solution. So, I was interested to see how Belviq works.

FDA / AP

(source)

According to the prescribing information, Belviq is a serotonin 2C receptor agonist that controls appetite by binding to serotonin receptors in the brain. That could be effective if the reason that you are overweight is because you have too much of an appetite, but my own food issues stem from eating when I am tired, stressed or bored–not from excess hunger.

The prescribing information summarizes the results of three randomized, double-blind, placebo-controlled trials conducted over 1 or 2 years. In the studies, Belviq was taken twice a day in conjunction with counseling on “reduced caloric intake” and “increased physical activity” that continued every four weeks throughout the trial.

It is striking that a large number of subjects (36-50%) withdrew from each study before the first year was completed. We all know how quickly New Year’s resolutions fall to the wayside, but you would think that the extra structure of a clinical trial would keep people motivated–maybe they got tired of the study requirements.

The clinical trial data show that statistically significantly greater weight loss was achieved with Belviq, but the numbers make me wonder whether it is worth the costs and risks. The year 1 placebo-adjusted weight loss achieved in patients treated with Belvig was 3.3 kg (7.25 lbs) in a patient population with an average starting weight of about 100 kg (220 lbs). (That’s about one “week” of weight loss on The Biggest Loser!) The raw numbers showed an average weight loss of 7.9 kg (17 lbs) for the Belviq group and 3.7 kg (8 lbs) for the placebo group.  That is a big difference, but considering the starting weight of the patients and the duration of the study, I’m not sure if it’s worth it.

I have even more questions looking at the Year 2 study data.

Patients in all three Year 2 patient groups (BELVIQ Year 1/ BELVIQ Year 2, BELVIQ Year 1/placebo Year 2, and placebo Year 1/placebo Year 2) regained weight in Year 2 but remained below their Year 1 mean baseline.

Been there, done that!

The raw numbers from the Year 2 study showed an average weight loss of 6.0 kg (13 lbs) from starting weight for the 2-year Belviq group and 2.6 kg (5.7 lbs) for the 2-year placebo group.  If I were starting at 220 lbs, I’d rather end up 13 lbs lighter than 6 lbs lighter, but I don’t know if losing those extra 7 pounds is worth the costs and risks of taking a prescription weight-loss drug twice a day for two years.

The report doesn’t examine the reasons behind the weight gain in year 2. Was the drug less effective at controlling appetite? Did the patients disregard the diet and exercise counseling? If patients continued for a third year, would the weight gain continue? level off? decline again?

Belviq may offer hope to those who have given up on getting to a healthy weight. It may help people get started on a diet and exercise plan, and encourage them with weight loss results. But what the clinical trial data mean to me is that there is no magic pill. You can do almost as well with diet and exercise and you can do better if you learn to make permanent lifestyle changes that support healthy choices. But that’s just my very humble, non-expert opinion.

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12 Responses to There Are No Magic Pills

  1. Marcia says:

    Your headline says it all: There is NO magic pill. But I guess that doesn't stop people from wanting one and drug companies from trying to make one.

  2. colleen says:

    You're exactly right, there is no magic pill, I know because I've tried pretty much every pill out there. Everyones weight loss is so different and so unique to them, the only way to do it right is the hard way unfortunately.

  3. One of my biggest fears in life is that my grandchildren will have access to good health in a pill form… that they'll be able to bypass exercise, eat whatever the hell they want and then just pop a pill and everything will be fine. My second fear is having grandchildren.

  4. I agree! It's all about root causes and no pill can address those!

  5. Ryan says:

    Great post! It is scary to see that people are able to possibly lose weight from a pill. One thing I’ve found to be extremely helpful and useful as a supplement to my current diet/exercise plan is Fullbar (www.fullbar.com). Not only do their products help you lose weight, they also help you maintain your weight loss.

  6. Miss Molly says:

    AMEN – nothing is magic it is just that people don't want to work hard!

  7. I lost 110 pounds on my own–no pills, no surgery. I'm proof it can be done and I've kept the weight off for 4 years. I agree, there is NO magic pill and weight loss IS attainable without it. Don't people remember Fen-Phen?? Scary stuff!

  8. Coco says:

    I'm sure I would have tried a pill if I thought it might work, but I see studies like these and am even more convinced that you just need to eat right and exercise. At least now I've figured out how to enjoy good food and getting sweaty!

  9. Love the title! It's so true – it's all about hard work and dedication (to quote Dolvet from Biggest Loser, lol)!

  10. 100% agree, no magic pill, no magic toning shoes, etc. But, if this pill helps jump start weight loss for someone who REALLY NEEDS it, then that's great–in my opinion.
    I've bounced up and down for years, it wasn't until 2010 when I got braces and couldn't eat anything, along with marathon training that I drastically lost weight, that drastic change was a huge motivator to me, and I didn't want to regain it after all the hard work I put into it (hard work meaning the marathon training).
    Natural weight loss takes a lot of patience, and I can understand why people have such a hard time sticking to it.
    Whoa, okay, rambled here!

    • Coco says:

      I agree with your rambling. I do hope the Belviq helps people. I just hope they also address the other issues that will help them keep the weight off long term!

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