Contrave Q&A: Dr. Adam Tsai Speaks on Weight Loss Drugs
Those who are trying to lose weight welcome a bit of help along the way. The FDA's latest nod of approval for that help is Contrave, a new weight loss pill meant for adults with a body-mass index of thirty or more.
Dr. Adam Tsai, Chair of the Public Affairs Committee at the Obesity Society, was gracious enough to lend his persepective on the matter. Dr. Tsai is an MD, MSCE, FACP, and a practicing Internal Physcian at Kaiser Permanente of Colorado, Departments of Internal Medicine and Metabolic Surgical Weight Management. He has published more than 50 peer-reviewed papers in clinical obesity research.
Dr. Adam Tsai Q&A
My Bariatric Life: Contrave is the third weight loss drug to gain FDA approval since 2012, alongside Qsymia and Belviq. What has impressed you so far about these prescription medications?
Dr. Tsai: Both Qsymia and Belviq have helped some patients lose a clinically important amount of weight. The cost has been the major disappointment.
MBL: What other drugs coming down the pike look promising to you?
Dr. Tsai: Liraglutide (Saxenda) is likely to be approved later this year, although the cost is going to be very high.
MBL: One of the early assumptions about weight loss drugs was that the medication in and of itself would be a successful therapy. We know now that to reduce weight, the human element is still required, and that weight loss drugs are only tools to augment habit changes around diet and exercise. Given that, do you really think such drugs can make a meaningful impact on the current state of obesity?
Dr. Tsai: Yes, the drugs can be a useful tool for some pateints to facilitate their lifestyle change. Not in all patients, but it does help some individuals.
MBL: In most patients, does the limiting time factor of use that weight loss drugs typically allow before discontinuing their use (because of side effects or reaching the limit-point of weight loss that the drug supports) allow for meaningful habit changes?
Dr. Tsai: We tell patients that drugs are required for long-term use. Qsymia, Belviq, and Contrave are all approved for long-term use so there is no time limiting factor. Typically however patients do hit a "plateau" even with medications, and we tell them that this is normal and expected, as it is the body's normal response to weight loss.
MBL: Is the research going on in pharma reflecting the reality that patients need to make significant, long-term habit change to lose weight and maintain the loss?
Dr. Tsai: Pharma trials typically use only a modest lifestyle intervention. Their interest is in showing that their drug works.
MBL: What is the current best method for instigating and supporting habit changes?
Dr. Tsai: I tell patients that the changes they make must be acceptable and sustainable long-term or else they will not keep off any weight they lose.
MBL: What role do you believe pharmaceutical companies play in supporting patient weight loss initiatives to succeed?
Dr. Tsai: The role of pharma is to develop the safest and most effective therapies available. Clinicians and patients can then decide whether it makes sense to use them.
MBL: How much do you think can be accomplished in reducing obesity and its related diseases over the next five years?
Dr. Tsai: I think this depends more on the willingness of the government to regulate the food industry than it does on pharma.
There is little to cheer about lately when it comes to weight-loss drugs. Sales have been low due in part to insurers not covering the cost of drug related treatment for obesity because of high pricing. Costs can run upwards of $200 a month.
Because weight loss drugs have been linked to heart problems in the past and withdrawn from the market, the makers of Contrave, Belviq, and Qsymia have all agreed to conduct long-term studies regarding heart safety. The results will be reported to the FDA.
For more on the subject, obesity Health Guide, Amy Hendel (aka HealthGal), weighs in with: “Are New Weight Loss Drugs the Answer?”
Living larger than ever,
My Bariatric Life