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Prescription Politics

Prescription drug making, and specifically the manufacture of weight-loss drugs, is a huge, growing, and extremely profitable industry. Unfortunately, the profit motive may get in the way of the best research and the best regulation.

The Redux and Fen/Phen fiasco is a good example of this problem. Redux (a component of Fen/Phen) was approved for use as a weight-loss drug despite evidence of serious increased health risks [The Council testified against the drug at its pre-approval FDA hearing]. Millions of prescriptions were written before doctors noticed serious and sometimes fatal problems with patients' heart valves. Redux was taken off the market.

If a regulatory agency has a bias against large people, and a basic prejudice in favor of weight loss at any cost, they may approve drugs that are less than safe, or less than effective. Our Medical Advocacy Project points out those biases, and argues for applying the standards of safety and effectiveness to all drugs, including diet pills.

The Council's Medical Advocacy Project is represented on important committees, task forces, and working groups connected with the NIH (National Institutes of Health), the FDA (Federal Drug Administration), and the FTC (Federal Trade Commission. Project Director Lynn McAfee has also established dialogues with pharmaceutical companies and research teams.

In a study by Consumer Reports magazine, dieters felt more customer dissatisfaction in weight loss programs than in any comparable service program. The Council has been working with the FTC and other advocacy groups to try to work out a way to protect consumers from diet fraud. In looking through diet ads, the FTC found that more than half of them give misleading or false information. Medical Advocacy Director Lynn McAfee spoke at the FTC's press conference announcing guidelines of proper business practices for weight-loss companies. Unfortunately, those guidelines are only voluntary, so the public still has no official protection from fraudulent, unethical, and fictitious weight-loss claims.

We have been advocates for large people in negotiations with The FTC and major diet companies. We have not yet been able to make the regulations mandatory, but we are part of a coalition working to get weight-loss programs to disclose professional credentials, program costs and long-term outcome. The first two of these goals is now part of a voluntary disclosure agreement, and we are working on the accountability for long-term success rates at keeping off weight lost. The good news is that the Council's Lynn McAfee was quoted extensively in news stories about the guidelines. Consumer advocates like CSWD have become a force to be reckoned with.

McAfee has been organizing the effort to get drug companies to change their advertising and promotional materials in small but important ways. One company has agreed to stop using "Before and After" photographs. These photographs have long been criticized for the false impressions they give. They imply that one must take that drug in order to become a smiling, active, popular person, when the fact is that anyone can look glamorous if enough attention is given to dress, makeup, hair, lighting, and photography.

You may have seen ads on TV for a new diet drug called Meridia. Our Medical Advocacy Project convinced the drug's manufacturer to show several sizes of large people, and to show them as happy, active, and health-conscious. This drug usually results in a few pounds lost, and must be taken for life, so it makes more sense to advertise it with plus-size women than with bikini models playing beach volleyball.

Currently known weight loss drugs will not turn a fat person into a thin person, but it is possible that some might have a place in medical treatment for obesity when there are serious complications. We have yet to see a new weight-loss drug that is reasonable effective, and so far all the new drugs have serious side effects. But with the money waiting to be made, we can count on drug companies to be doing the research. We must ensure that they are studying the biology of body size, and how and why people gain, lose, and regain weight. It is not enough to look for quick fixes.