It’s a paradoxical situation. Despite the growing numbers of obese, weight loss medications hold lean chances of success.

At a time when the World Health Organisation (WHO) statistics say the number of obese adults, globally, would rise from the present 400 million to 700 million by 2015, potential for weight loss pills should be bulky.

Estimates by Decision Resources, a leading pharmaceutical advisory firm shows that the market for obesity drugs would grow five-fold from $478 million in 2006 to $2.7 billion by 2016.

But unlike other lifestyle therapeutic areas such as diabetes, heart diseases, cancer, where the number of patients is directly proportional to growth potential for medicines, in the case of obesity, the situation is different.

Multiple issues ranging from poor effectiveness to side effects have rendered obesity medications a not so appealing territory for patients.

In India, where over 16% of the adult population falls in the obese category, the two weight loss medicines—Orlistat and Sibutramine are witnessing a decline in sales.

The effectiveness of both is ‘moderate’ say healthcare experts, with the dagger of side effects looming directly overhead.

Recently, the United States Food &Drugs Administration, world’s foremost medicines monitoring agency, issued new safety information concerning Orlistat to include risks of liver injury.

Orlistat also causes abdominal discomfort, while Sibutramine is associated with a rise in blood pressure, said Rajeev Chawla, diabetologist, North Delhi Diabetes Centre.

“Sibutramine is not very safe for people with heart problems, hypertension, etc as it can increase blood pressure,” said Ajay Aggrawal, senior consultant, endocrinologist, Saroj Hospital and Heart Institute in New Delhi.

Drugmakers such as Ranbaxy, Torrent Pharma make Orlistat, while Sun Pharmaceuticals, Torrent Pharma, amongst others, market Sibutramine in India.

A year and half ago, another slimming medicine—Rimonabant was withdrawn from several countries due to side effects such as suicidal tendencies.

“Its also a myth that by merely popping these pills, weight would reduce. They have to be coupled with dietary changes and exercise. The prescriptions for slimming pills are therefore tapering out,” said Chawla.

Moreover, patients don’t lose more than 5-10% of their body weight by using them, say experts. “There is also a tendency to regain weight after stopping medication,” said Aggrawal.

Also, these medicines work in only 70-80% of patients.

Muralidharan Nair, partner-life sciences practice, Ernst &Young, said medicines wont have much efficacy if they don’t address the root cause of the problem, in case of obesity, it very often being genetic factors.

Furthermore, obesity drugs are given only to severely overweight, those with a body mass index (BMI) above 25.

“But for those whose BMI is more than 40, bariatric surgery is advised as the pills will produce minuscule effect. So though the obesity numbers are rising, the target audience for this category is limited,” said Chawla.

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