It's a wonderful time of the year: spending quality time with friends and family, and eating good food. And then it's January, and you hop on the scales and then you hop off quickly in disbelief how can it take such a short time to add so many pounds when it takes so long to lose just a few! So, what is one of the most popular New Year's resolutions. Lose a few pounds. Many of us will go through this scenario, but for many others, the few extra pounds can become a lot of extra pounds leading to obesity. As the amount of excess fat increases, so does the risk of a wide range of mental and physician complications, including cardiovascular disease, arthritis, depression, and some cancers. None of which we want for Christmas.

However, there are a couple of gifts on the way for obese patients who have been unable to lose enough weight through lifestyle modifications: Orexigen/Takeda's Contrave and Novo Nordisk's Saxenda. In fact, Contrave arrived a couple of months before Christmas in the United States, although Santa may be a couple of months late with its delivery in Europe. Saxenda, too, is likely to be a belated but much appreciated gift early in the New Year in both markets. Although neither is as efficacious as Vivus's Qsymia (only available in the United States), both drugs appear to have encouraging risk-benefit profiles, and physicians and patients, particularly those in Europe, will be keen to receive them. The emergence of these two novel therapies will boost the small obesity market, which has been limited by a lack of safe and effective therapies and tough regulatory and reimbursement environments.

Unfortunately, physicians treating obesity and patients trying to lose weight may not have such exciting holiday seasons in the near future. The obesity drug development pipeline is weak; only Zafgen's beloranib really stands out as having a future. The attrition of drug candidates in early-stage development is very high and the regulatory obstacles for obesity drugs are unlikely to diminish greatly - physicians treating obesity cannot expect to have many more treatment options in the next decade other than those already on the horizon. Bah humbug.

Tim Blackstock, M.B. Ch.B., M.Phil., is a Business Insights Analyst in the Cardiovascular, Metabolic, and Renal Disorders team at Decision Resources Group.

In-depth analysis of the obesity market, with accompanying epidemiology driven sales forecast models, are presented in Decision Resources Group's Type 2 Obesity Pharmacor, available here. A new edition of this product is to be published in December 2014.

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