Tabletten gegen Adipostas

Wird bald die Adipositas mit Tabletten behandelbar?

Drug Makers Race to Cash In on Nation's Fight Against Fat

By STEPHANIE SAUL

New York Times, published: April 3, 2005

OBESITY INC.

Wanted: A Magic Pill

“ … Many drug makers, too, are seeking that magic pill. From pharmaceutical giants to tiny start-ups, the industry is spending billions of dollars developing obesity drugs. An estimated 200 possibilities are now in the research pipeline or under test among patients at dozens of clinics like L-Marc, according to MedMarket Diligence, a health care research firm.

Some drug makers say they are tackling fat in response to public health warnings of a national obesity epidemic - one that has been linked to diabetes, heart disease and other conditions and now accounts for more than $100 billion of the United States' $1.8 trillion annual medical bill. The obese are defined as those with a so-called body mass index of 30 or more. By that measure, obese people now make up one-third of the adult population.

But many drug industry analysts see a potentially even bigger market if such a drug also catches on among the more than 60 percent of adults in this country who are statistically overweight, those with a body mass index of 25 or more. Many experts also see a likelihood - some would say danger - that such a drug might appeal to millions who are by no means fat but would like to drop a few pounds.

"Everybody is just foaming at the mouth to make money" from obesity drugs, said Dr. Donna Ryan, an obesity researcher affiliated with Louisiana State University, which has received millions of dollars in government and drug-industry grants.

Industry forecasters say that an effective weight-loss drug could have annual sales far surpassing the current best-selling drug, the cholesterol treatment Lipitor, which reached $12 billion last year, especially now that Medicare says it will pay for "effective" obesity treatments.

Some experts caution that the complex variables of culture, environment, genetics and lifestyle that contribute to obesity may defy a mass-market solution. "One pill fits all doesn't seem like an outcome we'll be seeing on the horizon anytime soon," said Dr. Julie Gerberding, the physician who directs the federal Centers for Disease Control and Prevention.

But most of the biggest drug makers feel financially compelled to stay in the hunt. As it becomes more and more difficult to identify blockbusters, many companies see few other prospective best sellers in their research pipelines.

One of the most closely watched weight-loss treatments in late-stage clinical trials is Acomplia, made by Sanofi-Aventis, based in Paris. It works by blocking the same pleasure receptor in the brain that responds to the effects of marijuana. Test patients who took the drug for two years lost an average of 16 pounds, the company said. Sanofi-Aventis is expected to seek Food and Drug Administration approval for Acomplia by this summer.

Other approaches include a weight-loss nasal spray that a biotechnology company, Nastech Pharmaceutical, is testing in partnership with Merck. The spray contains a synthetic version of a human protein that signals a person's brain to stop eating when food reaches the intestines.

"Cures" for fat, of course, have long been staples of the herbal supplement and over-the-counter medicine businesses, as well as the diet industry. Amphetamines were widely used as diet pills in the 1950's and 1960's, before physicians recognized their addictive effects. More recently, amphetamine-like substances have been sold as over-the-counter treatments.

And the fen-phen prescription drug combination was popular during the mid-1990's, until it was found to damage patients' hearts. Indeed, the $21 billion that Wyeth estimates it will cost to settle legal claims related to fen-phen serves as a cautionary tale for any drug maker tempted to put a fat pill onto the mass market.

So might the reaction against another diet drug already on the market, Meridia, made by Abbott Laboratories , which has been linked to elevated blood pressure. Public Citizen, the consumer group, has asked for its withdrawal and an F.D.A. official listed it among five drugs that the agency needs to review.

Another currently approved diet drug, Xenical, by Roche, is considered safe and helps patients lose weight, but people often discontinue its use because of its embarrassing side effects: fatty stools and flatulence.

Despite the industry's risks, some medical experts worry that drug makers' big investments in obesity research will prompt companies to seek the broadest possible payback through the same type of aggressive promotion to doctors and consumers that helped turn the arthritis drugs Celebrex and Vioxx into widely prescribed general painkillers. Those drugs were taken by tens of millions of people before their safety risks became clear.

Dr. Donald A. Bergman, a Manhattan endocrinologist, predicts obesity drugs will end up being overprescribed and abused. "Some people are going to want to take them to get ready for an engagement, a TV appearance, whatever," he said. "Some people are going to take advantage of the system. …

Obesity Inc.

Articles in this series will periodically examine causes, costs and possible cures for obesity, one of the nation’s major preoccupations. An audio report by Stephanie Saul and additional photographs are online at nytimes.com/business. …”

Quelle: New York Times, published: April 3, 2005

Kommentar aus der Sicht der Chinesischen Medizin:

Nach diagnostischen Kriterien der Chinesischen Medizin findet man bei der Adipositas am häufigsten eine Schwäche des Milz-Pankreas, die meist zu vielfältigen Stagnationen der Lebensenergie führt. Diese Störungsmuster kann man mit Akupunktur, Moxibustion, Qi Gong oder mit Heilkräutern erfolgreich behandeln. Eine Ernährung nach den fünf Wandlungsphasen ist sehr hilfreich. Patienten mit suchtartigen Verlangen nach Essen kann man mit Hilfe von Ohrakupunktur helfen.

Schwäche des Milz-Pankreas-Qi, bzw. des Yang sind die häufigsten Störungsmuster, die bei Magen-Darm-Erkrankungen vorkommen. Diese Syndrome der chinesischen Medizin sind gekennzeichnet durch mangelhafte Verdauungsfunktion, also durch eine Maldigestion bzw. Malabsorbation. Bei ausgeprägten Formen werden unverdaute Nahrungsreste mit dem Stuhl ausgeschieden. Man findet als Kardinalzeichen Zahneindrücke in der Zunge, die häufig auch vergrößert sein kann. Weitere wichtige Symptome sind Völlegefühl bzw. Druckgefühl im Abdomen, Blähbeschwerden, Appetitmangel oder Heißhunger, oft auch weiche, wenig geformte Stühle. Häufig neigen die Patienten zu geringfügigen, teigigen Ödemen sowie zu einer Schwäche des Bindegewebes mit Uterus- oder Analprolaps und zu Adipositas.

Neben diesen häufig vorkommenden Schwächestörungen des Milz Pankreas Systems sind auch Blockaden im Fließen des Qi mit Fülle- und Hitzestörungen häufig zu diagnostizieren, z. B. bei Gastritis, Ulzera, irritablem Kolon. Bei Appetitstörungen, Übelkeit, Brechreiz und Erbrechen ist der normale Fluss des Qi umgekehrt, man spricht auch vom aufsteigenden Qi.