COMMENTARY

Advances in Obesity Management: 2014

Fatima Cody Stanford, MD, MPH

Disclosures

December 11, 2014

In This Article

Obesity Treatment Arsenal Grows

In September, the US Food and Drug Administration (FDA) approved Contrave® (naltrexone hydrochloride and bupropion hydrochloride extended-release tablets) as a treatment option for chronic weight management along with a reduced-calorie diet and physical activity.[7] This is the first new weight loss medication since the 2012 approval of Qsymia® (phentermine/topiramate extended-release)[8] and Belviq® (lorcaserin hydrochloride).[9]

Sales of the latter two drugs have been lower than expected, but many experts agree that additional tools are needed to treat persons with obesity, who represent about one-third of the adult US population.

The effectiveness of Contrave was evaluated in multiple clinical trials that included about 4500 patients who were overweight or obese. All patients received lifestyle modification that consisted of a reduced-calorie diet and regular physical activity.[7]

The FDA cleared the drug for use in adults with a BMI of 30 or higher and adults with a BMI of 27 or higher with one or more weight-related conditions, including hypertension, type 2 diabetes, or high cholesterol.

In March, the federal Office of Personnel Management, which governs federal employee health benefits, announced that federal insurance plans may not deny coverage of FDA-approved weight loss medications. The announcement noted that obesity could not be considered a "lifestyle" condition or that weight loss treatment was "cosmetic."[10] This bold move by the US federal government may lead commercial insurance providers to offer to cover weight loss medications in their plans.

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