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In story about ‘latest generation’ of weight loss drugs, NBC overlooks doctors’ pharma ties

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2 Star

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Weight-loss pills can help. So why don't more people use them?

Our Review Summary

This story suggested that lingering fear from the 1990s fen-phen scare continues to drive patients away from the “latest generation” of weight-loss drugs, which, it asserted, could safely help some people with obesity lose enough weight to improve their risk factors for heart disease.

But the story didn’t give readers much information to go on. There was no data quantifying the benefits of drugs now on the market or comparing them with alternatives, such as surgery. The story also didn’t mention cost or potential harms and relied largely on quotes from two physicians who have received significant compensation from companies that make weight-loss drugs–which wasn’t disclosed in the story. It is vital that journalists disclose such details.

The story made a lot of general statements about weight-loss medications but named just one that’s on the market — lorcaserin (Belviq).

 

Why This Matters

Medications for obesity have side effects and can be expensive. Those factors should be mentioned in news coverage, which should also give specifics on the evidence.

Eight years ago we reviewed a WebMD story about the weight-loss drug lorcaserin, which is highlighted in this story. Much of what we wrote then seems to still apply:

Drug companies want a diet pill that works and that doesn’t kill people in the process. If they can create one that does, they will make a mountain of money. … The evidence that this drug is a big improvement, though, is shaky.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story mentioned cost and lack of insurance coverage as factors in the low uptake of weight loss drugs, but it doesn’t give data. The drug highlighted in the story, lorcaserin, marketed in the U.S. as Belviq, costs $285 for a 30-day supply if you pay out of pocket, according to web sources. It wasn’t made clear how long people must stay on these drugs, which also affects cost.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Th story claimed the latest generation of diet pills can help “shave off enough excess fat to improve heart disease risk factors such as hypertension, high blood sugar and high cholesterol.”

Specifically, that the drug lorcaserin (Belviq) helped “nearly” 40% of patients have sustained weight loss of more than 5% of body weight, which it said “is associated with a 50 percent lower risk of diabetes and a 10 percent loss is associated with an 80 percent lower risk.”

It also said patients in a lorcaserin study “did see improvements in hypertension and blood sugar levels with weight loss.”

When we looked up the results in a large study published in the New England Journal of Medicine, the numbers aren’t as impressive sounding:

  • 38.7 percent of people on lorcaserin maintained 5% weight loss at one year–but so did 17.4% on the placebo (with none of the risks).
  • When it came to reduction of serious medical events, like a heart attack or stroke, very little improvement was seen. For example, 227 of 6,000 people on the placebo had a heart attack compared to 225 of 6,000 on the drug. That’s a rate of 3.8% in both groups–not statistically significant.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Although the story kept referring to weight loss drugs as a group, the story focused mostly on lorcaserin, including a three-year study that showed lorcaserin didn’t increase the risk of bad heart events versus a placebo in patients at high risk of heart disease. However, the story didn’t mention side effects and uncertainty about long-term use of that drug.

An accompanying editorial to the lorcaserin study said that the drug “may best be used on a cautious basis according to the needs of individual patients,” and mentioned uncertain safety of its long-term use as well as side effects such as headache, fatigue, dizziness, diarrhea, and nausea that led some patients stop using it.

Other research has raised concern about an increased risk of depression and other side effects that might outweigh lorcaserin’s benefits.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story focused mostly on one study of lorcaserin, and did not give any other information about the evidence for other weight-loss drugs that are relatively new to the market.

The story also didn’t caution against extrapolating from weight loss to other health outcomes that may or may not be affected by the drug. Just because a pill is effective for losing weight, doesn’t necessarily mean it will also lead to reduced risk of heart attacks or diabetes (as we saw with fen-phen).

Does the story commit disease-mongering?

Satisfactory

The story accurately stated that two-thirds of Americans have obesity or overweight. It could have been clearer explaining how not everyone in this group experiences health risks, and it’s not always clear why. It also could have avoided some stigmatizing language such as “packing on the pounds” and “fatter.”

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story didn’t disclose that two physician sources, Erin Bohula and Louis Aronne, received payments in the tens of thousands of dollars in connection with weight drugs, according to ProPublica’s Dollars for Docs database.

A third physician quoted in the story, Vijaya Surampudi, has received smaller payments from Novartis that were not tied to a weight-loss drugs.

The story would have benefited from more independent sources.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story did mention diet and exercise, but did not mention weight-loss surgery and didn’t explain how weight-loss drugs stack up against other interventions.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story makes it clear that, in general, the “latest generation” of weight loss drugs are FDA approved. But it never explains which ones fall under that category. There are at least nine weight loss drugs on the market.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story described that the “latest generation” of weight loss drugs that can “pare away the pounds without harmful effect.” But it remains to be seen whether that’s in fact the case.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to rely on a news release.

Total Score: 3 of 10 Satisfactory

Comments (2)

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Ralph Allen

September 7, 2018 at 10:48 am

Exactly who is going to fund 500 million to get drugs past the FDA extensive review process? Then you imply that the doctors are getting kick backs for prescribing Belviq which is NOT true. Not all pharma is evil so get real.

Reply

    Joy Victory

    September 7, 2018 at 11:31 am

    Hi Ralph —

    This review isn’t about who should or should not pay for medical research and FDA reviews.

    It’s about a news story that:

    1. Fails to disclose conflicts of interest. The doctors interviewed in this NBC story were *directly paid* by pharma (as consultants or researchers, or fees for speaking on their behalf, etc). This is a well-known conflict of interest and should always be disclosed in news stories so readers understand which sources have a financial stake in the intervention being written about.

    2. It also fails to include comments from an independent source who hasn’t directly been paid by the drug companies promoting these drugs. Without that balance, readers only get the perspective of people who have been enriched by drug companies.

    We never said all pharma is “evil,” but we do think all drug companies need to be scrutinized closely.

    Reply