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

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 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 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.