The Guardian
London, UK
23 May, 2007


Glaxo targets US minorities with launch of weight-loss drug in supersized market

• Pill aimed at grabbing slice of £500m spent every year
• Concerns over messy and dangerous side-effects

by Andrew Clark in New York

A new over-the-counter diet pill from Britain's biggest drugs company, GlaxoSmithKline, is to be specifically targeted at the high proportion of overweight people in the US's black and Hispanic communities.

At a ceremony in New York yesterday, Glaxo launched Alli - the only weight-loss treatment to be approved by the US food and drug administration for use without a prescription.

The company is hoping to secure some of the $1bn (£500m) spent annually by Americans on "quack" tablets, herbal potions and unproven laxatives in efforts to lose weight.

Glaxo is going to great lengths to reach out to minority groups by providing a Spanish-language website, bilingual materials at the point of sale and a variety of recipes for low-fat versions of Mexican cuisine and deep south-style "comfort" food.
According to government figures, 76% of black and Hispanic people in the US are overweight. Dr Valentine Burroughs, a specialist in obesity-related complaints who practices in Harlem, said: "There's a lack of recognition in minority populations of the connection between being overweight and the health complications that arise."

Dr Burroughs said a mixture of economic deprivation and cultural factors contributed to the problem: "In African-American communities, there's a cultural acceptance of the full physique - it's often preferred to the lean physique."

Historically, Dr Burroughs said, immigrant communities had access only to poor-quality foods and tended to over-season it with salt and other fatty additives. He added that first-generation arrivals who did heavy manual work developed a taste for large energy-rich helpings which they passed on to their often less active children.

Alli is a lower-dose version of a prescription drug, Xenical. It works by inhibiting the body's lipase enzymes, which break down fat in the digestive system. Tests have shown that it can increase the amount of weight lost by dieters by as much as 50%.

The drug increases the amount of fat that passes through the body unabsorbed, but unless users combine it with a strict low-calorie diet they risk unpleasant side-effects, including severe and unexpected bowel movements.

Steven Burton, head of Glaxo's weight-loss division, said that about half of users never experienced these side-effects. He cited personal experience: "I have used the prescription version of product for three years and I've had only one surprise. That was very early on and it was when I'd been very foolish with eating fatty foods."

Linda Bannister, a healthcare analyst at the stockbroking firm Edward Jones, has estimated that Alli could generate US sales of $200m annually. Glaxo intends to apply for over-the-counter approval in Britain by the end of the year.

Many obesity experts have welcomed Alli as a new weapon that could help tackle an obesity crisis, which has led to a diabetes epidemic and has put immense strain on the US healthcare system.

But Alli has its critics. The pressure group Public Citizen has called the FDA "reckless" for granting approval, saying Alli offers only marginal benefits given its side-effects. The group has raised concerns about animal trials of the prescription version, Xenical, which showed a high incidence of pre-cancerous lesions developing in the gut.

Avandia doubts

Doubts over the safety of GlaxoSmith-Kline's diabetes drug Avandia, could open up a black hole in the company's future profits of almost £1bn, analysts estimated yesterday.

The drugs company's shares slid by 19p to £13.71, bringing their two-day fall to 6.5% since doctors at an influential American cardiovascular hospital suggested Avandia could put patients at risk of heart attacks.

Citigroup forecast that sales of Avandia, which is Glaxo's second most lucrative drug, could be flat rather than rising for the next three years - wiping out £950m of the group's expected £9.9bn profit in 2010. At Deutsche Bank, the analyst Mark Purcell downgraded his advice on Glaxo shares from buy to hold. Both the US food and drug administration (FDA) and a Congressional oversight committee are investigating the issue.

The US is particularly sensitive to drug safety since a furore erupted last year over an arthritis drug, Vioxx, which was withdrawn by its maker Merck because of heart attacks. Critics said the drug should never have been approved by regulators.

Pharmaceuticals analysts at Morgan Stanley warned that the issue cast a cloud over the entire industry: "The melodramatic Senate and Congress reaction [to the Avandia study] indicates the phenomenal levels of distrust of industry and the FDA by Congress, posing a continued and significant negative dynamic for the industry."

http://www.guardian.co.uk/medicine/...2086002,00.html

Salt is a fatty additive?

Perhaps salt makes you fatter by water retention, but last I heard it was totally fat-free.

I'm not a language expert, but does Alli have some hispanic derivative meaning?

cjl

ps: Remember the old urban legend about Chevrolet. Inappropriately named, the car wouldn't sell in Spanish-speaking countries, since it was named "no va".

"with salt and other fatty additives"

Noone said salt was a fatty additive.



Next time I see black or hispanic people I'm moving FAR FAR away....lol

But I'll try This has got to be one of the dumbest ideas I've seen in quite some time! As an African-American female originally from NYC (Queens), I can't understand how they are going to get people to buy this stupid pill! I know that it may work to help overweight people lose weight, but it doesn't address the real problem: the food! When people are eating crap, a pill won't solve the problem!

As a child of immigrants from the Caribbean, I know that I was not fed crap as a child (well, i did eat cereal in the morning, but no fast food or chips or soda except as an occasional treat). I did not even eat a lot of junk food until I was in high school and able to buy the junk without my parents knowing. Even with homemade meals and little junk, I was always chubby and moved into overweight by the end of high school and obese in college. The problem was the type of food we ate: traditionally, there is always some kind of rice and bean dish, a meat dish and not a lot of fresh veggies. As we got older, my mom tried to add more veggies to our diets, but the basis of our daily menus continued to be starchy root vegetables (not potatoes) and rice and beans (and sometimes corn). This, I believe, is where the problem lies. There is a tradition of eating a lot of starches as the basis of the meal, not only in immigrant groups, but also in the U.S. African American community.

There won't be a change in weight until dietary habits change. This does not mean reducing fat and salt intake, like they try to shove down people's throats, but to get rid of the empty calories that are leading to epic numbers of diabetes and hypertension. A pill won't solve the problem. Changing our ideas about what is okay to eat is the only way to really deal with the problem.

There is also another issue to deal with. Who do they think will buy the product? At least for the people I know, they will not spend more money on medication that has little guarantee of ensuring a lot of weight loss. They already pay enough for the diabetes and hypertension medications! If they really want to target minority groups, they need to know who they are dealing with. A lot of immigrants in NYC don't look at extra weight as horrific. What may be considered overweight by medical standards is within the normal range in their eyes. And no, a lean physique is not looked down upon; it's just not held up as an ideal the way it is everywhere else. That does not mean that there is no acknowledgement about being overweight, it's just that it takes more weight before the problem is seen as a problem (hope that makes sense!).

After this long winded post, all I really want to say is that this is a retarded idea that has little chance of working in the long run. Dumb, dumb, dumb!