Filling the Therapeutic Gap

Published in March 2014 Issue             

There is always excitement about promising new treatments for obesity. Recently, the ASMBS was called upon to comment on emerging technologies in the treatment of obesity.

Some emerging technologies get a lot of attention in the media and consumers and potential patients often times cannot distinguish between what appears promising and what is clinically established. That's why it's important for our members to keep abreast of both journal articles and news reports so that we may guide patients to the appropriate treatment for their particular clinical situation.

ASMBS President-elect Dr. John Morton commented on the Obalon Balloon on ABC’s "Good Morning America." The show reported that the “weight-loss balloon has Americans crossing the border” to Mexico. The pill, which contains a balloon that when swallowed can be inflated inside the stomach, is currently available only for experimental use in the United States. Dr. Morton set a positive, but cautious tone, in that he reminded viewers that the pill is not a magic bullet or a permanent fix.

Dr. Aurora Pryor from the ASMBS Emerging Technology Committee also commented in an ABCNews.com story on the balloon and other technologies that hope to fill the therapeutic gaps between diet and exercise and medical therapy, and medical therapy and surgery, where the gap is quite large.

Currently, less than 1 percent of patients with severe obesity have bariatric surgery. A slightly larger percentage of patients use medications for obesity, while the vast majority turn to diet and exercise alone, which do not work for most people with obesity and severe obesity.

To close the gaps, new technologies and treatments must deliver an acceptable benefit for an acceptable risk. Not all new treatments must result in 70 percent or more weight loss to be deemed successful. Even modest weight loss can help improve patient health and many patients and health professionals are willing to accept less weight loss for less risk. Also, lower risk treatments may attract patients who would otherwise go untreated.

We are excited by the prospects of new technologies and treatments that offer new hope to those struggling with the disease of obesity, but it is critical to generate high quality evidence in peer-reviewed journals to clearly demonstrate the risk/benefit ratio. This will enable patients and health professionals to make more informed decisions about which treatments can meet their goals and when. Only innovation backed by evidence can help us close the therapeutic gaps and treat more patients with obesity.