June 12, 2001-Drug folks ride the death trail of obesity epidemic
There was a poll in Fitness magazine that asked American women which they would prefer: 1) live to be 90 years old, or 2) lose 20 pounds permanently.
It turns out that 54 percent of the sample chose weight loss over longevity. Better dead than fat. Usually, I dismiss this sort of news by rolling my Eyes or by working up a good rant on the body image-makers. What more proof do we need of the pressure that also fuels the sales of cellulite creams, women's magazines and 10-pounds-in-two-days diets? But this is not just a harmless window into our weight obsession and dieting madness. In fact, women have lost their lives in the pursuit of thinner thighs. In fact, they have died dieting.
By now everyone knows about Fen-Phen. This was the infamous fat pill that promised weight loss and delivered heart and lung disease. Some 300 deaths were attributed to the pills before they were taken off the market. But then again, maybe we just think we know about it.
I first opened Alicia Mundy's book, "Dispensing With The Truth," because one of her heroes is Alex MacDonald, a friend and lawyer who had his teeth in the ankle of the fen-phen case for years. But I read on because Mundy's scorched-earth reporting and high-energy writing build a story that leaves "A Civil Action" in the dust. Mundy fingers villains who helped get and keep fen-phen on the market even after the danger was known. She strings up the Wyeth-Ayerst drug moguls by their own documents and puts a harsh spotlight on the pressured FDA officials who were asleep at the switch. But the most dismaying part of the story to me is the marketing that so successfully pegged women customers.
As Mundy deconstructs it, the drug folks didn't just ride the tale of the "Obesity Epidemic," they hyped it. "They were ginning up medical papers to convince doctors that obesity will strike you dead and that taking pills long term for dieting was a necessary thing," says Mundy. Moreover, she adds, "they knew women were susceptible. They described weight loss as an evergreen issue, a blue- chip stock."
Indeed the marketing campaign for one of these diet drugs, Redux, identified the customer as "a woman age 35-54 ... needs to lose at least 50 pounds. Pink collar. Tried everything. Weight loss view simplistic." In short, a woman who was fat and dumb.
Of course, it wasn't only -- or mostly -- obese women who lined up for the pills. Indeed the leading character in this book is Mary Linnen, a 30-year-old woman who wanted to lose 25 pounds for her wedding ... and died in the attempt.
By 1997 when they took the fen in the Fen-Phen off the market, more than 7 million patients had popped the pills and 45,000 developed serious diseases. Wyeth-Ayerst's parent, American Home Products, was the target of one of the largest and most successful tort lawsuits in American history. But even now the story isn't over. There are still more Fen-Phen cases coming down the pike. Mundy also worries about women who took the drug and don't realize they should be monitored as they get older.
More unsettling is the fact that even in the wake of this scandal, the business Mundy calls "Obesity, Inc." is flourishing. The FDA recently had to tell another drug company to stop running an ad for a weight-loss drug that didn't list the grim side effects. And a recent article in Lancet, the British medical journal, took the FDA itself to task for being a wimp agency.
No one denies that obesity is a health risk. One of the dirty, or should we say, fatty little secrets is that we're producing this health risk and exporting it. In June's Atlantic Monthly there's a report from Micronesia, where people have suddenly bulked up on our diet imports like Spam and corned beef. About 85 percent of the Micronesians between 45 and 65 have developed what the author calls New World syndrome: obesity with skyrocketing rates of heart disease and diabetes.
Oh, one footnote to Fen-Phen: It didn't even work. In studies, the people who took the drug lost only 3 percent more than those given a sugar pill. Three percent? That's three pounds for every hundred.
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