“That was filmed in the morning and when I went to my office, within an hour later I got a phone call from a senior executive at Wyeth who saw the Today piece and was very upset. He warned me against ever speaking to the media again about his drug, and said if I did, some very bad things would start happening, and hung up the phone,” Rich said.
The Wyeth executive concerned has denied Rich’s version of events. However, once legal liability cases began, evidence emerged from internal documents that Wyeth knew of far more cases of pulmonary hypertension than had been declared either to the FDA or to patients. Redux was taken off the market and Wyeth set aside US$21.1 billion for compensation. The company has always denied responsibility.
With Wyeth out of the game, obesity was now an open door for other drug companies.
British giant GlaxoSmithKline (GSK) found its antidepressant, Wellbutrin, had a handy side effect — it made people lose weight. Blair Hamrick was a sales representative for the company in the US tasked with getting doctors to prescribe the drug for weight loss as well as depression, a move that would considerably widen its market and profitability. In the trade, this is called “off-labelling.”
“If a doctor writes a prescription, that’s his prerogative, but for me to go in and sell it off label, for weight loss, is inappropriate,” Hamrick said. “It’s more than inappropriate — it’s illegal; people’s lives are at stake.”
GSK spent millions bribing doctors to prescribe Wellbutrin as a diet drug, but when Hamrick and others blew the whistle on conduct relating to Wellbutrin and two other drugs, the company was prosecuted and agreed to a fine of US$3 billion, the largest healthcare fraud settlement in US history.
Drug companies had attempted to capitalize on obesity, but their fingers got burned.
Still, there was a winner: the food industry. By creating diet lines for the larger market of the slightly overweight, not just the clinically obese, it had hit on an apparently limitless pot of gold.
There now exist two clear and separate markets. One is the overweight, many of whom go on endless diets, losing and then regaining the weight, and providing a constant revenue stream for both the food industry and the diet industry throughout their adult lives.
As former finance director of Weight Watchers Richard Samber put it to me: “It’s successful because the 84 percent [who can not keep the weight off] keep coming back. That’s where your business comes from.”
The other market is the genuinely obese, who are being cut adrift from society, having been failed by health initiative after health initiative from government.
As Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University explained, the analogy must now be with smoking and lung cancer.
“There’s a very clear tobacco industry playbook, and if you put it next to what the food companies are doing now, it looks pretty similar. Distort the science, say that your products aren’t causing harm when you know they are,” he said.
The solution to obesity could follow the cigarette trajectory too, Brownell said. It was only after a combination of heavy taxation (price), heavy legislation (banning smoking in public places), and heavy propaganda (warnings on packets; an effective, sustained antismoking advertising campaign; and most crucially, education in schools) was brought to bear on a resistant tobacco industry that smoking became a pariah activity for a new generation of potential consumers, and real, lasting change took place. Similar measures could provide an answer to obesity, Brownell said.