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FDA Approves First New Weight-Loss Drug In More Than A Decade

Belviq, the first new prescription drug in years to help people lose weight, is expected to be available in four to six months.
Justin Sullivan
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Belviq, the first new prescription drug in years to help people lose weight, is expected to be available in four to six months.

For the first time in 13 years, the Food and Drug Administration has approved a new drug to help people lose weight.

The FDA gave the green light to Arena Pharmaceuticals to sell Belviq, or lorcaserin generically, a twice-a-day pill that suppresses appetite and appears to affect metabolism by influencing levels of the brain chemical serotonin.

"Obesity threatens the overall well-being of patients and is a major public health concern," Janet Woodcock, director of the FDA's drug center, said in a statement. "The approval of this drug, used responsibly in combination with a healthy diet and lifestyle, provides a treatment option for Americans who are obese or are overweight and have at least one weight-related comorbid condition."

The drug was approved for obese people (those with a body mass index of 30 or more) and overweight people with a BMI of 27 or more who also have at least one weight-related health condition, such as high blood pressure, Type 2 diabetes or high cholesterol.

In studies sponsored by Arena, about half of patients taking Belviq lost about 5 percent of their body weight after a year. The most common side effects include headache, dizziness, fatigue, nausea, dry mouth, and constipation.

The FDA had rejected the drug in 2010 after a panel of experts advised the agency to give it a thumbs down because of safety concerns. Early studies indicated the drug might cause tumors in rats and possibly heart problems in people. Lorcaserin works the same way as one part of the fen-phen diet pill combination that was pulled from the market in 1997 because it caused heart valve damage.

But the company submitted new data aimed at alleviating those concerns, and the same panel endorsed approval in May. Some panel members, however, again expressed concerns about the drug's safety, especially the heart problems, as have some consumer advocates.

"Faced with this serious concern, it would be dangerous and unconscionable for you to allow the FDA to disregard the available evidence and subject large numbers of obese patients, already at risk for cardiovascular disease, to the added risk of damaged heart valves," wrote Sidney M. Wolfe of the Public Citizen Health Research Group, in a letter to FDA Commissioner Margaret A. Hamburg.

Arena will be required to conduct six additional studies to monitor the drug's safety, including one specifically designed to examine cardiovascular risks, the FDA said.

The company told Shots it doesn't yet know the price for Belviq or when it will be available in pharmacies.

Late Wednesday, Arena CEO Jack Lief said on CNBC that Belviq would cost about the same as a Starbucks venti latte in New York. TheStreet.com reported the drug is expected to be available in pharmacies in four to six months.

The agency has been under pressure to make it easier for weight-loss drugs to get to market. More than two-thirds of Americans are overweight, including about one-third who are obese.

Despite millions of dollars in research, only a handful of government-approved weight-loss drugs are on the market, and only one, Orlistat, can be used long-term. The FDA hasn't approved a new weight-loss drug since Orlistat came on the market in 1999. Although it's now available without a prescription under the name Xenical, that drug isn't all that effective and can cause unpleasant side effects, most notably diarrhea.

The once-popular weight-loss drug Meridia was pulled from the market in 2010 because of concerns about heart attacks and strokes.

In February, FDA advisers also recommended approval of Qnexa, another weight-loss drug. The FDA had rejected Qnexa in 2010 because of concerns about heart problems and birth defects.

But Vivus, maker of Qnexa, submitted additional data aimed at alleviating those concerns. In April, the FDA said it was delaying a final decision on Qnexa until July 17. Qnexa is a combination of two drugs that are already on the market: phentermine, a stimulant used for short periods to help control weight, and topiramate, which is used for migraines and seizures.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Rob Stein is a correspondent and senior editor on NPR's science desk.