THE IDEA of introducing chemicals to your brain in order to tell yourself you aren't hungry seems like science out of control. But a new slimming drug, sibutramine - marketed in the UK as Reductil - has just come on the market that does just that, and doesn't use amphetamine-like drugs to suppress appetite. And, most importantly, it's now available on the NHS.
Is this a recognition that obesity is a problem big enough to merit action? Recent statistics suggest that it is. Currently, around 20 per cent of the population in England and Wales are obese. The NHS spends pounds 50m per year on treating it, yet, by 2030, as many as 50 per cent of people may suffer from it.
The approval, on Wednesday, of sibutramine by the National Institute for Clinical Excellence (NICE) means that within three years, the NHS will spend a further pounds 19.2m on obesity. With this move, Britain is following the lead of the United States. In 1997, the Food and Drug Administration (FDA) approved the use of sibutramine, manufactured by Knoll - who also manufacture the UK version - under the name Merida. Sibutramine suppresses hunger by inhibiting the neurotransmitters norepinephrine and serotonin, and promotes significant weight loss within short periods of time. NICE is quick to underline its approval with certain caveats. It insists that it must be used in conjunction with a healthy diet and exercise, and that only patients who have already made "serious attempts" to lose weight can be treated. In other words, sibutramine is being pushed as a "contribution", not a quick fix, and only those who have a body mass index (BMI) of 27.0kg/m2 or above and who suffer from other significant diseases can apply for treatment.
The last clause is an interesting one. Obesity is now recognised not simply as a problem with aesthetic or emotional consequences, but as having serious ramifications for the development of potentially fatal disease. It is not a coincidence, for instance, that 80 per cent of those who suffer from type 2 diabetes are obese.
Simon O'Neill, head of Care Developments Diabetes UK, underlines that it is obesity that causes diabetes, not vice versa: being overweight impairs insulin levels, which in turn control the amount of glucose. When this is affected, diabetes occurs.
"One million people have type 2 diabetes in this country," says O'Neill, "and a further one million have it but don't know. Worldwide, it's an epidemic."
And weight is a major cause. …