The Perils of Consumer-Directed Medication Marketing

How often does it come to our attention that things are not exactly what they seem?

Let’s consider the recent launching of a nationwide media campaign to shed light on binge eating disorder (BED). Using well-known and probably well paid spokespeople, such as international tennis star Monica Seles, these public service advertisements are supposedly designed to increase awareness of BED, provide much needed education and help people get the treatment they require.

An informative website has even been established to assist in this effort. Keeping in mind that BED is the fastest growing eating disorder in the United States today, how could this campaign be anything but very positive?

Now, let’s consider the recent and very rapid approval of lisdexamfetamine dimesylate, which goes under the brand name of Vyvanse, to treat BED by the United States Food and Drug Administration (FDA). It is important to note that this drug, a product of Shire, is not new. Historically, it has been used to treat attention deficit hyperactivity disorder (ADHD). In this capacity, it has proved highly lucrative. In 2014 alone, sales of Vyvanse reached 1.5 billion dollars.

Another interesting occurrence is that within days of approval, Monica Seles began visiting medical centers and patient advocacy groups. Allegedly this was to increase awareness of the condition, but in all likelihood based on who is paying her, it was to strongly promote using Vyvanse in the treatment of BED.

Now, let’s look at the relationship between the media campaign and the drug approval. Not only is Shire paying Monica Seles, and other celebrities, but by and large, they are funding the campaign. They are even donating money to popular non-profit eating disorder organizations to get them to jump on the drug bandwagon. The mission of these organizations is to increase awareness and prevention of eating disorders, NOT to promote Shire’s pharmaceutical products.

This is a calculated strategy that the drug company has used in the past, namely with ADHD. First the drug manufacturer embarked on a campaign designed to “help” people who struggled with ADHD by creating awareness, de-stigmatizing the illness and assisting them to get the medication they needed.

Isn’t it intriguing that the medication they would seek and ultimately receive was either Vyvanse or Adderall, a pharmaceutical drug produced by Shire? And what a success this strategy has proven to be. Sales of Adderall remain in the billions.

Shire has been cited and fined by federal officials for inappropriately marketing their products; clearly this hasn’t slowed them down in the least, since this is the strategy currently being used to market Vyvanse. The steps are as follows: awareness of the disorder is created through a widespread media campaign, the drug achieves approval, a consumer direct marketing campaign is launched, and people flock to doctors for a prescription. Additional sales of Vyvanse are expected to reach between 200 and 300 million dollars.

But here is the problem: all obese people do not struggle with BED. In fact, of those who are seeking treatment for obesity, only 7 to 10% meet the clinical criteria for BED. But now, due to the “helpful” website, it is likely that more obese people will get the prescription. This is because they know what to say to receive an appetite-suppressing medication (phen-phen anyone?) Included on the site are the correct questions to ask, and symptoms to discuss, in order to garner the diagnosis of BED. In the time it takes to reach for a prescription pad, the deal is sealed and Vyvanse is on board.

The truth is, drug seeking is not confined to pain killers, benzodiazepines such as Xanax and Ativan, and opiates. Imagine the hardship of being an obese person today, with all the struggles and abuses that go along with living in our culture, which is sick with the thin ideal: health problems, employment discrimination, and societal intolerance. Many frustrated obese people have tried every possible weight loss focused therapies and diet plans without success.

But now, here is this drug, being touted as the first of its kind ever to treat BED. Of course, the reality is that similar to Adderall, phen-phen, and even cocaine, it is actually an appetite suppressant.

This legitimate pharmaceutical will undoubtedly be supported by physicians with little to no eating disorder or addiction training, and little to no success helping obese patients lose weight.

Vyvanse can help people achieve that desired, albeit short-sighted and often unhealthy, treatment outcome. What treatment-seeking obese person would “not” want it? The desire is completely understandable.

What they don’t know is that Vyvanse won’t help them with the emotional and spiritual underpinnings of their eating disorder. And what they probably will not be told by their physician is that it is a stimulant, which carries a significant abuse potential.

The story is not a new one. The drug is taken, it “works,” tolerance and dependence develop, more is taken, and eventually abuse and addiction can result.

Pharmaceuticals can often be a critical component of a treatment plan built to support sustainable recovery. However when drug companies promote products in this fashion, when the exclusive intent is to make huge profits, when the risks and dangers of addictive medications are not communicated, the outcome for patients using the drug can be very poor.

It is no wonder that many Americans hold corporations which operate in this manner in utter contempt. And also why many academic centers, non-profits and treatment centers alike steer clear of receiving monies from big pharmaceutical companies under the auspices of helping to promote disease awareness.

-Our Research Team-
Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, CEDS-S
Professor Emeritus of Psychiatry and Behavioral Sciences
Dr. Christopher Womack
Medical Director, Child and Adolescent Psychiatry

Dr. Christopher Womack joins SunCloud as our Medical Director, Child and Adolescent Psychiatry.

Dr. Womack is board certified in Adult as well as Child and Adolescent Psychiatry, attending the University of Chicago Pritzker School of Medicine. Adult psychiatry residency and child fellowship training were completed at the University of Chicago Medical Center.

Dr. Womack’s treatment  philosophy hinges on strength based, evidence informed care, where collaboration is central to guiding individualized treatment.  He has experience caring for children and teens from varied backgrounds, appreciating the importance of how identity can inform treatment.

Favorite pastimes are cooking new recipes and exploring Chicago’s rich cultural diversity through its neighborhood and fine dining experiences.

Elizabeth E. Sita, MD
Medical Director of Adult Services

Dr. Elizabeth E. Sita, MD, is a Board Certified psychiatrist specializing in the care of patients with eating disorders. She completed her undergraduate training at the University of Chicago and graduated with Highest Honors. She then earned her medical degree at Northwestern University Feinberg School of Medicine and was recognized with the Chairman’s Award for Excellence in Psychiatry. She subsequently completed residency with the Department of Psychiatry and Behavioral Sciences at McGaw Medical Center of Northwestern University, where she was elected Chief Resident and received the Resident Psychiatrist Leadership & Service Award.

Upon completing her training, Dr. Sita joined the staff atAscension Alexian Brothers Behavioral Health Hospital Hospital, where she served as Assistant Medical Director of the Center for Eating Disorders and Director of Transcranial Magnetic Stimulation Services before transitioning to lead the new inpatient eating disorder unit as Medical Director of Eating Disorder Services at Ascension Saint Joseph Hospital – Chicago. In these roles, she has cared for a multitude of adolescents and adults struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders as well as severe, cooccurring mood, trauma, personality, and substance use disorders.

Dr. Sita has been recognized throughout her training and practice for a commitment to excellence in patient care and for her ability to engage patients in their most challenging moments. Her passions include the care of treatment-resistant eating and mood disorders as well as questions of medical capacity and end-of-life decision making.

She believes that, first and foremost, human connection is key to mental health and well-being and strives to share this philosophy in each and every patient encounter. She is excited to bring her expertise to SunCloud Health as the Medical Director of Adult Services!

 

VIDEO: Meet Elizabeth E. Sita, MD, Medical Director of Adult Services

 

Lacey Lemke, PsyD
Assistant Vice President of Clinical Services

Dr. Lacey Lemke (she/her) is a licensed clinical health psychologist with specialized expertise in the treatment of eating disorders and the practice of medical and health psychology. She completed her doctoral training in clinical psychology with a Primary Care emphasis at the Adler School of Professional Psychology. Dr. Lemke went on to complete both her predoctoral clinical internship and postdoctoral fellowship through Ascension Health, where she gained advanced training working with individuals experiencing eating disorders and self-injurious behaviors, as well as within pediatric subspecialty settings including endocrinology, neurology, and adolescent medicine.

Dr. Lemke is deeply committed to providing evidence-based, compassionate care and collaborates closely with interdisciplinary teams to ensure comprehensive treatment. Her professional mission is to support patients in achieving their fullest potential by guiding them to the most appropriate level of care and empowering them to make meaningful, sustainable progress toward improved health and well-being.

VIDEO: 2. Meet Lacey Lemke, PsyD.