Globalisation:National Obesity Forum - Funding

Partner Organisations

• All-Party Parliamentary Group on Obesity (APPG) - a group of MPs and peers who work to raise awareness of Obesity issues through policy change, discussion and debate.

• Department of Health – They advise the NHS and social services on health provisions in the UK. They also influence policy decisions. Some of the other organisations they work with include the National Stakeholder Forum, Medicines and Healthcare products Regulatory Agency (MHRA). They are involved in setting national standards on clinical trials and research in the UK.

• National Institute of Clinical Excellence – An independent organisation committed to raising awareness of good health and how to avoid ill-health

• Royal College of Paediatricians– A charity established by the Royal Charter involved in the training and examination of paediatricians. They also provide education and resources in the interests of better health and services for children and young people.

• Association for the Study of Obesity – A charity organisation who are dedicated the treatment and understanding of obesity. It is run by a board of unpaid trustees

• National Audit Office – A UK government organisation who advise government on public spending in the interests of the citizens.

• Korean Academy of Family Physicians

• National Association of Primary Care - An apolitical not for profit organisation who support the interests of healthcare professionals working in the primary care sector. Their partner organisations include AstraZeneca, The GP Group, The MSD, the NHS Confederation, Pfizer, Practice Profit, Tribal, Scot Mackenzie Consultancy, Servier, The Health Consultancy, William’s Medical Supplies and X-Genics Ltd.

• LighterLife UK Limited – A weight Management Programme with a focus on weight loss through counselling and healthy lifestyles.

• Roche Products Ltd – A partner organisation to the NHS who are involved in the research and development of pharmaceutical products. They also support the National Institute for Health and Clinical Excellence (NICE) and the Scottish Medicines Consortium.

• Abbott Laboratories – A pharmaceutical industry who develop a broad range of specialised medicines, Diagnostic systems and tests, Vascular devices, provisions in ophthalmic care, Blood glucose monitoring systems, Nutritional products for all ages and Veterinary care. They provide financial and practical aid to countries world-wide through their volunteer programme.

• Slim Fast Foods Ltd – A range of weight loss foods produced under the group Unilever originally developed from a range of foods created by the Thomson Medical Group. Unilever were rated as one of the world’s most influential companies in December 2008 and have launched world-wide programmes including aid in Africa to combat malnutrition.

• Safeway Foods plc

• Tanita UK Ltd – A Japanese based corporation who manufacture health care products. It has offices in the United States, the United Kingdom, Hong Kong and China and production facilities located in the Far East. It has almost 50% of the domestic market share in

• Sanofi-Aventis Ltd – The UK branch of the international pharmaceuticals organisation Sanofi-Aventis. They work in partnership with Anticoagulation Europe, Atrial Fibrillation Association, Diabetes UK (Cymru), Epilepsy Action, Lifeblood, Marie Curie, Prostate Cancer Charity Sparks and The Children's Medical Research Charity.

• Mantis Surgical Equipment Ltd - A supplier of surgical products as selected from manufacturers world-wide. In 2003 they became a member of the United Drug group.

• GlaxoSmithKline UK Ltd – A global pharmaceuticals company who research and develop medicines and health provisions. They are headed by a Board of Directors and Corporate Executive Team. They work in partnership with the World Health Organisation providing global aid to other countries.

• Canderel – A range of diet foods produced by the Merisant Group. They have approximately 30% in the market share for table top sweeteners and are worth $1.2billion. More than half of Merisant sales are made outside the US and they own 19 brands in more than 100 countries.

• British Meat Nutrition Education Services – Supported by the red meat industry this organisation provides resources and education on the importance of meat as part of a healthy lifestyle. This includes publications for schools and parents to promote commercial and industrial awareness.

• Rosemary Conley Enterprises – A celebrity lead weight management programme that includes tailored dietary foods and other named brands in the promotion of weight loss.

• Carlton TV Ltd -

• The Obesity Awareness and Solutions Trust (Toast) -

Sources of Funding

The main funding sources for the Forum are in the form of grants, donations and the income from the Annual Conference on Obesity held each October. The company received a total of £38,898 for the year ending 31/10/09 from Voluntary sources and 40,025 for the period 1/4/08 to 31/10/08. For that period £15,000 came from Glaxosmith Kline and 10, 000 from GoLower. For the year ending 31/10/09 Abbot Laboratories gave £5000, the Cambridge Diet £10,000, BMl Thornbury £5,000, Ethicon Endo-surgery £1,175, LA Sports4 Kids £5,000 and Lipotrim £10,000 in the form of grants. A further £61,000 in donations were made up from Sanofi Aventis who gave £25,000, Abbott Laboratories £5,000, Weight Watchers £10,000, Vita Clinics UK Ltd £1,000, Lighterlife UK Ltd £5,000 and Roche Products Ltd £15,000 for Raising Public and Government Awareness and Educating Health Care Professionals. Some of the organisations who support the NOF have also faced claims that they are selling unsafe weight loss products.

Case study: Slim-Fast Foods

One of the NOF's partner organisations Slim Fast Foods are part of the larger manufacturing group Unilver. According to Unilever, each Slim Fast meal contains one third of everything you need to eat in a day - protein, carbohydrate, essential fatty acids, fibre, vitamins and minerals. They consider it an ideal food with only 200 calories. The ingredients listed on their products also include high levels of sugar and controversial sweeteners such as aspartame.. Food corporations are using the current increasing levels of obesity to market diet related goods and the NOF advocate the use of meal replacements such as slim fast to help people lose weight.

Slim Fast has the longest clinical trials running of any slimming programme. In Pound, Wisconsin the the use of Slim Fast has created a population that is an average of 11.5kg lighter than the population in a nearby town Unilever United States alongside the U.S. Food and Drug Administration (FDA), carried out a nationwide voluntary recall of all Slim-Fast®ready-to-drink (RTD) products in cans in 2009, due to the possibility of contamination with Bacillus cereus, a micro-organism, which may cause diarrhea and possibly nausea and/or vomiting. They claimed that the probability of serious adverse health consequences was remote. . Unilever USA claimed at the time that no illnesses or deaths were officially reported in connection with the recall but MSNBC reported that a number of people became sick from Slim Fast drinks, in the proceeding 6 to 15 hours after the shake was consumed. The report indicated that the individuals recovered within about 24 hours.

GlaxoSmithKline and ‘Alli'

Glaxo Smith Kline are the manufacturers of the weight loss drug Alli which went on sale in the UK in April 2009. However there have been concerns over the possible side effects associated with taking the drug. The US Food and Drug Administration received over 30 reports that claimed Alli caused serious damage to the liver. GlaxoSmithKline disagreed with these claims and said there was no association with liver damage. Out of the patients reported to the FDA, six developed organ failure. Other problems have included Diarrhoea and gas problems if users eat fat while taking the drug. Between 1999 and 2008, the FDA received 32 reports of liver damage.

Alli blocks the absorption of fat in the body and should only be used by adults with a Body Mass Index (BMI) of 28 or more. Orlistat is the active ingredient used in Alli. It was initially extremely popular in the UK and EU but due to its lack of effect, sales fell. Xenical has a higher dosage of Orlistat and has experienced higher sales but many people found the weight loss process too slow. Clinical trials have shown that taking Orlistat alongside a reduced-calorie, lower-fat diet, can help people lose 50% more weight than dieting alone.

The Medicines and Healthcare products Regulatory Agency (MHRA) in the UK claimed to have received around 1,295 cases of negative side-effects associated with taking Orlistat. The European Medicines Agency had no plans of changing the safety information of the product but said that they would carry out a review.

GlaxoSmithKline (GSK) were quoted to have said that ‘patient safety was its top priority, and reports of side effects were constantly monitored.’ They claimed to have carried out clinical trials of the drug with more than 30,000 patients."Alli is a 'non-systemically' acting medicine - it is minimally absorbed in the blood and works locally in the gastro-intestinal tract. "There is therefore no obvious biological mechanism to suggest liver damage can occur with Alli."

The Chairman of the National Obesity Forum recently disagreed with the European Medicines Agency decision to suspend Reductil (sibutramine) in the European Union. Dr David Haslam stated that their proposal was “preposterous, totally naive and unscientific.” to which the only alternative is Orlistat. The decision of the European Medicines Agency has lead to many countries increasing the warning labels on these products.

LighterLife

LighterLife is a company which was set up in 1996 with the aim to help overweight and obese people to lose weight. They claim that since then they have helped more than 200,000 people to become a healthier weight. The programme involves meal replacements such as soups, shakes and meal bars which provide around just five hundred calories per day. It also involves counselling and monthly health checks. In recent years, Lighterlife has been at time reported as being unsafe, as there have been many reports of people becoming ill and even dying whilst on the diet plan.

The Daily Mail reported that in 2006, twenty five year old Matilda Callaghan died due to heart failure, caused by her extreme ten stone weight loss.

In 2008, The Mirror reported the case of forty year old Jaqueline Henson, who died due to swelling of the brain after drinking four litres of water in just two hours whilst on the diet plan.

In 2009, the BBC reported the story of thirty four year old Samantha Clowe, who died due to what was thought to be heart failure caused by the very low calorie nature of the diet.

LighterLife responded to each of these reports, stating that their diet was not directly responsible for the unfortunate deaths of these women. In relation to the death of Samantha Clowe, a LightlerLife spokesperson stated that "...it was difficult to make such a connection" (between the diet plan and Samantha's death). However, it could be argued that LighterLife are indirectly responsible for the deaths of those following the plan, especially where the death was thought to be as a result of complications following a dramatic weightloss.

As well as being linked to deaths, the LighterLife diet has also been linked to other health issues. It was reported that the diet had caused one patient to become anorexic after following the plan. The case of Christina Massingham shows how risky the diet really is, in the way that it disassociates a person from ‘real’ foods. Christina was diagnosed with anorexia after months on the LighterLife plan, after loosing around thirteen stone in weight. She followed the plan for around a year, despite the fact that such a very low calroie diet should only be followed for a maximum of three months Whilst LightlerLife do provide counselling for those on the regime, these counsellors do not have a medical background and so may be fully aware of how to deal with those who develop or health or mental health problems.

Other health issues have also been reported, including water poisoning, hair loss and complications with the menstrual cycle. There have been many reports of people who have experienced dramatic hair loss as a result of following the restricting diet. This is most likely caused by the lack of nutriants in such a low calorie diet. Some are claiming that they were 'misled' by LighterLife as they were not consulted about any possible side effects.

Abbot and Sibutramine

The administration of the anti-obesity drug Sibutramine has been suspended in Europe due to concerns that it is related to Cardiovascular problems. Sibutramine blocks the reuptake of serotonin and norepinephrine by presynaptic nerve terminals and this suppresses appetite through increased satiety. It was approved by the FDA in 1997. The drug also increases blood pressure and number of heart beats per minute. As a result there is an increased risk of a ‘cardiovascular event’. Despite these risks it was not until thirteen years later that clinical trials with a substantial amount of participants were carried out. The SCOUT trial looked at 10, 000 patients who had existing cardiovascular disease, diabetes mellitus or both and issued them with either Sibutramine or a placebo at random. The trials showed an increased risk of a cardiovascular event in those with existing cardiovascular conditions. The amount of weight loss achieved through the drug did not outweigh the risks . The FDA advisory committee have decided to re-assess the use of the drug in Europe but are sceptical about it’s potential benefits. Dr David Haslem, Chair at the National Obesity Forum, had commented that Europe withdrew the drug too hastily. He argues that with the removal of subtramine people will be faced with little choice in anti-obesity pills and there will be an increased use of the amphetamine based drugs. He also criticised the European Medal Association, claiming that it, ‘has failed to recognise the difference between primary and secondary prevention, designating all fat people as cardiovascular victims.’ and that ‘sibutramine should not have been suspended until the conundrum has been properly dissected, in order that patient safety is foremost.’

Abbott Laboratories, who are a partner organisation of the NOF were also involved in the production and marketing of sibutramine. Following the recommendation from the SCOUT trials they released information about the dangers associated with the drug. The company announced their plans to suspend marketing in January 2010. . In a press release they revealed a number of warnings. The article stated that patients who have seizures, a history of heart disease, are taking monoamine oxidase inhibitors (MAOIs) or other weight loss medications that act on the brain, with an overactive thyroid, narrow angle glaucoma, tumors on the adrenal gland, men with an enlarged prostate or those with a mental illness should not take sibutramine. The company listed trouble sleeping, constipation and dry mouth as the main side effects. Other possible dangers included a fast heartbeat, increased blood pressure, awareness of the heartbeat (palpitations), headache and anxiety or dizziness. Eugene Sun, M.D., vice president of Global Pharmaceutical Research and Development at Abbott stated that "We believe there are many patients who benefit from sibutramine and respectfully disagree with the committee's opinion and the recommendation to suspend the medicine,”. Abbott also said that based on their assessment of the SCOUT trials they would not change their perspective on the “positive benefit/risk profile” of the drug.

Notes

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