Arundhati Parmar Sr Editor for MD &DI: North American Obesity Market to Swell to $139.5B by 2017, Spells Opportunity for Device Makers

Published: July 8, 2013

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North American Obesity Market to Swell to $139.5B by 2017, Spells Opportunity for Device Makers

A new research report forecasts that the weight loss and obesity management market in North America will increase to $139.5 billion in 2017, up from $102 billion in 2012.

The market includes medical device products used in weight loss surgery, and the report from MarketsandMarkets underscores the opportunity for medical device manufacturers. In the medical device arena, the opportunity seems to be primarily in areas that provide patients an alternative to invasive surgery. The report said:

Minimally-invasive and non-invasive surgical procedures that use highly sophisticated equipment like endoscopes and laparoscopes have been developed. In addition, non-invasive weight loss techniques like cryolipolysis, transoral obesity revision surgery, cold laser shaping, and Stomaphyx are also gaining popularity.

It remains to be seen whether American Medical Association's decision to consider obesity a disease will have an effect on the overall size in the market. When the June decision from the AMA came down, it marked a real uproar because some believed that considering obesity a disease basically means that individual responsibility can be denied. People who lead unhealthy lifestyles can simply believe that clinical intervention is automatically required instead of a change in behavior.
The same debate has spilled over to a discussion on the LinkedIn Medical Devices Group. Politics aside, what is salient about the discussion is that some users of the group believe the growing market holds great promise for medical device inventors.
Take user Paul Stein for instance. A medical device professional, formerly with St. Jude Medical, Stein believes that medical devices will succeed in tackling the epidemic that is obesity where pharmaceutical companies have failed. Here is an edited version of his comments:

For us in the medical devices industry, we need to look at this as a tremendous opportunity to create the next generation of medical devices.
The current set of drugs, along with their toxicities, do very little. And, the one marketed medical device, the Lap Band, has proven its worth in treating obesity. But, the most important fact that needs to be soberly understood is that the little medical device company that invented that device was paid $1.2B by Allergan for it. Yes, that's a B.
One of the other very popular treatments for obesity, the vertical sleeve gastrectomy, uses several thousands of dollars of linear staples (Covidien, J&J) per procedure. Performed over a million times per year, you do the math.

Stein points to one startup that he is working with - Onciomed - that he believes has the potential to address the global obesity challenge. The Irvine, California firm has devised a minimally-invasive procedure called the GVS System that restricts food intake while providing a feeling of fullness and satiety.
Fred Voss, another LinkedIn user who commented on the discussion, is also working on an innovative device to treat obesity while achieving the positive effects of bariatric surgery. San Clemente, California-firm PlenSat, where Voss is CEO, has developed what it calls digestible balloons. The capsules containing the balloons can be ingested over several days, thereby slowly changing stomach volume. They result in the patient feeling a sense of fullness.
The opportunity in treating obesity is not simply limited to startups though. Another LinkedIn user, Patrick Pickerell commented on how insurance reimbursement for devices used in obesity procedures as a result of AMA's decision is proving to be a boon to his company - Peridot. Pickerell is president of that firm based in Pleasanton, California.

My company (Peridot) is a supplier of precision metal and plastic components to the minimally invasive device companies. As such we have at least half a dozen clients in the stomach reduction space that have placed their bets on just such a ruling. Insurance reimbursement codes mean the difference between a viable exit/sale of these startups so from a business standpoint (somewhat selfishly I admit) I am glad for the ruling.
From an economic point of view it seems better to treat obesity now than pay for the long term effects of diabetes and heart disease.

 [Photo Credit: iStockPhoto.com user jangeltun]

-- By Arundhati Parmar, Senior Editor, MD+DI

Obesity and Diabetes may Banckrupt the Nation!! This is a unmet need!

We all know that Obama care will make it more expensive and we will pay more out of pocket to get treatment.
Obesity cost the nation $140 Billion annually.Obesity is the world's biggest market.

The policy makers can make it easy by incentivizing VCs to invest in Obesity technologies and in life science technologies. This will enable innovation or we will be paying more for royalties to international innovators.
WHITE HOUSE its up to you now!!!

Ultimately, Obamacare  may be able to offer healthcare to a wide array of people but may fail to remedy the ills of rising health insurance and healthcare costs. Meanwhile, in addition to taxes and penalties, the new entitlement program will be financed by more than $700 billion in cuts from Medicare over a ten year period. This means that retirees will need to buy additional supplemental insurance through one of the health care companies.

Childhood Obesity Now Becoming A Major Health Care Concern: Focus on UK's Childhood Obesity Admissions

Childhood Obesity Now Becoming A Major Health Care Concern: Focus on UK's Childhood Obesity Admissions
Obesity is now the worlds biggest health care market. Currently the treatments are diet, exercise, appetite suppressants from Vivus and Arena pharmaceuticals, medical devices like the lap-band from Allergan and then novel medical devices like The DUO from Reshape, Endo-barrier from Gi Dynamics, GVS from Onciomed, Inc, Intra-gastric balloon from Obalon, Baronova.
These are a few companies that are at the top list of obesity intervention. But the problem is so profound and options so few that all these companies have a tremendous opportunity to grow or get acquired. Unfortunate that a company like Satiety was ahead of its time in adoption and regulatory process. The product had its limitations like the ( profile and navigation through the esophagus) would have been approved in the current regulatory environment and possibly be acquired for v high valuation. VCs were on the side lines and now returning to the obesity field to invest in new technologies.
 
The number of children admitted to hospital for problems related to obesity in England and Wales quadrupled between 2000 and 2009, according to the 'Rising Obesity-Related Hospital Admissions among Children and Young People in England: National Time Trends Study', by researchers at Imperial College London, UK.
Using the Hospital Episodes Statistics database, they reported on the number of hospital admissions for children and young people aged five to 19 where obesity was recorded in the diagnosis, between 2000 and 2009.
The study, published in the journal Plos One, states that in 2009 there were 3,806 children admitted to hospital for obesity-related conditions, compared with just 872 in 2000. Alarmingly, nearly three quarters of these admissions were to deal with problems complicated by obesity such as asthma, breathing difficulties during sleep and complications of pregnancy, rather than obesity itself being the primary reason.
"The burden of obesity is usually thought to have its serious consequences in adulthood, but we now see it manifesting earlier, in childhood," said Dr Sonia Saxena, from the School of Public Health at Imperial, who led the study. "It's clear that rising obesity levels are causing more medical problems in children, but the rise we observed probably also reflects increasing awareness among clinicians, who have become better at recognising obesity."
For this study the researchers defined total obesity admissions as comprising both primary and secondary diagnoses of obesity and reported on the number of children and young people who underwent bariatric surgical procedures for the management of obesity during the study period.
The found that between 2000 and 2009, age- and sex-specific hospital admission rates in 5–19 year olds for total obesity-related diagnoses increased more than four-fold from 93.0 (95% CI 86.0 to 100.0) per million children to 414.0 (95% CI 410.7 to 417.5) per million children, largely due to rising admissions where obesity was mentioned as a co-morbidity.
The median age of admission to hospital over the study period was 14.0 years; 5,566 (26.7%) admissions were for obesity and 15,319 (73.3%) mentioned obesity as a comorbidity (Table 1). Admissions were more common in girls than boys (56.2% v 43.8%) and the most common reasons for admission where obesity was a comorbid condition were sleep apnoea, asthma, and complications of pregnancy.
Overall admissions were more common in girls than boys (56.2% v 43.8%) and increased with age from 18.7%, 40.1% and 41.2% for age groups 5–9, 10–14 and 15–19 years respectively.

Table 1. Demographic characteristics of children and young people admitted with obesity-related diagnosis over the entire study period, by primary or secondary diagnosis, 2000 to 2009.

Hospital admission rates for obesity increased almost four-fold from 21.0 (95% CI 17.5 to 24.5) per million children in 2000 to 78.8 (95% CI 77.0 to 80.6) in 2009. Admission rates for obesity as a comorbidity increased from 70 (95% CI 65.6 to 78.4) per million children in 2000 to 335.3 (95% CI 332.3 to 338.3) per million children in 2009 (Figure 1).

Figure 1. Trends in age and sex-specific hospital admission rates per million children among children and young people ages 5 to 19 years, for obesity and where obesity was a comorbidity, 2000–2009.

Bariatric surgery

Of the 20,885 children and young people admitted to hospitals in England during the study period, 111 patients had a bariatric surgery procedure performed during 2000 and 2009 and the number increased from one procedure in 2000 to 31 in 2009. Of those 111 patients, 109 were in the 15–19 years age group and only two were in the 10–14 years age group. The majority of these procedures (75.6%, n=84) were performed in girls and the median age was 18 years (Figure 2). Laparoscopic gastric banding was the most commonly performed bariatric surgical procedure, accounting for 36% (n=34) of procedures during the study period.

Figure 2. Number of hospital admissions for bariatric surgery for children and young people ages 13 to 19 years by sex, 2000 to 2009.

“We found that patients undergoing bariatric procedures were mainly girls and the number of these procedures increased substantially during our study period,” the authors write. “While the number of these surgeries started from a very low base of one in the year 2000, and the numbers are still lower than US estimates. The increase is large and suggests that England may be moving towards the greater number of these procedures seen in the US.”
The researchers state that there needs to be a full economic analysis of the cost of managing and treating obesity in children and young people and future research should aim to identify target groups of children with higher prevalence of obesity and investigate how this compares with those treated for obesity-related conditions in hospitals in England.
In addition, they urge further researcher as to whether the publication of national guidelines have impacted on hospital admission patterns for obesity.
Conclusion
“Our findings support emerging evidence that the childhood obesity epidemic may lead to substantial problems of obesity-related disease much sooner in children and young people’s lives than previously expected,” the authors conclude. “With levels of admissions for obesity-related diagnoses rising, there is likely to be increasing demand on health services and also greater use of more radical interventions, such as pharmacological or surgical treatment, as part of efforts to address the increasing trend of obesity that threatens the lives of many children and young people in England and globally.”

“Obesity: Global Public Health Challenge or Investment Opportunity?”

1. Rachel says:

   If we take a look at it, the problem of Obesity is more like an investment opportunity. It is hard to avoid for companies not to take the opportunity to invest in this kind of global health problem. Due to large investment placed on this issue, the account of obesity as being a global public health challenge was easily set aside. Hope we can also have generous amount of campaigns against obesity, that will clearly warn the public than seeing the anti obesity acts commercially.
   

   

   Reply
2. ams says:

   Industry will try to make money off of anything, so why not obesity? I feel like there has been a boom of dieting adds on TV over the last couple years when compared to the last decade. You can’t get through one commercial break without seeing a Weight Watchers, NutraSystem, or Jenny Craig add (not to mention diet/fat burning pills).
   To me, the obvious fix is to have everyone be more active more often and eat less. But who wants to do that? That would probably solve A TON of our problems, especially in the US, but people can come up with all kinds of excuses as to why neither of those options can fit into their lives.
   It will be interesting to see the true impact (if any) this industry explosion will have on obesity. The complications of obesity put such a strain on healthcare systems all over the world–which is a shame because obesity is largely preventible (and, thus, its complications like type 2 diabetes, etc). When it comes down to it, any morally and ethically sound strategy for decreasing incidence and prevalence of obesity should be fully embraced, even if it means someone is going to make a killing in profit.
   

   Reply
3. Jane says:

   There’s no disputing that obesity is a health challenge. A lot of people from different countries are suffering from obesity. The industry will most likely take advantage of the problems in the society such as obesity. They make these problems an investment opportunity. You know. Sadly, that’s life.
   

   Reply
4. Glenn says:

   

   Obesity is #1 cause of preventable death in US.
   70 Million people are obese, of which 14 million are super obese and are approved by medicare to get invasive treatment like bariatric surgery.
   The cost of surgery ranges from $35,000 to $85,000 you do the math.
   Obesity was never a disease it was a medical condition, so no doctor knew how to deal with this, so now CDC has declared it as a disease as a result new treatment have emerged resulting in a tremendous investment opportunity. One such company developing a novel technology to treat obesity and diabetes is http://www.onciomed.com
   This company is working on novel treatments and is located in Orange County. I just learned that their name ONCIOMED was derived from “Unit of weight Ounce”
   I think in the next decade obesity clinics are going to be everywhere in the US. This is going to be the worlds biggest market! Cardiac surgeons are converting to become bariatric surgeon or obesity surgeon
   So BOA and ML is correct, the disease has become an investment opportunity.
   I
   

   Reply
5. lila says:

   
   

   Well said Mr Glenn!
   “Obesity is going to be the worlds biggest market” I agree. China is seeing an obesity epidemic.
   Surprisingly, I was looking at the same website a few days ago. Onciomed.com they have not mentioned what they do, but the website videos are so informative.
   I don’t see anything wrong if obesity is an investment opportunity. I would like people to modify their lifestyle and live health lives. But the fact is we are more addicted to the TV and the electronics and kids spend more time in front of a TV than the playground.
   I had LASIK surgery, i remember, before the invention of LASIK procedure,
   all ophthalmologist were ophthalmologist, after LASIK invention, everyone became a LASIK surgeon. I think the same is going to happen with Obesity. All bariatric surgeons will become obesity surgeons and it will not be a stigma to get treatment for obesity. Already insurance is paying for Lapband. That is a great surgery. I heard that the company who invented lapband sold the company to Allergan for over a $ Billion.
   So surely, BOA_ML is right Obesity is a BIG investment opportunity.
   ALso, good for patients, more investments will translate into new technologies. It’s an ecosystem.
    I looked at Onciomed, Inc, Reshape, Obalon,  GIdynamics and Valentx they all look very promising technologies. I like Onciomed, Inc and Reshape Medical  and Obalon because they are in So Cal.

Promising Novel Technology from Onciomed, Inc: Great Opportunity in a Multi Billion Dollar Market

Irvine, Calif.-based medical device company Onciomed, Inc., has received a U.S. patent to treat obesity and diabetes with a path-breaking minimally invasive procedure.

The medical device, GVS technology system, mimics gastric surgery without the need to cut the stomach and offers an alternative to highly invasive, irreversible bariatric surgery.
“We restrict the stomach and imitate the procedure similar to gastric bypass surgery, without cutting portions of the stomach,” said Onciomed founder and CEO Dr. Raj Nihalani, who developed the device.“This technology helps us get to the next level of intervention without doing much harm,” he told India-West.


Nihalani has worked for nearly 17 years in the medical device sector — where he focused on cardiology research, invented devices for coronary stents, and worked at start-ups including Endologix  ( acquired by larger company).
Nihalani said he was inspired to address major health issues not only in the U.S., but worldwide. His research led to his focus on obesity and diabetes, which he said is “one of the biggest healthcare markets in the world.”
Onciomed’s process involves a single incision laparoscopic procedure. Once in place, the GVS provides a feeling of “fullness and satiety” and reduces absorption of fat and glucose.
Nihalani noted that the company has the opportunity to expand to 20 additional patents. Currently, Onciomed is raising capital and inviting private investors to invest in its technologies. The goal is to do clinical trials outside the U.S, and eventually seek U.S. Food and Drug Administration approvals.
“With the invention of these novel products, what it does is it reduces the absorption of fat and glucose at the intestinal level which can help with diabetes prevention or reduce dependence. It can really help these patients not only lose weight, but correct diabetes status,” Nihalani said.
According to the World Health Organization, obesity has nearly doubled since 1980. In 2008, over 1.4 billion adults were overweight and more than half a billion were identified as obese. About 2.8 million people die from conditions related to being overweight or obese, the WHO said. More than one-third of adults in the U.S. and about 17% (12.5 million) children between the ages of 2-19 are obese, according to the Centers for Disease Control and Prevention.
“What we are working on is a very novel technology. We feel that this is the next big thing in the healthcare field, and I’m glad that I am one of the first Indians to get patents in the obesity and diabetes phase,” Nihalani told India-West.
A study, “South Asian American Perspectives on Overweight, Obesity, and the Relationship Between Weight and Health,” was recently published through the CDC. It looked at the effects of health and weight among South Asian Americans by interviewing 75 South Asian Americans and measuring their BMI (body mass index). About 67% of the participants in the study were identified as overweight or obese and about 82% of those who were obese believed their weight affected their health, according to the study.
South Asians have higher risks for both cardiovascular disease and Type 2 Diabetes than do most other ethnic groups, the study noted.
“Among all Asians in the United States, South Asians have the highest rates of overweight and obesity,” the study said.
Children are also at risk for diabetes and obesity, especially with dietary changes and accessibility to junk food and carbonated drinks. “For South Asian children, 14 percent are obese. It’s lower than the general U.S. population, but yet there is a tendency to be obese,” Nihalani said.
The Indian American entrepreneur explained that in recent years the size of portions offered to children at schools has dramatically changed. “How we eat and the way we eat has changed. Obesity trends have increased in the last two decades. Portions (children) are offered and complex carbohydrates have drastically affected wave points. It won’t end, so this is going to be a very big issue," he asserted.
“One in six kids is obese in the United States and one in 10 kids is obese in the South Asian population,” he emphasized.
Nihalani hopes to focus in the future on addressing childhood obesity and set aside a portion of the profits in his current venture towards that goal.
“I want to focus on how to connect the two worlds on the healthcare front and the ones in developing countries — how to connect the knowledge and infrastructure here and how to integrate that for healthcare," he said.

Read more at http://www.indiawest.com/news/10077-onciomed-patents-minimally-invasive-obesity-treatment.html?goback=%2Egmp_2136343%2Egde_2136343_member_230290831#UOcVOweGMGmBoQ7M.99

Shanghai is acting to head off an "obesity epidemic" as health authorities warn of a rising tide of diabetes and weight-related diseases.

Shanghai (China Daily/ANN) - Shanghai is acting to head off an "obesity epidemic" as health authorities warn of a rising tide of diabetes and weight-related diseases.

Roughly 40 per cent of adults in Shanghai are overweight or obese, and one-fourth of residents do not exercise enough, according to a report by the Shanghai Municipal Health Bureau, released on Monday.
The rise in obesity is being considered as an investment opportunity in treatments. Most of the innovation is happening in the US. Companies in SoCal like Allergan, Onciomed, Reshape are working on innovations in the obesity space. Onciomed, Inc recently announced its vital patent in treating obesity and diabetes.












"The rise in obesity among children and adults is very disturbing," said Li Guangyao, deputy director of the Shanghai Health Promotion Committee. "It will lead to many health problems and should be given attention."
In a recent academic paper, sports scientist Colin Boreham found that over the past 20 years, the number of obese Chinese men has grown from 3 per cent to 11 per cent, while the number of obese women has increased from 5 per cent to 10 per cent.
Abdominal obesity problems are particularly prominent, wrote Boreham, director of University College Dublin's Institute for Sport and Health.
The ratio of men with abdominal obesity, meaning with a waist circumference of 90 cm or more, increased from 8 per cent to 28 per cent, while women with abdominal obesity, a waist circumference of 80 cm or more, increased from 28 per cent to 46 per cent.
The findings of another survey, released at the end of 2011 by Shanghai health authorities, showed that the average weight of male residents has increased by 2.9 kg when compared with 2000. Over that same period, the average waistline of men has increased 2.3 cm.
"More health campaigns and public education activities are urgently needed to help residents better understand the harm being overweight or obese can do, and prompt them to keep moving and take measures on weight control," said Chen Wenhe, a professor at Shanghai University of Sport.
Like many people, Zhao Bin, a 25-year-old IT worker, spends a lot of his time either sitting in an office or curled up on the sofa at home.
"I know I'm putting on weight, but I barely have any energy to move after a whole day working," he said. "I just want to throw myself into bed after dinner."
Zhao weighs 90 kg, and is among a large group of people who are not inclined toward physical activities.

A citywide survey conducted this year by the Shanghai Health Promotion Committee, which surveyed about 8,600 residents aged 18 or over, found that adults spend a lot of time on sedentary pursuits.
An adult spends an average of 3.9 hours a day sitting without any significant physical movement, the poll discovered. Compared with a year earlier, nearly 70 per cent of residents also said they had reduced the time spent on daily physical exercises.
The city is encouraging residents to live healthier lifestyles and take positive steps to control their weight.
In addition to activities in communities, the committee also organises a contest to encourage residents to shed weight. Residents who successfully lose 3 kg can win prizes worth up to 2,000 yuan (US$321).
"Various campaigns and activities are aimed at helping residents have a healthier lifestyle, which can effectively reduce the chances of suffering various chronic diseases," said Li from the committee.

Obesity: The Next Investment Driver

As the U.S. gets fatter, so might your wallet..

Investors worldwide are looking at Obesity as one of the maga investment drivers. Obesity cost US $147 Billion. 

Obesity once considered as a medical condition, in the last decade has become one of the biggest health problem facing all the developed countries. Countries like India, China, Brazil are seeing unprecedented obesity rates. Urban India has seen an 14% obesity in tier 1 and 2 cities. China has seen a 40% obesity rate in children, the primary reason is the new found wealth and one child policy which has translated into over pampered kids. 

Individual investors are looking at US to invest in obesity and related technologies. Early stage companies are raising capital from individual investors who clearly believe that investing in obesity is a long term investment. Companies like the lapband technology is so popular all over the world, it is reversible technology that can provide over 45% excess weight loss. This company once was sold to Allergan for over $1.2 B. 

Venture Capitalist saw slowing down of LPs investing in their funds during the 2008-2011 downturn. VCs focused on investments that are later stage or ones that were throw away deals to increase their portfolio. This would make them look good!.

So, what happened to VCs and obesity technologies 2001-2010. Some VCs were first to jump in and experimented their investments on projects while industry was still in learning mode. Today in 2012 the technology companies have become mature, the market is mature, the users mainly the bariatric surgeons have understood how to treat obesity. FDA is now approving drugs and devices to treat obesity. So now, the VCs are looking at obesity as an opportunity. However, VCs are now competing with individual investor community and wealth mangers to invest in next generation technologies in the obesity space. 

Obesity technologies in the US are very limited. Most of them are located in California. The 10 main players in the obesity space mainly Allergan, GI dynamics, Reshape Medical , Obelon, Onciomed, Valentx, J&J, Coviden, Vibrynt Medical and Cavu Medical.

Allergan, Reshape, Onciomed and Obelon are located in SoCal.

Recently, Reshape and Obelon raised their capital . 

Onciomed has announced that it is raising capital for its novel approach to treatment of obesity and diabetes. They got a second patent for their technology Nov 2012.

 Vybrint, Cavu and Vallentx are in the SV and Santa Barbara area. 

J&J and GI Dynamics is located on the East Coast.

In 2011 Bill Hawkins spoke at the Obesity Innovation Summit in Cleavland Clinic in Ohio and mentioned Medtronic is looking at innovations to treat obesity and metabolic technologies.

Big PE players are looking at obesity as an investment opportunities. Companies that have surgical products are looking at innovative medical devices to add them to their portfolio of products or create a brand new franchise.