ABC News recently aired a story about the drug Qnexa, which is a combination drug which seems to treat obesity (watch the story here).  The results have been impressive, as can bee seen in the featured before and after photos.  And yes, like almost all other diet drugs, it comes with side effects.  The question, in this case, is do those side effects outweigh the benefits (no pun intended)?

In other words, this asks that if the adverse effects of the drug are worse that the health problems associated with obesity, which include heart disease and type II diabetes.  We will see what the FDA decides, but make no mistake, a drug like this is badly needed.

The conventional wisdom about the current obesity epidemic is that stressing a “better lifestyle,” that is, improved diet and more exercise is the solution.  But this has clearly been an utter failure.  What society at large does not understand that a guideline for a better lifestyle isn’t a treatment for obesity, but rather—like education—is a sorting mechanism.  Only those who are inclined to follow whatever recommendations given will do so.  Many of the rest continue to have expanding waistlines.

The prescription for better diet and exercise is based on the flawed belief that people have free will and have an unlimited ability to choose whatever lifestyle they wish.

However, that’s clearly not the case.  Instead, as Cochran and Harpending point out in The 10,000 Year Explosion, most humans spent much of their recent evolutionary history in scare food situations.  Modern people have only recently emerged from the Malthusian trap, that is having population growth checked by the availability of food.   Today’s environment—with high-calorie foods cheaply available any time of the year and not requiring massive amounts of toil to obtain them—is an environment highly different from the environment most humans have evolved to be adapted to.  Obesity and diabetes are diseases arising from this environmental mismatch.  Only a “magic pill” could hope to solve it.

However, make no mistake, if Qnexa is approved, it will be the new crack.  As you might suspect, the drug’s effect requires continual use, so taking it is a life long commitment.  Its approval would be an enormous boon to its makers.  And that is fine; I hardly imagine that it would be any different.  Some people look down on such solutions, hoping for some “natural” cure to the obesity epidemic.  But instead, perhaps they should look at it this way:  it is was an unnatural process that created the obesity crisis (modern society), it would take an unnatural solution to treat it.