Worldwide Market for the Clinical Management of Obesity, 2007-2015

Table of Contents

Section 1: Clinical background

• 1.1 BMI
• 1.2 Growth of Obesity Worldwide
  • 1.2.1 Prevalence of Obesity in the US Population
  • 1.2.2 Obesity in the European Union
  • 1.2.3 Japan' s Rising Obesity
  • 1.2.4 Prevalence of Obesity in China
• 1.3 Why Treat Obesity?
• 1.4 Overweight, Obesity and Morbidity
  • 1.4.1 The Multifactorial Causes of Obesity
    • 1.4.1.1 Role of the Weight Regulatory System
      • 1.4.1.1.1 Ghrelin
      • 1.4.1.1.2 Peptide YY (PYY) & the Y2 receptor
    • 1.4.1.2 Adipose Tissue
    • 1.4.1.3 Abdominal Girth
    • 1.4.1.4 Metabolic Syndrome
    • 1.4.1.5 Obesity and Diabetes
    • 1.4.1.6 Binge Eating Disorder (BED) and Surgery
  • 1.4.2 Infectobesity: Fat Viruses and Microbes?
  • 1.4.3 Genetic Roots of Obesity
    • 1.4.3.1 Fat as Survival Mechanism: the Thrifty-Genotype
    • 1.4.3.2 Leptin
    • 1.4.3.3 Metabolic Liver Enzyme Defect
    • 1.4.3.4 The Gene CD-38
    • 1.4.3.5 The Gene FTO
  • 1.4.4 The Obesogenic Picture: Body & Environment
  • 1.4.5 Patient Population Segmentation
    • 1.4.5.1 The Elderly
    • 1.4.5.2 Children and Adolescents

Section 2: Weight Loss Management Approaches

• 2.1 Medically Supervised Diet, Behavior Modification and Nutritional Counseling Programs
  • 2.1.1 Healthy Living Academies for Adolescents and Young Adults
  • 2.1.2 Duke University' s Rice Dieta program
  • 2.1.3 Medically Supervised Low Calorie and Very Low Calorie Diets (LCDs and VLCDs)
  • 2.1.4 Behavior Modification Programs
• 2.2 Surgical Approaches
  • 2.2.1 Restrictive Bariatric surgery
  • 2.2.2 Malabsorptive Bariatric Surgery
  • 2.2.3 Combination Restrictive-Malabsorptive bariatric surgery
  • 2.2.4 Roux-en-Y gastric bypass surgery
  • 2.2.5 Laparoscopic surgery
  • 2.2.6 The Post-Op Period
  • 2.2.7 Medical Device Implantation (Gastric Stimulation Device)
  • 2.2.8 Gastric Balloon
  • 2.2.9 Other Invasive Approaches Currently Under Development
    • 2.2.9.1 Disabling the vagus nerve
    • 2.2.9.2 Trans-Oral Stapling Device
• 2.3 Current Drug Developments
  • 2.3.1 Cannabinoid (CB1) Receptor Agonists
  • 2.3.2 Lipase Inhibitors
  • 2.3.3 RNAi (RNA Interference)
  • 2.3.4 Serotonin Receptor Agonists
  • 2.3.5 Compounds Based on Intestinal Peptides

Section 3: Impact of Obesity

• 3.1 Obesity Treatments, Related Costs and Reimbursement
  • 3.1.1 Difficulty of Calculating Costs and Morbidity
  • 3.1.2 Real Costs, Real Morbidity
• 3.2 Impact on Businesses/Economies
  • 3.2.1 Increase in Workers' Compensation Costs
• 3.3 Government Approaches to the Health Problem of Obesity
  • 3.3.1 United States
    • 3.3.1.1 The NIH: a Strategic Plan for Obesity Research
    • 3.3.1.2 Other US Agency Efforts
    • 3.3.1.3 Changes in Medicare policy
    • 3.3.1.4 “F as in Fat”
    • 3.3.1.5 IRS and Deduction of Obesity Treatments
  • 3.3.2 European Union
    • 3.3.2.1 The ‘European Charter' to Halt Obesity
    • 3.3.2.2 The UK: NHS, NICE and the Costs of Treating Obesity
    • 3.3.2.3 SCOPE Internet-Based Physician Training
    • 3.3.2.4 France: the Caisse Nationale d' Assurance Maladie (CNAM)
  • 3.3.3 Latin America & the Caribbean

Section 4: Clinical Trends

• 4.1 Prevention and Intervention
• 4.2 Drug Developments
  • 4.2.1 Utilizing Combinations of Drugs
  • 4.2.2 CNS Versus Gastrointestinal Action
  • 4.2.3 Stumble of CB1 Receptor Agonist Class
  • 4.2.4 OTC alli
• 4.3 Tailoring the Strategy to the Patient
• 4.4 Bariatric Surgery
  • 4.4.1 Gastric Bypass Versus Banding
  • 4.4.2 Bariatric Surgery for Teens
  • 4.4.3 Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS)

Section 5: Products & Technologies

• 5.1 Medical Devices
  • 5.1.1 Bariatric Surgery Devices in Use and Under Development
  • 5.1.2 Restrictive Stomach Banding Devices
  • 5.1.3 Restrictive Device Delivered Transorally
  • 5.1.4 Gastric Stimulation Devices
  • 5.1.5 Disabling the vagus nerve
  • 5.1.6 Oral device
• 5.2 Drug development
  • 5.2.1 CB-1 cannabinoid receptor agonists
  • 5.2.2 Lipase inhibitors
  • 5.2.3 RNAi
  • 5.2.4 Serotonin receptor agonists
  • 5.2.5 Intestinal peptide compounds
  • 5.2.6 Ghrelin-based vaccine
• 5.3 Genetic therapy

Section 6: Market Assessment

• 6.1 Bariatric Surgery Devices
  • 6.1.1 United States and Canada
    • 6.1.1.1 Medicare Coverage Decision
    • 6.1.1.2 US & Canada Market Shares
  • 6.1.2 European Union
    • 6.1.2.1 United Kingdom
    • 6.1.2.2 France
    • 6.1.2.3 Germany
    • 6.1.2.4 Italy
    • 6.1.2.5 Spain
    • 6.1.2.6 Scandinavia
  • 6.1.3 Rest of World
• 6.2 Pharmaceuticals
  • 6.2.1 Rimonabant
  • 6.2.2 PYY3-36
  • 6.2.3 Pharmaceutical Market Assessment
    • 6.2.3.1 United States & Canada
    • 6.2.3.2 European Union & Scandinavia
      • 6.2.3.2.1 United Kingdom
      • 6.2.3.2.2 France
      • 6.2.3.2.3 Germany
      • 6.2.3.2.4 Italy
      • 6.2.3.2.5 Spain
      • 6.2.3.2.6 Scandinavia
    • 6.2.3.3 Rest of World
• 6.3 Genetic Therapies
• 6.4 Obesity vaccines

Section 7: Opportunities

• 7.1 Pharmaceutical Opportunities
• 7.2 Device Opportunities
  • 7.2.1 Acquire or Partner with a Company with a Promising Device
  • 7.2.2 Continue to develop Devices for Treatment
  • 7.2.3 Off-Label Uses of Current Devices
• 7.3 Market a Bundled Communication Package
• 7.4 Target the Market for Overweight & Obesity, Not Just Morbid Obesity
• 7.5 Working the Reimbursement Angle

Section 8: Company Profiles

Appendix: List of Companies

List of Exhibits

• Exhibit ES-1: Selected Countries Ranked by Percentage of Overweight or Obese (BMI >25), 2006.
• Exhibit ES-2: Co-Morbidities Linked to Obesity
• Exhibit ES-3: Clinical Management of Obesity, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 1-1: Calculation of Body Mass Index (English or Metric)
• Exhibit 1-2: Selected Countries Ranked by Percentage of Population (Age 15+) Overweight or Obese, 2005
• Exhibit 1-3: Selected Countries Ranked by Percentage of Overweight or Obese (BMI >25), 2006
• Exhibit 1-4: WHO Graph of Mortality, Obesity (per 1 million people), Jan 2004
• Exhibit 1-5: USA: Percentage of Children Ages 6-17 Who Are Overweight by Gender, and Race, and Hispanic Origin, 1976-1980 and 2003-2004
• Exhibit 1-6: Co-Morbidities Linked to Obesity
• Exhibit 1-7: Diagram of the Weight Regulatory Pathways
• Exhibit 1-8: Leptin' s Role in the Body
• Exhibit 3-1: Examples of Annual National Costs of Obesity (US$ Millions)
• Exhibit 3-2: A Selection of Federal Agencies and Their Involvement in Obesity Policy
• Exhibit 5-1: Bariatric Treatment Devices on Market and in Development
• Exhibit 5-2: Bariatric Device Company Market Shares, 2007
• Exhibit 6-1: Clinical Management of Obesity, Global Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-2: Clinical Management of Obesity, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-3: Clinical Management of Obesity, Global Pharmaceutical Revenue Market Share vs. Device Revenue Market Share, 2004-2015 (US$M)
• Exhibit 6-4: Bariatric Surgery Devices, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-5: Bariatric Surgery Devices, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-6: Bariatric Surgery Devices, Regional Share of Total World Revenues, 2004-2015 (US$M)
• Exhibit 6-7: Bariatric Surgery Devices, Market Forecast, United States and Canada, 2004-2015
• Exhibit 6-8: Bariatric Surgery Devices, Market Forecast, United States and Canada, 2004-2015
• Exhibit 6-9: Bariatric Surgery Devices, Market Shares, United States and Canada, 2015
• Exhibit 6-10: Bariatric Surgery Devices, Market Forecast, European Union, 2004-2015
• Exhibit 6-11: Bariatric Surgery Devices, Revenue Forecast, European Union, 2004-2015
• Exhibit 6-12: Bariatric Surgery Device Revenues by Country Share, EU & Scandinavia, 2007
• Exhibit 6-13: Bariatric Surgery Device Revenues by Country Share, EU & Scandinavia, 2015
• Exhibit 6-14: Bariatric Surgery Device Market, United Kingdom, 2004-2015
• Exhibit 6-15: Bariatric Surgery Device Market, United Kingdom, 2004-2015
• Exhibit 6-16: Bariatric Surgery Device Market, France, 2004-2015
• Exhibit 6-17: Bariatric Surgery Device Market, France, 2004-2015
• Exhibit 6-18: Bariatric Surgery Device Company Market Shares, France, 2007
• Exhibit 6-19: Bariatric Surgery Device Market, Germany, 2004-2015
• Exhibit 6-20: Bariatric Surgery Device Market, Germany, 2004-2015
• Exhibit 6-21: Bariatric Surgery Device Company Market Shares, Germany, 2007
• Exhibit 6-22: Bariatric Surgery Device Market, Italy, 2004-2015
• Exhibit 6-23: Bariatric Surgery Device Market, Italy, 2004-2015
• Exhibit 6-24: Bariatric Surgery Device Company Market Shares, Italy, 2007
• Exhibit 6-25: Bariatric Surgery Device Market, Spain, 2004-2015
• Exhibit 6-26: Bariatric Surgery Device Market, Spain, 2004-2015
• Exhibit 6-27: Bariatric Surgery Device Company Market Shares, Spain, 2007
• Exhibit 6-28: Bariatric Surgery Device Market, Scandinavia, 2004-2015
• Exhibit 6-29: Bariatric Surgery Device Market, Scandinavia, 2004-2015
• Exhibit 6-30: Bariatric Surgery Device Market, Rest of World, 2004-2015
• Exhibit 6-31: Bariatric Surgery Device Market, Rest of World, 2004-2015
• Exhibit 6-32: Pipeline of Selected Anorectic Pharmaceuticals, 2007
• Exhibit 6-33: Global Anorectic Pharmaceutical Market, 2004-2015
• Exhibit 6-34: Global Anorectic Pharmaceutical Market, 2004-2015
• Exhibit 6-35: Anorectic Pharmaceutical Market, USA & Canada, 2004-2015
• Exhibit 6-36: Anorectic Pharmaceutical Market, USA & Canada, 2004-2015
• Exhibit 6-37: Anorectic Pharmaceutical Market, EU & Scandinavia, 2004-2015
• Exhibit 6-38: Anorectic Pharmaceutical Market, EU & Scandinavia, 2004-2015
• Exhibit 6-39: Anorectic Pharmaceutical Market, United Kingdom, 2004-2015
• Exhibit 6-40: Anorectic Pharmaceutical Market, United Kingdom, 2004-2015
• Exhibit 6-41: Anorectic Pharmaceutical Market, France, 2004-2015
• Exhibit 6-42: Anorectic Pharmaceutical Market, France, 2004-2015
• Exhibit 6-43: Anorectic Pharmaceutical Market, Germany, 2004-2015
• Exhibit 6-44: Anorectic Pharmaceutical Market, Germany, 2004-2015
• Exhibit 6-45: Anorectic Pharmaceutical Market, Italy, 2004-2015
• Exhibit 6-46: Anorectic Pharmaceutical Market, Italy, 2004-2015
• Exhibit 6-47: Anorectic Pharmaceutical Market, Spain, 2004-2015
• Exhibit 6-48: Anorectic Pharmaceutical Market, Spain, 2004-2015
• Exhibit 6-49: Anorectic Pharmaceutical Market, Scandinavia, 2004-2015
• Exhibit 6-50: Anorectic Pharmaceutical Market, Scandinavia, 2004-2015
• Exhibit 6-51: Anorectic Pharmaceutical Market, ROW, 2004-2015
• Exhibit 6-52: Anorectic Pharmaceutical Market, ROW, 2004-2015
• Exhibit 7-1: Company Alliance Options