A Fat Market
The market for treating obesity is one of the most potentially lucrative opportunities for manufacturers of neurotechnology devices, a point not lost on the numerous venture capital firms that have invested in this space recently [see article, page 1].
In many respects, the obesity market opportunity is greater than that posed by depression, itself a blockbuster for healthcare firms. One reason we believe this is that the success of neurotech approaches to treating obesity, should they emerge as hoped, will be readily evident to anyone with a scale—or even just a pair of eyes. Conversely, the failure of drug therapies for treating obesity will stand out like a sore...well, you pick the body part. Unlike the case with drug-resistant depression, individuals with morbid obesity who fail to respond to drugs will be readily apparent and presumably more amenable to neurotech interventions.
Another reason for our optimism is that many of the new gastric stimulation devices that may reach the market in the next few years can be implanted with minimal surgical intervention, a barrier that confronts other neurostimulation devices. And the fact that the therapy is readily reversible is likely to help win over individuals who have been reluctant to consider gastric surgical interventions.
That morbid obesity represents a high-growth market opportunity is hard to dispute, given the great cost to society in general and Medicare in particular. Surgical treatments for morbid obesity have grown six-fold over the last 10 years. More than three quarters of new cases of type II diabetes are related to obesity.
Still, one could wonder whether the market that emerges can support seven or eight competitors, when you add Medtronic and Cyberonics, two established neurotech players who are already eyeing the market, to startups like Leptos Biomedical, GI Dynamics, EnteroMedics, and IntraPace. Fortunately, neurotech firms are using at least three different approaches. These include autonomic system neuromodulation, brain stimulation, and direct stimulation of the stomach. It is quite possible that all three approaches will demonstrate different success profiles that a clinician can exploit to tailor an effective therapy for patients. It is also possible that certain obesity stimulation approaches will work well in combination with drugs or other therapies.
Some cynics may wonder whether we should celebrate the advent of technological interventions to treat obesity, rather than promote societal changes in diet and exercise that might be more appropriate in the long run. We would indeed listen to such criticism and nod our heads in approval, but nonetheless acknowledge that any and every medical approach that can help attack this growing problem should be kept on the table.
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