Obesity is a global epidemic, afflicting more than 66 million people in the United States (U.S.) and an estimated 300 million people worldwide.  Obesity directly contributes to several life-threatening conditions, including cardiovascular disease, cancer, diabetes, hypertension and stroke and costs for treating obesity in the U.S. surpass $120 billion.

This report discusses current and emerging anti-obesity drugs and bariatric surgical devices.  In 2005, the U.S. market for obesity drugs and bariatric surgical devices was estimated at more than $350 million.  This market is expected to grow at a compound annual rate of approximately 36%, reaching more than $1.6 billion in 2010.

While the obesity drug market has had a checkered history due to serious or unwanted side effects and several major product withdrawals, several new improved drugs are emerging that are expected to turn this segment into a significant growth market.  Dozens of pharmaceutical companies have promising anti-obesity compounds under clinical trials and the competitive landscape will no doubt change dramatically over the coming decade.  A blockbuster obesity drug—if proven safe and effective long-term—has the potential to achieve annual sales in excess of $1 billion.  It is expected that one or more leading obesity drugs, including sanofi-aventis’ ACOMPLIA, will hit the market over the next five years.

Bariatric surgery—although typically reserved for the morbidly obese with no other options—is continuing rapid growth due to the increase in the obese population and increase in bariatric surgery advertising, surgeon training, insurance coverage, and public awareness.  While gastric bypass comprised approximately 80% of all bariatric surgery procedures in 2005, gastric banding is expected to continue double-digit growth due to the popular LAP-BAND, as well as the introduction of competitive systems.  In addition, less invasive intragastric balloons may serve as a “bridge” to bariatric surgery and new and emerging noninvasive weight loss devices are under development.  Finally, less invasive gastric nerve stimulators, pioneered by Medtronic, are expected to be introduced on the market in 2008 and may initially achieve annual sales of more than $100 million.

This dynamic report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities.  Covered topics in this report include: obesity drugs, gastroplasty, gastric bypass, gastric banding, intragastric balloons, general and laparoscopic surgical instruments, body contouring, gastric nerve stimulators and emerging noninvasive weight loss devices.

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U.S. Markets for Obesity Drugs and Bariatric Surgical Devices	A150	February 2007	$4,750*
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TABLE OF CONTENTS AND LIST OF EXHIBITS

EXECUTIVE SUMMARY

i.       Causes of Obesity

ii.       Obesity as a Component of Metabolic Syndrome

iii.      Obesity-Related Comorbidities

iv.      Obesity Statistics

v.      Emerging Obesity Drugs

vi.      Obesity Drugs Market

vii.     Bariatric Surgical Devices

viii.    Bariatric Surgery Market

ix.      Gastric Stimulators

x.      Gastric Stimulators Market

xi.      Total Obesity Drugs and Devices Market

xii.     Methodology

Exhibit ES-1:       Obesity Classification, by Body Mass Index

Exhibit ES-2:       Causes of Obesity

Exhibit ES-3:       Cellular Mechanisms Involved in Lipid Deposition and Mobilization

Exhibit ES-4:       Macronutrient Modulation Theories of Obesity

Exhibit ES-5:       Obesity Comorbidities

Exhibit ES-6:       2005, Obesity, Facts and Figures

Exhibit ES-7:       Increase in Overall Prevalence of Overweight and Obesity in Adults, 1976 to 2004

Exhibit ES-8:       2007, Selected Obesity Drugs Under Development

Exhibit ES-9:       2007, Most Promising Obesity Drugs Expected to Launch in the Next 5 Years

Exhibit ES-10:     Prescription Obesity Drugs, Patient Volumes Forecast, 2005-2010

Exhibit ES-11:     Prescription Obesity Drugs, Market Forecast, 2005-2010

Exhibit ES-12:     2007, Selected Gastric Banding Devices

Exhibit ES-13:     Bariatric Surgery, Procedure Volumes Forecast, 2005-2010

Exhibit ES-14:     2005, Bariatric Surgeries, by Type

Exhibit ES-15:     2010, Bariatric Surgeries, by Type

Exhibit ES-16:     Bariatric Surgical Devices, Combined Market Forecast, 2005-2010

Exhibit ES-17:     Overview of Gastric Stimulation

Exhibit ES-18:     2007, Selected Current and Emerging Gastric Stimulators

Exhibit ES-19:     Gastric Stimulators, Market Forecast, 2005-2010

Exhibit ES-20:     Total Obesity Products Market, Market Forecast, 2005-2010

Exhibit ES-21:     2005, Total Obesity Products Market, Share of Sales, by Application

Exhibit ES-22:     2010, Total Obesity Products Market, Share of Sales, by Application

1. CLINICAL AND STATISTICAL OVERVIEW

1.1 Overview of the Digestive System

1.2 Obesity Defined

1.2.1 Body Mass Index

1.2.2 Waist Circumference and Visceral Obesity

1.3 Causes of Obesity

1.3.1 Hormonal Factors

1.3.1.1 Cholecystokinin

1.3.1.2 Ghrelin

1.3.1.3 Leptin

1.3.1.4 Obestatin

1.3.2 Genetic Factors

1.3.3 Behavioral and Environmental Factors

1.3.4 Other Causes of Obesity

1.3.5 Obesity as a Component of Metabolic Syndrome

1.4 Obesity-Related Comorbidities

1.5 Obesity Statistics

1.5.1 Incidence

1.5.2 Prevalence

1.5.2.1 Prevalence by Age

1.5.2.2 Prevalence by Gender

1.5.2.3 Prevalence by Ethnic/Racial Group

1.5.2.4 Prevalence by Economic Status

1.5.2.5 Prevalence by State

1.5.2.6 Prevalence of Morbid and Super Morbid Obesity

1.5.2.7 Prevalence in Children and Adolescents

1.6 Economic Impact

1.7 Treatment and Prevention

1.7.1 Drug Therapy

1.7.2 Surgery

1.8 Medicare Coverage

1.9 Societal and Legal Issues

Exhibit 1-1:         Obesity Classification, by Body Mass Index

Exhibit 1-2:         Obesity Classification, by Body Fat Distribution

Exhibit 1-3:         Causes of Obesity

Exhibit 1-4:         Cellular Mechanisms Involved in Lipid Deposition and Mobilization

Exhibit 1-5:         Hunger-Affecting Hormones

Exhibit 1-6:         Macronutrient Modulation Theories of Obesity

Exhibit 1-7:         Obesity Comorbidities

Exhibit 1-8:         Proportion of Cancers that May Be Attributed to Obesity

Exhibit 1-9:         Prevalence of Selected Medical Conditions in Men, by Body Mass Index

Exhibit 1-10:       Prevalence of Selected Medical Conditions in Women, by Body Mass Index

Exhibit 1-11:       2005, Obesity, Facts and Figures

Exhibit 1-12:       Increase in Overall Prevalence of Overweight and Obesity in Adults, 1976 to 2004

Exhibit 1-13:       Historical Prevalence of Obesity, by Age and Gender, 1988-1994 and 1999-2000

Exhibit 1-14        Historical Prevalence of Overweight, Obesity, and Morbid Obesity, by Gender, 1988-1994 and 1999-2000

Exhibit 1-15:       Historical Prevalence of Overweight and Obesity, by Racial/Ethnic Group, 1988-1994 and 1999-2000

Exhibit 1-16:       Obesity Prevalence, by Education Level, 1991, 1998, 2000, and 2001

Exhibit 1-17:       Prevalence of Obesity, by State, 1991, 1998, 2000, and 2004

Exhibit 1-18:       Prevalence of Morbid and Super Morbid Obesity, by Gender and Racial/Ethnic Group, 1988-1994 and 1999-2000

Exhibit 1-19:       Prevalence of Morbid and Super Morbid Obesity, by Age, 1990-1991 and 2000

Exhibit 1-20:       Prevalence of Morbid and Super Morbid Obesity, by Level of Education, 1990-1991 and 2000

Exhibit 1-21:       Prevalence of Obesity in Children, 1971-1974, 1988-1994, and 1999-2000

Exhibit 1-22:       Prevalence of Obesity in Children, by Racial/Ethnic Group

Exhibit 1-23:       2005, Obesity-Related Standards in Schools

Exhibit 1-24:       Estimated Obesity-Related Disease Costs to Medicare, 1992, 2000, and 2004

Exhibit 1-25:       2005, National Institutes of Health Funding, by Selected Areas

2. OBESITY DRUGS MARKET

2.1 Drug Safety and Efficacy

2.1.1 Drug Safety History

2.1.2 Efficacy

2.2 Regulatory Approval Process

2.2.1 Enhancing Drug Safety and Innovation Act of 2006 and Fair Access to Clinical Trials Act

2.3 Insurance Reimbursement

2.4 Current Obesity Drugs

2.4.1 Benzphetamine Hydrochloride/Didrex

2.4.2 Diethylpropion Hydrochloride/Tenuate

2.4.3 Mazindol/Mazonor and Sanorex

2.4.4 Phentermine/Adipex

2.4.5 Orlistat/Xenical

2.4.5.1 Alli

2.4.6 Sibutramine Hydrochloride Monohydrate/Meridia

2.5 Emerging Drugs

2.5.1 Cannabinoid Antagonists

2.5.1.1 Bristol-Myers Squibb and Solvay Pharmaceuticals/Solvay

2.5.1.2 Glenmark Pharmaceuticals

2.5.1.3 Merck

2.5.1.4 Pfizer

2.5.1.5 sanofi-aventis

2.5.2 Lipase Inhibitors

2.5.2.1 Alizyme

2.5.2.2 Genzyme and Peptimmune

2.5.3 Melanin-Concentrating Hormone Antagonists

2.5.3.1 Amgen

2.5.3.2 GlaxoSmithKline

2.5.3.3 Neurocrine Biosciences

2.5.3.4 Neurogen

2.5.4 Peptide YY3-36

2.5.4.1 Amylin Pharmaceuticals

2.5.4.2 Nastech Pharmaceutical

2.5.5 Selective Serotonin Receptor Agonists

2.5.5.1 Arena Pharmaceuticals

2.5.5.2 Biovitrum and GlaxoSmithKline

2.5.5.3 EPIX Pharmaceuticals

2.5.5.4 (OSI) Prosidion/OSI Pharmaceuticals

2.5.6 Other Emerging Drugs

2.5.6.1 AdipoGenix and Johnson & Johnson

2.5.6.2 Amylin Pharmaceuticals

2.5.6.3 BioLineRX

2.5.6.4 Biovitrum and Amgen

2.5.6.5 ChemGenex Pharmaceuticals

2.5.6.6 CytRx

2.5.6.7 Daiichi Pharmaceutical/Daiichi Sankyo

2.5.6.8 Eisai

2.5.6.9 FASgen

2.5.6.10 Forbes Medi-Tech and Merck

2.5.6.11 Glenmark Pharmaceuticals and Merck KGaA

2.5.6.12 Karo Bio

2.5.6.13 Manhattan Pharmaceuticals

2.5.6.14 Metabolic Pharmaceuticals

2.5.6.15 OREXIGEN Therapeutics

2.5.6.16 Surface Logix

2.5.6.17 VIVUS

2.5.7 Delayed or Discontinued Drug Programs

2.5.7.1 GlaxoSmithKline

2.5.7.2 Johnson & Johnson

2.5.7.3 Eli Lilly

2.5.7.4 Merck

2.5.7.5 Millennium Pharmaceuticals

2.5.7.6 Phytopharm and Pfizer

2.5.7.7 Regeneron Pharmaceuticals

2.6 Alternative Therapies

2.7 Market Analysis

2.8 Competitive Analysis

Exhibit 2-1:         Selected Centrally Acting Obesity Drugs

Exhibit 2-2:         Safety Risks Associated with Leading Prescription Obesity Drugs

Exhibit 2-3:         Efficacy of Leading Prescription Obesity Drugs

Exhibit 2-4:         2007, Leading Prescription Weight-Loss Medications

Exhibit 2-5:         2007, Selected Obesity Drugs Under Development

Exhibit 2-6:         2007, Most Promising Obesity Drugs Expected to Launch in the Next 5 Years

Exhibit 2-7:         2007, Selected Cannabinoid Antagonists Under Development

Exhibit 2-8:         2007, Selected Lipase Inhibitors Under Development

Exhibit 2-9:         2007, Selected Melanin-Concentrating Hormone Antagonists Under Development

Exhibit 2-10:       2007, Selected Peptide YY3-36 Drugs Under Development

Exhibit 2-11:       2007, Selected Serotonin Receptor Agonists Under Development

Exhibit 2-12:       Prescription Obesity Drugs, Patient Volumes Forecast, 2005-2010

Exhibit 2-13:       Prescription Obesity Drugs, Market Forecast, 2005-2010

Exhibit 2-14:       2005, Prescription Obesity Drugs Market, Share by Supplier

Exhibit 2-15:       2010, Prescription Obesity Drugs Market, Projected Share by Supplier

3. BARIATRIC SURGERY MARKET

3.1 Surgical Risks

3.2 Efficacy

3.3 Regulatory Approval Process

3.4 Insurance Reimbursement

3.5 Bariatric Surgery

3.5.1 Traditional Bariatric Surgery

3.5.1.1 Gastric Bypass

3.5.1.1.1 Laparoscopic Gastric Bypass

3.5.1.1.2 Vertical Banded Gastric Bypass

3.5.1.2 Gastroplasty

3.5.1.2.1 Horizontal Gastroplasty

3.5.1.2.2 Vertical Banded Gastroplasty

3.5.2 Less Invasive Bariatric Surgery

3.5.2.1 Gastric Banding

3.5.2.1.1 Agency for Medical Innovations

3.5.2.1.2 Cousin Biotech

3.5.2.1.3 EndoArt/Allergan

3.5.2.1.4 Ethicon Endo-Surgery/Johnson & Johnson

3.5.2.1.5 Hélioscopie

3.5.2.1.6 Inamed/Allergan

3.5.2.1.7 Médical Innovation Développement

3.5.2.2 Intragastric Balloons

3.5.2.2.1 Hélioscopie

3.5.2.2.2 Inamed/Allergan

3.5.2.2.3 Satiety

3.5.2.3 Emerging Noninvasive Weight Loss Devices

3.5.2.3.1 BaroNova

3.5.2.3.2 BaroSense

3.5.2.3.3 EndoGastric Solutions

3.5.2.3.4 GI Dynamics

3.5.2.3.5 Satiety

3.5.2.3.6 Scientific Intake

3.6 Body Contouring

3.6.1 Syneron

3.6.2 LipoSonix

3.7 General and Laparoscopic Surgical Instruments

3.7.1 Aesculap/B. Braun Melsungen

3.7.2 ConMed EndoSurgery/ConMed

3.7.3 Wilson-Cook Medical/Cook Group

3.7.4 Ethicon Endo-Surgery/Johnson & Johnson

3.7.5 Gore Medical/W.L. Gore & Associates

3.7.6 Olympus Surgical & Industrial America/Olympus

3.7.7 Silhouette Medical

3.7.8 Karl Storz

3.7.9 United States Surgical/Tyco International

3.8 Market Analysis

3.9 Competitive Analysis

Exhibit 3-1:         Common Bariatric Surgical Procedures

Exhibit 3-2:         Risks Associated With Leading Bariatric Surgical Procedures

Exhibit 3-3:         Contraindications for Bariatric Surgery

Exhibit 3-4:         Efficacy of Leading Bariatric Surgery Procedures

Exhibit 3-5:         Comparison of Mean Weight Loss and Diabetes Resolution of Major Types of Gastric Surgery

Exhibit 3-6:         Food and Drug Administration Medical Device Classes, Bariatric Surgical Instruments and Implantable Devices

Exhibit 3-7:         Comparison of Major Types of Bariatric Surgery

Exhibit 3-8:         2007, Selected Gastric Banding Devices

Exhibit 3-9:         The Bioring Adjustable Gastric Banding System

Exhibit 3-10:       Easyband Telemetrically Adjustable Gastric Banding System

Exhibit 3-11:       The Lap-Band Adjustable Gastric Banding System

Exhibit 3-12:       Selected Benefits of the Lap-Band Adjustable Gastric Banding System

Exhibit 3-13:       The Heliosphère Intragastric Balloon

Exhibit 3-14:       The BioEnterics Intragastric Balloon System

Exhibit 3-15:       Possible Complications Associated with the BioEnterics Intragastric Balloon System

Exhibit 3-16:       Satiety’s Space-Occupying Intragastric Device and Minimally Invasive Anchoring Procedure

Exhibit 3-17:       Ethicon Endo-Surgery’s Harmonic Scalpel

Exhibit 3-18:       Ethicon Endo-Surgery’s ENDOPATH Endoscopic Linear Cutters

Exhibit 3-19:       Bariatric Surgery, Procedure Volumes Forecast, 2005-2010

Exhibit 3-20:       2005, Bariatric Surgery, by Type

Exhibit 3-21:       2010, Bariatric Surgery, by Type

Exhibit 3-22:       Gastric Banding Devices, Market Forecast, 2005-2010

Exhibit 3-23:       Intragastric Balloons, Market Forecast, 2005-2010

Exhibit 3-24:       Bariatric Surgical Devices, Combined Market Forecast, 2005-2010

Exhibit 3-25:       2005, Bariatric Surgical Devices, Share of Sales,  by Segment

Exhibit 3-26:       2010, Bariatric Surgical Device, Share of Sales,  by Segment

4. GASTRIC STIMULATORS MARKET

4.1 Methods of Gastric Stimulation

4.1.1 Overview of Vagus Nerve Stimulation

4.2 Safety

4.3 Efficacy

4.4 Insurance Reimbursement

4.5 Regulatory Approval Process

4.6 Current and Emerging Gastric Stimulators

4.6.1 Advanced Neuromodulation Systems/St. Jude Medical

4.6.2 Cyberonics

4.6.3 EnteroMedics

4.6.4 GI Dynamics

4.6.5 IntraPace

4.6.6 Leptos Biomedical

4.6.7 Medtronic

4.6.8 MetaCure

4.7 Market Analysis

4.8 Competitive Analysis

Exhibit 4-1:         Overview of Gastric Stimulation Technology

Exhibit 4-2:         2006, Selected Advantages and Disadvantages of Gastric Stimulation

Exhibit 4-3:         Known Risks/Complications of Gastric Stimulation

Exhibit 4-4:         Efficacy of Gastric Stimulation

Exhibit 4-5:         2007, Selected Current and Emerging Gastric Stimulators

Exhibit 4-6:         EnteroMedic’s Vagal Blocking for Obesity Control Therapy

Exhibit 4-7:         EnteroMedic’s Vagal Blocking for Obesity Control Therapy Compared to Lap-Band and Gastric Bypass

Exhibit 4-8:         Medtronic’s Enterra Gastric Stimulation System

Exhibit 4-9:         MetaCure’s TANTALUS Gastric Stimulation System

Exhibit 4-10:       Gastric Stimulators, Procedure Volumes and Market Forecast, 2005-2010

5. COMPANY PROFILES

5.1    Abbott Laboratories

5.2    Arena Pharmaceuticals, Inc.

5.3    BaroNova, Inc.

5.4    BaroSense, Inc.

5.5    Cyberonics, Inc.

5.6    EndoArt SA

5.7    EnteroMedics, Inc.

5.8    Ethicon Endo-Surgery/Johnson & Johnson

5.9    GlaxoSmithkline PLC

5.10  Hélioscopie SA

5.11  Inamed Corporation/Allergan, Inc.

5.12  IntraPace, Inc.

5.13  Leptos Biomedical, Inc.

5.14  Medtronic, Inc.

5.15  Merck & Company, Inc.

5.16  MetaCure NV

5.17  Pfizer, Inc.

5.18  F. Hoffmann La-Roche LTD/Roche Group

5.19  Sanofi-Aventis

5.20  Satiety, Inc.

5.21  Scientific Intake

5.22  VIVUS, Inc.

APPENDIX:  COMPANY LISTING

Copyright 2007, Medtech Insight, LLC