It is a repeated theme in the history of medtech development. Drugs represent an alluring treatment alternative, since the option to swallow a pill to deal with a problem will almost always be more attractive than any other option. Biotech products offer the potential to target the root cause of the problem. However, drugs and biotechs have enormous hurdles to proving safety and efficacy. Meanwhile, medical devices — being far more difficult to use than drugs and being much more symptom-oriented and less root cause-oriented than biotechs — are frequently able to more readily prove safety and efficacy.
So, now, as yet another obesity drug (Orexigen's Contrave) has been rejected by the FDA, the upside for obesity devices (with many already on the market) continues to be more promising (while biotechs are not even part of the equation here). Below is the outlook for different obesity device treatment types through 2019.
Source: "Products, Technologies and Markets Worldwide for the Clinical Management of Obesity, 2011-2019", Report #S835.
To be clear, this does not say that there still isn't enormous potential for obesity drugs — indeed, reports that the obesity drug market is dead are naively premature, even with recent FDA drug rejections — since the demand for drugs remains high even if obesity incidence rates were not skyrocketing or even if there was not already an enormous and growing obesity device market as shown above.
The precedence in clinical practice, the regulatory environment and the healthcare market for obesity devices simultaneously represent the opportunity and challenge for obesity drugs to succeed.