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Rimonabant for the treatment of obesity:
a few kilos less but too many unknowns

Rimonabant, widely trumpeted in recent months as the miracle cure for obesity, "metabolic syndrome" and tobacco dependency, has turned out to be much ado about nothing.

The clinical trials conducted on rimonabant, an anti-obesity drug which should soon be on sale in France, show that the drug leads to a modest weight loss of around 4 to 5 kg in a year. On stopping the treatment, the lost weight is regained in around 9 months. The currently known adverse effects of rimonabant are mainly psychiatric (anxiety, depression), neurological (giddiness) and digestive (nausea and diarrhoea). There are still a lot of unanswered questions concerning its long-term adverse effects.

Many patients suffer from excessive weight, which can lead to various cardiovascular and rheumatological complications. To treat obesity, it is better to adhere to a hypocaloric diet and a regime of moderate but regular physical exercise. In adults, if it is judged appropriate to prescribe drug therapy for a few weeks or months, orlistat is preferable because it has been used for some time, even if it is not very effective and often unpopular with patients because of its adverse effects.

It is advisable to avoid using rimonabant until its effect on morbidity and mortality rates can be proven, and until there is sufficient data on its adverse effects.

©Prescrire July 2006

Source: "Rimonabant (Acomplia°). Obésité : quelques kilos en moins mais trop d'inconnues" Rev Prescrire 2006 ; 26 (273) : 405-409.

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