Overweight and obesity increase the risk of a number of chronic conditions, including cardiovascular disease and type 2 diabetes . Rimonabant, a weight-loss medication that is still being studied in clinical trials, has shown promise in promoting weight loss and reducing diabetes and other cardiovascular risk factors in overweight and obese people.

A new study in the November 17, 2005 issue of the New England Journal of Medicine examined the effects of rimonabant in overweight and obese people with cholesterol problems. Researchers found that rimonabant resulted in significant reductions in body weight and waist circumference, as well as improvements in diabetes and other cardiovascular risk factors.

About the Study

This study included 1,036 people who were overweight or obese with untreated cholesterol problems. The participants were randomly assigned to receive 5 milligrams (mg) rimonabant, 20 mg rimonabant, or a placebo pill daily for 12 months. In addition, all participants followed a reduced-calorie diet. Each month, researchers measured the participants’ weight, waist circumference, and blood levels of cholesterol and other markers of cardiovascular risk, including diabetes.

Over 12 months, 20 mg of rimonabant was associated with a 19-pound weight loss, compared with 9- and 5-pound weight losses in the groups receiving 5 mg of rimonabant and the placebo, respectively. The participants lost 3.5, 1.9, and 1.3 inches around their waist while taking 20 mg of rimonabant, 5 mg of rimonbant, and the placebo, respectively. Participants taking 20 mg of rimonabant showed significant improvements in triglyceride, HDL (“good”) cholesterol, total cholesterol, blood pressure, and insulin levels. Adverse events (e.g., nausea, influenza, anxiety, diarrhea, insomnia) were slightly higher in the participants receiving rimonabant.

It is important to point out that this study was funded by Sanofi Aventis, the pharmaceutical company that developed rimonabant and will sell it if approved for use.

How Does This Affect You?

These findings suggest that taking rimonabant in combination with a restricted diet results in weight loss, reductions in waist circumference, and improvements in diabetes and other cardiovascular risk factors. Since waist circumference may be even more important in determining cardiovascular risk than bodyweight, rimonabant could result in health benefits beyond what could be expected with weight loss alone.

Another study in the same issue of the New England Journal of Medicine underscored the importance of combining weight-loss medications with lifestyle modifications (e.g., healthful diet, regular exercise). Researchers found that people who took another weight-loss medication, sibutramine (Meridia), in combination with lifestyle modification lost approximately twice as much weight as people receiving the medication or lifestyle-modification counseling alone.

If you are overweight or obese, a new weight-loss drug may be on the horizon (rimonabant may be available in early 2006). But the widespread use of rimonabant is still far off, and the long-term effects have not yet been established. Some weight-loss medications that have become available in the past few decades have since been pulled from the market because of dangerous adverse effects. If rimonabant becomes available, talk to your doctor to find out if the benefits of rimonabant outweigh its possible risks.