Rimonabant is an anorectic anti obesity drug. It is a CB1 cannabinoid receptor antagonist. Its main avenue of effect is reduction in appetite. Obesity is now the most common nutritional disorder in western countries. Defined as a body mass index of greater than 30, it arises from the accumulation of excess fat in the body from overconsumption of fatty foods. Prevalence of obesity in the US and Europe has reached epidemic levels.
Data from the World Health Organization show that in some parts of Europe over 70% of men aged 55-64 years are clinically obese or overweight (BMI >25) and almost 70% of women in this age group. One in five of all Americans is obese and one in three overweight. Furthermore, increasing rates of childhood obesity are likely to exacerbate the trend towards increasing obesity in adulthood.
Some other prescription medicines are used to treat weight loss, but aren’t FDA-approved for treating obesity. They include drugs to treat depression, drugs to treat seizures and drugs to treat diabetes. Some depression treatments cause an initial weight loss and then a regain of weight while taking the medicine.
Two drugs used for seizures, topiramate and zonisamide, have been shown to cause weight loss. These drugs are being studied to see whether they will be useful in treating obesity, but have not received FDA approval. Metformin, a diabetes drug, may cause small amounts of weight loss in people with obesity and diabetes. It’s not known how this drug causes weight loss, this I being studied at the moment.
Over the counter products often claim that a person taking them will lose weight. The FDA doesn’t regulate these products because they’re considered dietary supplements, not medicines. However, many of these products have serious side effects and aren’t generally recommended. A few over the counter products include:
• Ephedra (also called ma-huang). Ephedra comes from plants and has been sold as a dietary supplement. The active ingredient in the plant is called ephedrine. Ephedra can cause short-term weight loss. It also has serious side effects. It causes high blood pressure and stresses the heart. In fact, because ephedra poses a serious health risk, the FDA has advised people to stop using dietary supplements that contain it.
• Chromium. This is a mineral that’s sold as a dietary supplement to reduce body fat. While studies haven’t found any weight loss benefit from chromium, there are few serious side effects from taking it. A study from Dartmouth College has shown that chromium can damage genetic material in hamster cells. It is studied now if chromium could cause cancer or similar side effects in humans.
• Diuretics and herbal laxatives. These products cause you to lose water weight, not fat. They also can lower your body’s potassium levels, which may cause heart and muscle problems.
• Hoodia. Hoodia is a cactus that is native to Africa. It’s sold in pill form as an appetite suppressant. However, there is no firm evidence that hoodia works. No large-scale research has been done on humans to show whether hoodia is effective or safe.
Before starting any weight loss treatment consult your primary physician. Inform him of your decision and of any drug or supplement you intend to take during your weight loss course.