Is Rimonobant the Answer to Obesity?

Trials have shown that Rimonobant, just launched in the UK and sold under the brand name Acomplia, can reduce body weight by 10%.

It's an anti-obesity drug developed by the pharmaceutical company Sanofi Aventis and emerged as a result of research into the action of cannabis!

It's the first drug of its type to be approved for use in the UK.

So what does it do?

Rimonobant - What is it and How Does it Work...?

Research largely resulting from work on the action of cannabis has identified the endocannabinoid system.

This is a system of receptors and the enzymes that destroy them.

In their normal state, endocannabinoids act as neuromodulators and are produced when needed and quickly deactivated. However, in conditions such as obesity, endocannabinoid receptors can be overstimulated for long periods due to overproduction or not being deactivated quickly enough.

This overstimulation contributes to excessive food intake and fat storage, which can lead to obesity.

The logical question to ask then is whether blocking the endocannabinoid system could counter obesity and help people to lose weight?

Rimonobant is an endocannabinoid system blocker, which has undergone trials to research its potential as an anti-obesity therapy.

The one year trials reported in 2004 and the two year trials reported in 2005 were promising.

Rimonobant - Does it Work...?

Studies have shown that 20mgs taken daily for one year produced significant reductions in body weight and waist circumference compared with a placebo group.

Participants also exhibited improved glucose tolerance and insulin resistance and lowered tryglyceride levels.

Rimonobant also doubled the chances of quitting smoking compared to a placebo group - quit smoking and lose weight at the same time? Now that's a first!

The trials carried out in the US and Europe involved over 6,000 people.

The RIO Europe Study led by Luc Van Gaal reported in 2004 that 1 in 4 participants lost more than 10% of their body weight after a year, an average of 20lbs (9kg). Over half the participants lost over 5%.

Waist circumference reduced by an average 3 inches (7.5cms).

However, participants were also put on a calorie controlled diet and the placebo group lost around 5lbs (2.25kgs).

The drug also seems to be well tolerated with relatively mild and short-lived side effects in some users. These included nausea, dizziness and diarrhoea.

However, other research has indicated that it may excacerbate neurological disorders, the progression of multiple sclerosis and be contraindicated for stroke and head injury victims.

As a result of the two year trial data, Rimonobant was licensed for use in the UK. It's available on prescription for the treatment of obese patients and those with associated risk factors including high cholesterol and type 2 diabetes.

The UK's National Institute for Clinical Excellence (NICE), however, won't be assessing its cost-effectiveness for use in the NHS until 2008.

Rimonobant - The Bottom Line...

The National Obesity Forum recognised its potential to tackle the UK's growing obesity crisis. In particular, its potential benefit for overweight patients with high tryglycerides and low HDL cholesterol.

This was qualified by the recognition that weight management remains a lifestyle issue and that medication should be a last resort for people who've tried and failed to shift the excess pounds through diet and exercise.

Comments echoed by other doctors and health professionals...along the lines of drugs not being a substitute for diet and exercise. We'd go along with that.

Rimonobant costs £55 for a month's supply in the UK and judging by the trial results, you could expect to lose around 20lbs a year on average.

The evidence suggests that it does work and may be particularly beneficial for obese patients with associated risk factors...but so is a healthy diet and exercise. We know what we'd rather spend £55 a month on!

Rimonobant is also only available in the UK on prescription and for good reason. We'd advise against buying it over the internet or from anywhere else for that matter without a prescription from your doctor.

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