Pleasure-Blocker Accomplia Shows Promise as Weight-Loss Drug
A 2-year longitudinal study shows that men and women taking the experimental weight-loss drug rimonabant lost weight and kept it off. However, specialists warn that medication use should be minimized when lifestyle changes can achieve the same purpose.
A two year randomized controlled trial of rimonabat — to be sold as Accomplia — published in the Journal of the American Medical Association reports both weight loss and an improvement in blood levels of cholesterol and triglycerides in individuals who stayed on the experimental drug for the full trial period. If approved by the FDA, Accomplia would become the third major drug approved for weight loss, after orlistat (sold as Xenical) and sibutramine (sold as Meridia).
However, specialists are already warning — in an editorial in the same issue of the journal — that use of medications for weight loss should be minimized: “I think rimonabant should play a very minimal role,” says Dr. Denise Simons-Morton, author of the accompanying editorial and director of the clinical applications prevention program at the National Heart, Lung, and Blood Institute. “I don’t think the weight loss they got was any better than what you get from lifestyle, and drugs always have side effects. We should minimize using medications if lifestyle [changes] will serve the purpose.”
According to an article carried by PsycPort:
Rimonabant acts by blocking receptors in the endocannabinoid system, one of the body’s pleasure centers — the same class of centers affected by marijuana. It is the first such drug to be tested.
For this trial, more than 3,000 obese or overweight adults who also had hypertension or dyslipidemia (abnormal blood fat levels) were randomized to receive daily doses of either a placebo, 5 milligrams of rimonabant, or 20 milligrams of rimonabant for one year.
Only 51 percent of the participants in the placebo or 5-milligram rimonabant group finished one year of therapy, the researchers report, and just 55 percent did so in the 20-milligram group.
At the end of the first year of the study, 26.1 percent of patients receiving 5 milligrams of rimonabant achieved a 5 percent or greater weight loss versus 48.6 percent for patients receiving 20 milligrams of rimonabant, and 20 percent for patients receiving the placebo.
Compared with the placebo group, participants taking the higher dose of rimonabant had greater average reductions in weight, waist circumference and triglyceride levels, along with a greater increase in HDL (”good”) cholesterol levels. The weight loss was comparable to weight loss achieved with either Xenical or Meridia, the researchers added.
The article goes on:
Outside experts were concerned that other adverse effects might materialize once the drug is taken by a greater number of people and possibly for longer periods of time.
“We still don’t know how long people will be on it, and we’re worried about side effects,” Simons-Morton says. “When you get more people on the medication, you discover more effects.”
The dropout rate for the study was also very high, with only about half the people in each treatment group staying on the drug, she says. Calculations were based only on those who took the drug, not on the original number in the study.
“That’s an extremely high dropout rate,” Simons-Morton says.
“Doing those kinds of educated guesses to pick values isn’t nearly as good as actually having measurements. I don’t know if their assumptions are correct or not. If you want to know what the results of a drug will be, you have to take into account everyone it’s prescribed for, and not just the people who take it.”
Overall, Simons-Morton says, the evidence for pharmaceuticals trumping lifestyle change for effective weight loss is less than overwhelming.
“People are looking for magic bullets and things are much more complicated than that,” she says. “Human biology and life in society is just more complex than that. Lifestyle is the preferred way to go. The drug may be useful in some people if they are successful early on in lifestyle and start to gain weight back.”
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This article was last reviewed by on Thursday, 16th February 2006. You can leave a response below.
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13th March 2007
I have read your comment with interest as a diabetic person type 2 I have tried the other 2 slimming tablet the Sibutramine made me extremly thirsty and did nothing to the painfull hunger therefore had the reverse effect and as for Orlistat(Xenical)has not stop the hunger but however the weight remained steady but the down side is very Oily messy. By the Way I used to be 12.5 Stones and now 17.13 stones.
For the last 2 weeks I have been on accomplia I have noticed an important difference is I crave no more for food and I feel happier within myself as for the side effect I have noticed none maybe is too early?
I hope this will help others outthere.
21st April 2007
I have been on acomplia for just 4 days now,and I have already noticed that I am not as hungry,and I am not craving food. I have had afew side effects, mainly feeling abit tired and slightly more relaxed. I did also have abit of a headache for the first two days that I took it. I feel alot happier in myself already( due to the fact I am just glad to be given the chance to take this pill). I have tried sibutramine and xenical,and did manage to lose six stone in ten months on sibutramine,but I think it alters your mind(as it works on your brain) and seems to give you a “high” feeling,but my body got used to it and it stopped working. I will post more about my experience with acomplia in due course,and to anyone else taking acomplia “Goodluck”!!!