The ingenuity that has been devoted to obesity is boundless. Whether this be psychological, surgical or therapeutic .
As weight losses, achieved with lifestyle intervention are modest and limited by high rates of recidivism and compensatory slowing of metabolism there is a potential for even greater use of drug treatment In a meta analysis review by Rucker the use of the long term efficacy of anti-obesity drugs in reducing weight and improving health status is looked at.
The trials (30 trials of one to four years duration) were reviewe, all lasted for over a year. .
The drugs studied were
Orlistat, a gastrointestinal lipase inhibitor
sibutrarnine. a central!) acting monoamine reuptake inhibitor,
rimonabant an endocannabinoid receptor antagonist,
Compared with placebo, orlistat reduced weight by an average of 2.9 kg ,
sibutramine by 4.2 kg
rimonabant by 4.7 kg.
Patients receiving active drug treatment were significantly more likely to achieve 5% and 10% weight loss than control subjects.
Ortistat reduced the incidence of diabetes and improved concentrations of total cholesterol and low density lipoprotein cholesterol, blood pressure, and glycaemic control in patients with diabetes but increased rates of gastrointestinal side effects and slightly lowered concentrations of high density lipoprotein.
Sibutramine improved concentrations of high density lipoprotein cholesterol and triglycerides but raised blood pressure and pulse rate.
Rimonabant improved concentrations of high density lipoprotein cholesterol and triglycerides, blood pressure, and glycaemic control in patients with diabetes but increased the risk of mood disorders.
Rucker et al 2007, Long term pharmacotherapy for obesity and overweight: updated meta-analysis BMvol 335, 1194-9

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