Rimonabant Diet Pills Work and Lower HDL Cholesterol and Triglycerides - Weight Loss Drug for the Obese

February 15th 2006

Rimonabant

The diet pill rimonabant not only helped lower weight in test subjects and keep it off, it also lowered the bad cholesterol HDL and triglyceride levels. According to the background information in the Journal of the American Medical Association (JAMA) article, the researchers believe that besides weight loss, obesity management should target improvement in certain cardiometabolic risk factors, which include abnormal cholesterol and glucose (blood sugar) levels and excess weight around the waist.

This research determined just that. It looked at rimonabant in conjunction with promoting reductions in weight, waist circumference, long-term weight maintenance, and reduction of cardiometabolic risk factors in obese and higher risk overweight patients.

F. Xavier Pi-Sunyer, M.D., of St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York did a randomized, double blind, placebo-controlled study. It involved 3,045 obese and overweight adults, and other adults with dyslipidemia. Dyslipemia is a condition where the patient has abnormal levels of certain lipids and lipoproteins in the blood.

The test subjects received a placebo, a 5mg/d of rimonabant or a 20mg/d of rimonabant. They took the pills for 1 year. After the first year the subjects were re-randomized to receive placebo or continued to receive the same rimonabant dose while the placebo group continued to receive placebo during year 2.

The diet pill worked. After randomization, weight loss from baseline to 1-year was significantly greater in patients receiving 20 mg or 5 mg of rimonabant than in patients receiving the placebo.

The 20mg patients did better than the 5 mg patients. The percentage of patients achieving a 5 percent or greater weight loss at 1-year was 26.1 percent for patients receiving 5 mg of rimonabant, 48.6 percent for patients receiving 20 mg of rimonabant, and 20.0 percent for patients receiving placebo. The 20mg group also had a greater average reduction in waist circumference, and level of triglycerides and a greater increase in level of high-density lipoprotein (HDL) cholesterol.

The bad news is that once the 20mg patients discontinue use, the weight came back. Those that continued the 20mg regimen did not regain the weight. The authors concluded, “Our observations collectively suggest that rimonabant may well represent an innovative approach to the management of multiple cardiometabolic risk factors, facilitating and maintaining improvements through weight loss–dependent and –independent pathways.”

There were some side effects and a high dropout rate for the study. The authors said "It must be acknowledged that the trial was limited by a high dropout rate and that long-term effects of the drug require further study.” The most common side effect was nausea. This was experienced by 11.2% of the 20mg group, and by 5.8% of the placebo group.