We know about Xenical, Meridia, and phentermine. Xenical blocks fat absorption, with unpleasant effects in a number of people. Meridia affects our brain chemistry, which some people can handle, and others canít. Phentermine has helped many, but itís also part of the infamous fen-phen combination that killed and injured many desperate people.
And for what? An extra 2-10% weight loss that often comes back when the medication is stopped? And now rimonabant [named Acomplia] is next on the horizon. It blocks cannabinoid receptors in the brain, believed to be involved in cravings. Itís finding uses in helping people stop smoking, and in reducing food consumption. Some people think itís a miracle, others are more cautious.
Thereís been some evidence that blocking these cannabinoid receptors may result in colon inflammation, like irritable bowel syndrome or Crohnís disease. Thereís even been a case of multiple sclerosis reported, although that might have been a coincidence. Bottom line, thereís no real way to determine the risks associated with rimonabant Ė or any other drug for that matter Ė until itís on the market and used by many many people.
Iím not necessarily anti-drug. They have a place in our lives. But, given the complexity of obesity and overeating, and the fact that neurochemistry is involved, I donít think that a single drug will necessarily be the answer. We just donít know enough about the many roles each brain chemical has. So far, they all seem to wear many hats. And jiggling the balance may improve one disease, but worsen or even cause another.
We have to be careful of claims. We have to make ourselves informed consumers, and we have to consider all the risks and benefits, and decide what we can live with. But perhaps more important, if we decide that one of these drugs will help us, weíd better be prepared to use them carefully and to make whatever changes we need to keep the weight off. These drugs are designed for weight LOSS, not for weight MAINTENANCE, and no matter how well they might work for us, we can’t stay on them forever.