Original Article

Drugs in the treatment of obesity: sibutramine, orlistat and rimonabant

Miguel A Rubio^a1 c1, Manuel Gargallo^a2, Ana Isabel Millán^a3 and Basilio Moreno^a3

^a1 Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, c/ Martín Lagos s/n, 28040 Madrid, Spain

^a2 Department of Endocrinology and Nutrition, Hospital Virgen de la Torre, Madrid, Spain

^a3 Department of Endocrinology and Nutrition, Hospital Gregorio Marañón, Madrid, Spain

Abstract

Background Modification of lifestyle is the main therapeutical approach in the treatment of obesity, but use to fail on long terms of time. Addition of anti-obesity drugs allows keeping the weight loss during years and improving obesity-related comorbidities.

Methods This review is an actualisation on efficacy, safety and tolerability of the approved drugs on the long-term treatment of obesity (orlistat and sibutramine). New indications and effects of their use far beyond the weight loss are as well commented. Finally, potential benefits of the administration of CB1 antagonist rimonabant on the weight loss and cardiometabolic risk factors are analysed in detail.

Discussion A decade of experience on the use of orlistat and sibutramine has demonstrated their higher efficacy on the weight loss when compared to placebo either on adult or teenage population as well as safety and tolerability on long-term administration. Beneficial effects on the lipid profile, glycosilated haemoglobin on diabetic patients, blood pressure and levels of inflammatory cytokines, contribute to decrease the cardiovascular risk on obese patients. Phase III clinical trials using rimonabant show additional benefits to the expected weight loss, mainly reducing visceral fat and cardiometabolic risk factors.

Conclusion Pharmacological treatment of obesity must be considered as a therapeutical tool that has to be used together with long-term lifestyle changes, contributing to the body weight reduction as well as to the improvement of the cardiometabolic risk related to obesity.

(Received November 08 2006)

(Accepted June 22 2007)

Keywords

• Obesity;
• Drug treatment;
• Sibutramine;
• Orlistat;
• Rimonabant;
• Safety;
• Efficacy

Correspondence:

^c1 Corresponding author: Email mrubio.hcsc@salud.madrid.org