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Cited by 753Pharmacology and Obesity TreatmentBariatric Surgery and OutcomesObesity, Physical Activity, Diet

Drug treatments for obesity: orlistat, sibutramine, and rimonabant

Padwal, Raj S, Majumdar, Sumit R·2007·The Lancet
DOI 10.1016/s0140-6736(07)60033-6
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Abstract

Antiobesity treatment is recommended for selected patients in whom lifestyle modification is unsuccessful. Two antiobesity drugs are currently licensed for long-term use. Orlistat, a gastrointestinal lipase inhibitor, reduces weight by around 3 kg on average and decreases progression to diabetes in high-risk patients; adverse gastrointestinal effects are common. Sibutramine, a monoamine-reuptake inhibitor, results in mean weight losses of 4-5 kg, but is associated with increases in blood pressure and pulse rate. Rimonabant, the first of the endocannabinoid receptor antagonists, reduces weight by 4-5 kg on average and improves waist circumference and concentrations of HDL cholesterol and triglyceride; however, an increased incidence of mood-related disorders has been reported. To date, all antiobesity drug trials have been limited by their high attrition rates and lack of long-term morbidity and mortality data. Other promising antiobesity drugs, including those acting within the central melanocortin pathway, are in development, but are years away from clinical use. In light of the lack of successful weight-loss treatments and the public-health implications of the obesity pandemic, the development of safe and effective drugs should be a priority. However, as new drugs are developed we suggest that the assessment processes should include both surrogate endpoints (ie, weight loss) and clinical outcomes (ie, major obesity-related morbidity and mortality). Only then can patients and their physicians be confident that the putative benefits of such drugs outweigh their risks and costs.

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Crossref · 10.1016/s0140-6736(07)60033-6

Cites

71 of 71 references verified0 citation errors · 0 not checkable

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  • Central satiety centers often interconnect with other core regulators in the brain, causing psychotropic side effects.

    “Second, as the experience with endocannabinoid receptor antagonists has shown, central satiety centers often interconnect with other core regulators in the brain, causing psychotropic side effects 10.”

    From Cellular bioenergetics as a target for obesity therapy (2010) · cites this paper as [10]

  • Pharmacotherapy with orlistat and sibutramine have both been associated with weight loss, improvements in serum lipids, and insulin sensitivity.

    “Pharmacotherapy with the two currently approved drugs for obesity treatment, orlistat (a gastrointestinal lipase inhibitor) and sibutramine (a monoamine reuptake inhibitor), have both been associated with weight loss, improvements in serum lipids, and insulin sensitivity (76, 109, 270).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [270]

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Authors
Padwal, R. S., & Majumdar, S. R.
Affiliations
Alberta Hospital Edmonton (CA)
Corresponding author
Padwal, Raj S
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2007-01
Volume
369
Issue
9555
Pages
71-77
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(07)60033-6
OpenAlex
W2119754700
Cited by
753
References
71
Citations by year
2026: 7 · 2025: 10 · 2024: 21 · 2023: 27 · 2022: 35 · 2021: 28 · 2020: 40 · 2019: 27 · 2018: 41 · 2017: 28 · 2016: 28 · 2015: 30 · 2014: 43 · 2013: 42 · 2012: 56
FWCI
8.52
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
obesity, anti-obesity drugs, orlistat, sibutramine, rimonabant, lipase inhibitors, monoamine reuptake inhibitors, weight loss, diabetes prevention, cardiovascular adverse events, mood disorders, surrogate endpoints, obesity-related morbidity and mortality, melanocortin pathway, drug development
MeSH terms
Rimonabant, Orlistat, Blood Pressure, Cyclobutanes, Half-Life, Humans, Lactones, Cholesterol, HDL, Obesity, Piperidines, Pyrazoles, Weight Loss, Randomized Controlled Trials as Topic, Anti-Obesity Agents

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