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Diet Drug Cuts Weight Most with Diet, Exercise

Two studies showed significant weight loss with combined therapy

WEDNESDAY, Nov. 16 (HealthDay News) -- Pharmacotherapy can be effective in weight loss but only when accompanied by lifestyle modifications and sufficient patient compliance, according to two studies in the Nov. 17 issue of the New England Journal of Medicine.

Thomas A. Wadden, Ph.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues tested the serotonin-norepinepherine reuptake inhibitor, sibutramine, with or without lifestyle counseling on weight loss in 224 obese adults. Those who took sibutramine and had long-term counseling lost nearly 2.5 times as much weight as those who only took the drug. Those who only had counseling, or took sibutramine and had only brief counseling sessions, showed intermediate weight loss but both were better than drug-use alone.

In the second study, Jean-Pierre Despres, Ph.D., of the Quebec Heart Institute, Canada, randomized 1,036 overweight or obese patients (BMI 27 to 40) with untreated dyslipidemia to either placebo or one of two doses of rimonabant, a selective cannabinoid-1 receptor blocker, in addition to a hypocaloric diet for 12 months. High-dose rimonabant (20 mg) significantly reduced body weight, waist circumference, triglycerides and increased HDL-cholesterol and adiponectin compared with controls. Nearly 40% of patients in each group did not complete the program.

Non-drug treatments should be the initial intervention for obesity, according to an editorial. However, "there is a need for adjunctive treatments that can assist patients in carrying out the changes in lifestyle needed to produce and sustain weight loss."

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