Abstract
Obesity and cardiometabolic risk, or the metabolic syndrome, continue to be major
public health concerns. To date, treatment with lifestyle and pharmacotherapy interventions
has resulted in limited efficacy in reversing the upward trend in this present-day
health crisis. Research reveals that a modest 5% to 10% weight loss results in substantial
improvement in health. While obtaining modest weight loss is often achievable, maintaining
lost weight is challenging. Research has recently improved our understanding of several
endogenous pathways that influence body weight regulation and disease risk. The endocannabinoid
system has been found to regulate appetite and energy expenditure, as well as lipid
and glucose metabolism. Interest in blocking stimulation of this pathway to aid weight
loss and reduce cardiometabolic risk factor development is an area of interest and
research. This article reviews the mechanisms by which the endocannabinoid system
is believed to influence body weight regulation and cardiometabolic risk factors,
as well as the results of clinical trials investigating the safety and efficacy of
a selective cannabinoid-1 receptor antagonist (rimonabant). Clinical trials investigating
rimonabant treatment resulted in substantial reductions in body weight and markers
for cardiometabolic risk in study participants. However, increases in adverse events
were reported in the drug-treated group. Data regarding long-term benefit and adverse
events from rimonabant treatment are being collected in several ongoing clinical trials.
Rimonabant is currently available in 42 countries, but has not received United States
Food and Drug Administration approval. Food and nutrition professionals play a pivotal
role in tackling the current obesity crisis; it is essential that they understand
the many physiological mechanisms regulating body weight. Emerging research data reveals
pathways that influence appetite and energy metabolism, and this knowledge may form
the foundation for new clinical treatment options for obese individuals.
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Biography
K. Keenan Isoldi is coordinator of clinical nutrition services, The Comprehensive Weight Control Program, New York, NY, and a doctoral candidate at New York University, New York.
Biography
L. J. Aronne is clinical professor of medicine at Weill-Cornell Medical College of Cornell University and director of The Comprehensive Weight Control Program, New York, NY.
Article info
Publication history
Accepted:
November 5,
2007
Identification
Copyright
© 2008 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
