Those who are "stout around the waist and abdomen" are at particularly high risk of developing type 2 diabetes and hypertension. Reducing the risk is down to reducing that excess weight and keeping it off. However, that's difficult for lots of people. Now, a possible alternative is being trialled in the form of a drug that not only blocks feelings of hunger but also reduces blood lipid levels, thereby reducing the risk for cardiovascular diseases and type 2 diabetes.
The new drug, Rimonabant, has been in clinical trials for more than two years in Europe and the US. The European Director of the clinical trials, Professor Luc Van Gaal of the University Hospital in Antwerp, Belgium, presented results of this study at the 4th International Symposium on Obesity and Hypertension at the Max Delbrueck Center for Molecular Medicine (MDC) Berlin-Buch on Saturday, October 29, 2005.
Rimonabant has few side effects and interferes with the body's endocannabinoid system (ECS). Endocannabinoids are the body's own internal version of cannabis, which are released when we're under stress, hungry or in pain. Endocannabinoids also play a role in the intricate regulation of the cardiovascular system.
Up to now, particularly two endocannabinoids were known - one of them is anandamide. The name originates from Sanskrit and means "bliss". According to Vincenzo di Marzo, the system was discovered during research on how cannabis (hashish) works, which gave the system its name. When hungry, the organism releases increased amounts of anandamide, he continued. This is in line with the known fact that hashish users frequently have attacks of the 'munchies'.
In the RIO trial, 1,507 patients from 60 clinics in Belgium, Germany, Finland, Sweden, the Netherlands, and the US with a Body Mass Index (BMI) of over 30 kg/m2 and of over 27 kg/m2 who additionally have high blood pressure and elevated blood lipid levels were treated with Rimonabant. The RIO trial is one of a total of four Phase III trials (testing effects and side effects in a larger number of patients) with 6,600 patients. The patients were put on a diet and also had to complete an exercise program. They were divided into three groups: the first group received 20 mg of rimonabant daily, the second group received 5 mg, a day and the third group received a placebo.
Van Gaal reported that for these patients, the risk factors for metabolic syndrome and cardiovascular diseases were reduced more than could be expected from mere loss of weight. He estimates that 50 percent of this effect is due to rimonabant. The reason: while patients who received the 5 mg dose of rimonabant clearly lost weight, their blood lipid levels were not as improved as in patients with the higher dose.