Interventions that reduce weight and abdominal adiposity have been shown to improve
obesity-associated disorders of
glucose and lipid metabolism, reduce blood pressure, and promote other beneficial effects on cardiometabolic risk parameters. When long-term adherence to diet/exercise recommendations is suboptimal, management of
overweight and obese patients at high cardiometabolic risk includes the use of adjunctive pharmacologic agents to facilitate
weight loss and
weight loss maintenance.
Rimonabant, a cannabinoid-1 (
CB1) receptor blocker, has been shown to induce
weight loss and improve cardiometabolic parameters, implying that the
endocannabinoid system is a promising target for
obesity-related health improvement. Herein we summarize the results of the
Rimonabant in
Obesity (RIO) studies, which have evaluated the effectiveness of
CB1 receptor blockade in facilitating
weight loss and improving cardiometabolic health in >6,600 patients from the United States and Europe. As compared with placebo, 20 mg/day of
rimonabant consistently produced greater reductions in weight and waist circumference, as well as improvements in
dyslipidemia and parameters of
glucose metabolism. The improvements that were noted for several cardiometabolic parameters with
rimonabant were greater than what would be expected from the
weight loss alone, suggesting there may be an independent effect of the
drug on metabolic function. The results of these studies suggest that
CB1 receptor blockade may be a useful treatment for multiple cardiometabolic risk factors in
overweight and obese patients.