Anti-obesity drugs needed unless attitudes change
Unless there is a complete revision of attitudes to obesity,
drug therapies should continue to play an important role in treatment,
the authors
of a Lancet article published online on
27 October argue.
“
Until there is a sea change in society’s attitude to obesity and,
with it, an appetite for environmental improvements, the role of drug
therapy must be given serious consideration,” Stephen Cleland and
Naveed Sattar of Stobhill Hospital, Glasgow, urge. “The extensive
resources required for successful and long-term behavioural change cannot
be covered by the budgets of most health care systems. Moreover, education
alone will be doomed to failure without sustainable changes to our environment,” they
add.
Dr Cleland and Dr Sattar’s comments come in response to the online publication
(also on 27 October) of the full results of the RIO-Diabetes
study, initial analysis of which was presented at
the American Diabetes Association meeting in San Diego last year (PJ,
9 July 2005, p42). The RIO-Diabetes trial found that one year’s
treatment with rimonabant 20mg/day reduced weight, waist circumference
and HbA1c levels in overweight patients with type 2 diabetes
inadequately controlled by metformin or sulphonylurea.
However, Dr Cleland and Dr Sattar support the conclusion of a recent
Cochrane review (see below) that work still needs to be done before rimonabant
can be introduced into routine care. “Further studies are required
on putative peripheral mechanisms, which, if proved, could increase the
chances of this drug class becoming established as part of routine diabetes
management,” they say.
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