Managing Cardiometabolic Risk

Key Points

• Orlistat, sibutramine, and rimonabant all promote weight loss and its maintenance over time.
• Lifestyle changes and drug interventions have an additional impact on weight loss.
• Rimonabant is the only drug that has been shown to improve the metabolic profile beyond that expected from weight loss alone, likely because it works directly on peripheral metabolic pathways.
• Rimonabant has been tested specifically in individuals at risk for CVD. Investigation of any weight reduction drug should include at-risk individuals, with special focus on intra-abdominal obesity and its response to treatment.
• Further study is required to determine the long-term benefits and side effects of pharmacotherapy and its impact on clinical cardiovascular endpoints relevant to obesity-related morbidity and mortality.