Have you heard the story of a breakthrough weight loss medicine called rimonabant?

As a once-a-day oral medicine, rimonabant was approved in Europe in 2006 based on randomized controlled trials demonstrating clinically significant weight loss1. It had all the signs of being the next blockbuster. Beyond the sustained weight loss results, for example, study participants also showed improvements in central adiposity (waist circumference), triglycerides, and HDL cholesterol. That means that people weren't just getting thinner on rimonabant, they were getting healthier. Many participants even reported unexpected decreases in their cravings for sweets and desires for addictive substances such as nicotine.

One medicine with so many beneficial features. Released during nearly the same year, rimonabant looked to some like the pharmaceutical equivalent of the iPhone.

Somehow, almost overnight, it then all fell apart for rimonabant. By just 20082, rimonabant approval had been withdrawn (and never received FDA approval in the U.S.) due to psychiatric safety concerns. Clinical trials and meta-analyses reporting increases in depression, anxiety, and suicide led to the swift and stunning downfall of this once-heralded medicine.

Compounded by the equally sudden banning of the weight loss drug, phen-fen (phentermine-fenfluramine), in 1997 due to increases in cardiovascular risks, a mushroom cloud effect fell across the field of obesity medicine. More than a decade after the collapse of rimonabant, there........

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