OBESITY
When scientists at Sanofi-Aventis took on the challenge of developing a weight-loss drug, they chose an unusual approach. Instead of studying ways to curb the body’s natural desire to eat, they decided to home in on the very biological circuits that activate hunger. Even more unorthodox was the craving phenomenon they decided to analyze: the marijuana munchies. If marijuana can trigger the appetite, then perhaps that system could be coaxed into switching off.

Rimonabant, the weight-loss compound they developed, is the first drug that manipulates the endocannabinoid system, a network of cells in the brain, the liver and fat tissue that regulates hunger by linking appetite to the body’s reward and satisfaction system. Rimonabant reduces food cravings by deactivating the cannabinoid receptors. The drug, to be marketed as Acomplia, is being reviewed by the FDA and will be targeted at those who not only carry excess weight but also harbor unhealthy signs of metabolic disorders such as diabetes and hypertension. In half a dozen clinical trials, the compound helped 6,000 patients lose up to 10% of their body weight over a year and maintain that loss for another year. And because rimonabant works in liver and fat cells as well, it also improved the patients’ cholesterol profiles, boosting “good” HDL levels and lowering amounts of dangerous triglyceride fats in the blood.

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