TAKE DRUG WITH GRAIN OF SALT

Fat smokers rejoice: If you're trying to shed that panza and kick the
habit, the pharmaceutical industry has good news for you.

Brace yourselves - the next miracle drug is targeting
you.

The new drug is called Rimonabant, or Acomplia, and you can't get
through a single popular article about it without reading the words
"wonder drug."

Though the drug isn't expected to be approved in the United States
until next year, health care professionals and pharmaceutical
investors are salivating. After all, the pool of potential clients is
gigantic.

It has been a while since we've come to terms with the dangers of
smoking. Nevertheless, 20 percent of Americans are still smoking, and
tobacco consumption remains the No. 1 preventable cause of death.
Meanwhile, the obesity epidemic continues to expand like Violet
"Blueberry" Beauregarde in "Willy Wonka and the Chocolate Factory."
More than 66 percent of the U.S. population is overweight or obese. A
host of life-threatening diseases are associated with obesity,
including diabetes and heart disease, and today, obesity is linked
with more than 100,000 avoidable deaths a year.

Initial research is promising, and the negative side effects appear to
be limited.

Believe it or not, the drug was developed by investigating the
phenomenon pot smokers call the munchies. Our bodies are equipped with
special receptors - called cannabinoid receptors - that are sensitive
to THC and other chemicals in weed. Our bodies don't have these
cannabinoid receptors just so we can all get high before art class. We
naturally have our own cannabinoid molecules swimming around in our
systems, regulating our body function by provoking similar responses
observed with marijuana consumption, like lowering of blood pressure,
slowing heart rate and, of course, appetite stimulation.

Scientists worked from the premise that if cannabinoid molecules
stimulate appetite, blocking those receptors would inhibit appetite.
And that's exactly how Rimonabant works - by blocking these receptors.

It's also by blocking the receptors that the drug helps people quit
smoking. Though marijuana's reputation as a gateway drug has long been
considered to be total bunk by most scientists, our natural
cannabinoid receptors have been studied for their role in
drug-addiction relapses. The relationship between cannabinoids and all
kinds of drugs have been examined, including cocaine, alcohol and
heroin. Apparently, cannabinoids have a role in nicotine addiction as
well.

Most of the research on nicotine was performed with mice, not on
humans, but the results are interesting. Scientists bred mice without
the receptors, and the mice didn't groove on nicotine at all - that
reward aspect just didn't happen. In another experiment,
nicotine-addicted mice stopped crawling the walls for their nic-fix
when dosed with these receptor blockers. It seems that the receptor
blockers softened the psychological purgatory of addiction, even as
the mice continued to show physical symptoms of nicotine withdrawal.
There is evidence that the drug is effective for humans, too. People
taking Rimonabant were more likely to lose weight than those not
taking the drug. People trying to quit smoking had better luck when
taking the drug, also.

In addition, the negative side effects have been minimal, with nausea
being the most commonly reported problem.

But before we get in line to take this new wonder drug, let's consider
a couple things.

First, the drug doesn't work for everybody. The research shows that
Rimonabant doesn't work for the majority of people's weight problems
or smoking addictions. Second, remember Vioxx? It also had promising
results from similarly sized trials, but it eventually got yanked for
doing more harm than good. And finally, even if Rimonabant does help
some people lose weight, that weight appears to come back the second
people stop taking the drug. Test results show that successful
Rimonabant dieters gained back all the weight they lost within two
years after they stopped taking their pills. The recidivism rate with
smokers has not yet been studied.

No wonder some people in the pharmaceutical industry are ecstatic -
the drug works, as long as you keep taking it the rest of your life.
I'm not suggesting that the drug companies are purposefully coming up
with ways to make people more dependent on medication, but I am saying
they make a lot more money when people turn to taking a pill for 50
years instead of, say, making basic changes in diet and exercise
habits alone.

As I've detailed in my column before, losing weight isn't easy for a
lot of reasons. Will power isn't the only barrier - there are also the
complicated influences of car-centered communities, food marketing,
emotional issues, work environments and literally hundreds of other
factors. So, with that in mind, it doesn't hurt to have another tool
to help people reach a healthier weight.

Will Rimonabant work for a few? Seems likely. But a wonder drug? I'd
say that's the cannabinoid receptors talking.