[Sibutramine, an upcoming drug for weight loss acting on energy consumption and energy expenditure].

Individuals with a low activity of the sympathoadrenal system are at high risk of weight gain and obesity, and obese patients with low sympathetic activity lose less weight on dietary reduction programs. Treatment with sibutramine may be particularly efficient in these patients, because sibutramine normalizes sympathoadrenal activity and thereby stimulates thermogenesis. By a combined stimulation of adrenergic and serotoninergic pathways satiety is enhanced and energy intake is suppressed. This dual effect of sibutramine on energy balance seems to be responsible for the efficient weight loss and improved weight maintenance observed in clinical trials with obese patients. In conclusion, sibutramine can contribute to normalization of the disturbed energy balance in obesity by enhancing satiety and by stimulation of energy expenditure, thereby producing weight loss and an important improvement in risk factor profile and comorbid conditions. Meantime sibutramine is on the market in the United States under the trade name Meridia.