The Low Sacrifice‘ Diet’ 68 Rimonabant also increases blood Adiponectin levels, which otherwise go down as weight goes up. Higher levels of Adiponectin are protective against diabetes, arterial disease and obesity. Rimonabant is probably the pick of the bunch unless you are predisposed to anxiety, depression or irritability – as these are its most common side-effects. Unfortunately, Rimonabant is only available in some countries. Phentermine and Diethylproprion are the oldest,‘ dirtiest’ drugs and are used less often because of problematic side-effects and their possible abuse potential. Speaking of‘ dirty’ drugs, truth be told, Orlistat probably wins this race due to its potential to create an oily( by preventing the absorption of fat) diarrhea that can, shall we say,‘ surprise’ the unsuspecting user. The last entry, Fluoxetine, is not a typical weight-loss drug as it is primarily used as an antidepressant. However, it has been reliably found to be as effective as most drugs in this class. Fluoxetine is particularly helpful for obese people also suffering from depression or anxiety( which it is also effective in treating). For weight loss it is prescribed in higher doses( around 60mg daily) than when treating depression and anxiety( typically 20-40mg). One advantage of Fluoxetine is that it has been taken by millions of people for so long that we can be relatively confident about its safety in the longer term i. e. more than a year. This level of demand also now means it is the cheapest in this class of drugs. In a recent review of these medications( excluding Rimonabant), The American College of Physicians found all of them effective in bringing about moderate weight loss of three to five kilograms per year. Again, not enough alone, but a helpful headstart if you are making all the right lifestyle changes and you are suffering from life-threatening complications of obesity.