Sadly, few things in life come without effort. Being thin is one of them (at least for most, especially once outside of their 20s).

Being overweight is the norm now in America, although it ranges from a few extra pounds to obesity. Women seem to struggle with weight issues more than men, and things like eating disorders are far more prevalent amongst women.

So the success of Alli, the only FDA approved over-the- counter weight-loss aid for overweight adults, is not surprising. If we all could lose a few pounds by just taking a pill (in conjunction with a sensible diet and exercise, of course), why not?

Seeing the success of Alli, other drug companies are looking to market their own versions of safe, over-the-counter weight loss pills that are proven to work. One such drug is called rimonabant, an endocannabinoid receptor antagonist, meaning it works in the brain in the opposite way that marijuana makes people hungry.

People taking the drug lost on average about 10 pounds over the course of a year and a half. But there was an unintended side effect too:

However, 43% of those who took rimonabant had adverse psychiatric effects, mostly anxiety, depression and insomnia, compared with 28% of those who took the placebo.

That’s a one-third increase in such feelings, something that is both statistically and clinically significant. So you may have lost a few pounds, but now you’re depressed. Great.

And let’s put 10 lbs in the course of 18 months into perspective. That’s an average of 1 pound every 1 1/2 months. The average overweight person could easily achieve even better results simply through a proper diet and a regular exercise program.

The drug company Merck also reported unpublished results from a one-year study examining its weight-loss candidate drug, taranabant, a formulation that also works on the cannabinoid receptors:

The trial of 2,502 obese people showed that they lost nine to 12 pounds more than those taking a placebo.

Psychiatric side effects occurred in 20% of those taking a placebo and in 28% and 40% of those taking different doses of the drug.

Again, anywhere from 1 1/2 times to twice the amount of psychiatric side effects as those taking a placebo. Disturbing results, given the recent sensitivity to such side effects in existing medications.

Weight loss is a serious issue in America. But no pill is going to achieve the miracles many are looking for. And at the price of our mental health (exchanging one mental health concern, self-image, for another, depression), it doesn’t seem like a pill worth considering.

Results of this research were presented at the American College of Cardiology meeting this past week.

Read the full article: You’d be thinner, but possibly sad

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 5 Apr 2008
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