8 medical breakthroughs that can change your life

A weight-loss pill, personalized drugs, the scent of trust, a powerful new cancer fighter, and more

Colleen Rehman started smoking when she was 13, and then spent the next 20 years wishing she could stop. When she tried nicotine patches, she gained weight; inhalers couldn't block her cravings. "I didn't want my three sons to have to say they lost their mom because she wouldn't quit smoking," the 35-year-old says. Then 2 years ago, she got a break. In Minneapolis, near where she lives, a trial of a new drug called rimonabant (brand name: Acomplia) was getting under way. It sounded like a superpill: It could suppress appetite, lower the risk of heart disease and diabetes—and help kick tobacco addiction.

Rehman didn't think twice. Within a few days of starting the drug she went from two packs a day to just 10 cigarettes. In 2 weeks, she had stopped entirely, and 2 years later, she's still smoke free.

By the time you read this, the FDA may have already approved rimonabant. The drug is based on a discovery made in the early 1990s by scientists studying marijuana. They found that the body naturally produces substances similar to cannabinoids-the stuff in pot that makes you high-that came to be known as endocannabinoids. Knowing that smoking marijuana makes people ravenously hungry, scientists posed a question that went well beyond potheads: Would shutting down the activity of endocannabinoids in the body turn off food cravings?

The answer seems to be yes. What's more, it turns out that using rimonabant to short-circuit endocannabinoids has wide-ranging effects:

• weight loss Endocannabinoids make you want to eat. Then, "with overeating and obesity, the system gets revved up and makes you want to keep eating more. It's a vicious cycle," says Douglas Greene, MD, vice president of regulatory affairs for Sanofi-Aventis, the company behind rimonabant. The drug interrupts the cycle by preventing endocannabinoids from attaching to receptors in the brain.

Last April, European researchers published the first major human study of rimonabant: After a year, patients on a reduced-calorie diet who took the drug lost nearly 15 pounds, on average, and trimmed about 3 1/2 inches from their waistlines; other study subjects who got placebo pills lost just 4 pounds and 1 1/2 inches from their bellies.

• diabetes People with type 2 diabetes have trouble absorbing and then converting glucose, the body's main source of fuel, into energy. Rimonabant raises blood levels of a hormone that may help burn glucose. In one study, a group of diabetics who were unable to lower their blood sugar to safe levels added rimonabant to their regimens. After 1 year, patients taking rimonabant were twice as likely to have healthy levels of blood sugar as a placebo group, says Priscilla Hollander, MD, of Baylor University Medical Center. Hollander believes that rimonabant could become a drug of choice for many diabetics.

• smoking In one trial, rimonabant helped one-quarter of users quit smoking for at least 1 month. That's only a bit better than other smoking-cessation aids, such as nicotine gum or patches. But rimonabant users didn't gain weight after quitting, a problem for many people who give up smoking.

• heart disease Quitting smoking and controlling diabetes can reduce heart attack risk. But rimonabant also blocks endocannabinoids from prompting the liver to release triglycerides, blood fats that clog arteries. At the same time, rimonabant triggers the liver to release more "good" HDL cholesterol.

Greene says the drug will help people who've been unable to improve their cholesterol, blood fats, blood sugar, and other heart disease risk factors through diet and exercise. "As an added benefit, they might lose some weight," he adds.

Not everyone is wowed by the drug. "I think it will help people who have a lot of food cravings," says Richard L. Atkinson, MD, president of the American Obesity Association. Others, he says, may not benefit at all. And some doctors have concerns about using rimonabant indefinitely. "It alters the chemical balance of the brain," says Christine Gerbstadt, MD, RD, spokeswoman for the American Dietetic Association. She says patients using it will need monitoring for mood swings.

Still, rimonabant appears to produce at least as much weight loss as the two major obesity drugs currently on the market, says Steven T. Boyd, an assistant professor of pharmacy at Xavier University. And it has fewer—and milder—side effects.

"Quitting smoking wasn't exactly easy. But it was doable," says Rehman. "I didn't get cravings. And I didn't gain weight."

PHOTO (COLOR): Rehman finally stopped smoking—and didn't gain weight

PHOTO (COLOR): Hollander says the drug helps with hard-to-treat diabetes

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By Timothy Gower

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