NICE has published final guidance on the use of rimonabant for the treatment of overweight and obese patients within the NHS in England and Wales (technology appraisal 144). This guidance should be read in conjunction with NICE clinical guideline 43: 'Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children'.

The overall recommendations are as follows (taken directly from the guidance):

• Rimonabant, within its licensed indications, is recommended as an adjunct to diet and exercise for adults who are obese or overweight and who have had an inadequate response to, are intolerant of or are contraindicated to orlistat and sibutramine.

• Rimonabant treatment should be continued beyond 6 months only if the person has lost at least 5% of their initial body weight since starting rimonabant treatment.

• Rimonabant treatment should be discontinued if a person returns to their original weight while on rimonabant treatment.

• Rimonabant treatment should not be continued for longer than 2 years without a formal clinical assessment and discussion of the individual risks and benefits with the person receiving treatment.

When considering the presence of current or previous depressive disorders/mood alterations, and during regular monitoring for the emergence of such symptoms, use should be made of the NICE clinical guidelines on the management of anxiety and depression (NICE clinical guidelines 22 and 23), noting the need for careful and comprehensive assessment.