Meridia (sibutramine) helps reduce hunger by working on the appetite control center in the brain that makes you feel full.

"Meridia can help add 5%-10% additive weight loss that you would not get with diet and exercise alone" says Aronne.

Kushner prescribes Merida to patients who struggle with cravings and have trouble knowing when to stop eating. Aronne says that younger patients who are at a low risk for heart disease are good candidates.

Side effects include dry mouth, constipation, and insomnia. Meridia should not be used by anyone with cardiovascular risk factors.

"We recommend regular blood pressure checks for anyone on Merida," says Blatner.

FDA has approved sibutramine (Meridia) for the management of obesity, a widespread, chronic disease that, combined with other risk factors contributes to the deaths of an estimated 300,000 Americans each year. Marketing is pending scheduling by the U.S. Drug Enforcement Administration. The following can be used to answer questions:

Sibutramine helps reduce food intake and is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced calorie diet. It is indicated for people whose initial body mass index (BMI) is at least 30 -- that is, someone who is 5'6" and weighs 185 lbs. or more. Patients with other risk factors, such as hypertension or diabetes, can be treated with the drug if their BMI is 27 or higher, for example someone who is 5'6" and weighs 167 lbs. or more.

Sibutramine works to suppress the appetite primarily by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. The anti-obesity drug dexfenfluramine also inhibits the reuptake of serotonin. However, dexfenfluramine, unlike sibutramine, also causes an increase in release of serotonin from the nerve cell.

In clinical trials, patients treated with sibutramine while on a reduced-calorie diet, showed a significant weight loss during the first six months of treatment, and significant weight loss was maintained for one year. In one 12-month study, the average weight loss in patients taking sibutramine, 10 mg daily, was about 10 lbs., and in those taking 15 mg daily was about 14 lbs. The average weight loss in persons on only a reduced calorie diet was 3.5 lbs.

The most common side effects associated with sibutramine include dry mouth, headache, constipation and insomnia. The drug causes a small increase in average blood pressure, and causes a higher increase in some patients. FDA recommends patients taking sibutramine have regular blood pressure evaluations. People with uncontrolled high blood pressure should not take sibutramine. No cases of pulmonary hypertension, a rare but serious side effect associated with the anti-obesity drugs fenfluramine and dexfenfluramine, have been reported in clinical trials of sibutramine. Echocardiograms on patients taking sibutramine did not show more valvular disease than those on placebo.