Sibutramine for weight gain attenuation during smoking cessation with varenicline: A pilot study

Introduction: Weight gain following tobacco abstinence is a significant barrier to cessation. Varenicline is the most effective medication for smoking cessation but does not prevent weight gain. Combining sibutramine and varenicline may facilitate smoking abstinence if weight gain is attenuated. Methods: Our aim was to assess the safety and efficacy of sibutramine for weight gain prevention among women quitting smoking with varenicline. Ten smokers enrolled in a pilot study of open-label sibutramine and varenicline for 12 weeks. Results: Participants rated themselves low on appearance evaluation, health evaluation, health orientation, and body-areas satisfaction. Ninety percent reported that they would return to smoking if they gained weight after stopping smoking. For the 6 subjects who met criteria for prolonged abstinence, weight change from baseline to Week 12 (11 weeks after the target quit date) was 0.2 ± 1.3 kg, and the 7-day point-prevalence smoking abstinence rate at Week 12 was 70% (95% CI 35%-93%). Discussion: Combination therapy with sibutramine and varenicline for weight gain prevention and smoking cessation as an intervention for smokers at risk for relapse to smoking because of weight gain may warrant further investigation.