Sibutramine, a serotonin-norepinephrine reuptake inhibitor (SNRI), has been approved by the Food and Drug Administration for the long-term treatment of obesity. In clinical trials of up to 18 months, when combined with carefully monitored dietary control programs, sibutramine has resulted in weight loss of up to 10% of initial body weight, a clinically significant feature, with weight loss nadirs usually seen at approximately 6 months (5, 6). When the medication is discontinued, weight is regained, not unlike other agents effective in promoting weight loss (7). In contrast to other SNRIs, sibutramine has not been shown to be particularly effective for the treatment of depression. Similar to other SNRIs, treatment may result in usually mild blood pressure elevations in some patients, and other adverse effects may occur, particularly headache, constipation, dizziness, and dry mouth. Since some questions pertaining to adverse effects remain, ongoing monitoring has been recommended to determine the long-term safety and efficacy of the drug (8). Regarding real-world impact, a community-based study conducted in British Columbia reported that 1-year persistence rates among patients who refilled their sibutramine prescriptions were <10%, and 2-year persistence rates were 2%, which is much lower than reported in clinical trials (9).