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By the end of the year the drug was pulled from the market. Three years later, Meridia, a top-selling weight loss drug in Canada, was voluntarily withdrawn by its makers over an increased risk of heart attack, stroke and cardiovascular death. Now, however, the pharmaceutical industry is bringing anti-obesity drugs back to the market.

Several have been approved in the last few years, and many more are likely to come. The demand is certainly there. The number of people living with obesity nearly tripled between and Bariatric surgery is the most successful treatment for obesity, bar none. Even those who opt for surgery can face wait times of up to eight years. The question is whether the mistakes of the past can be overcome.

Sean Wharton, an internal medicine specialist at McMaster University, is among the optimists. Before, the prevailing theory was that the way to spur weight loss was to get people to burn more calories. Wharton, who is also the director of the Wharton Medical Clinic for weight and diabetes management in Burlington, Ont. But he is not alone in his belief in the future of drug treatments. The oldest drug on the market was approved by Health Canada in Instead, the fat is excreted in feces, which contributes to its rather unpleasant side effects, such as fatty and oily stools.

Contrave, authorized last year, combines low doses of the addiction drug naltrexone, used to treat alcohol and opioid dependence, and the anti-depressant, bupropion. The drugs are thought to work on two separate areas of the brain, decreasing hunger and possibly cravings. Saxenda, a once daily injected drug produced by the Denmark-based pharmaceutical giant Novo Nordisk, works on the brain as well.

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