A meta-analysis of all randomised controlled trials examining the efficacy and safety of the anti-obesity agent Rimonabant (Acomplia, 20 mg/d) found an efficacy of 4.7 kg (4.1-5.3) more weight loss after one year compared to placebo. Rimonabant increased the risk of adverse events, including depressive episodes and anxiety, despite depressive symptoms being an exclusion criterion in these trials. This, combined with an increased risk of suicidality during Rimonabant treatment, warrants increased awareness from prescribing physicians.