A U.K. government panel which assesses the cost-effectiveness of medical therapies has labeled obesity "the most serious threat to the health future of our nation," but said on Dec. 13th that obese people should receive diet drugs like Acomplia (rimonabant) or surgery only as a last resort.

The statement by the National Institute for Health and Clinical Excellence, which advises the National Health Service on which drugs should be provided to patients, cannot come as much comfort to Sanofi-Aventis, which is hoping the NHS will ultimately decide to provide obese patients with Acomplia.

While Acomplia has been on the market in the U.K. since early summer, a final decision by NICE on whether its cost should be covered by the NHS may be as much as two years away.

Britain's Primary Care Trusts -- the local NHS entities that provide guidance to general practitioners and pharmacists -- are not expected to make Acomplia widely available until it is approved by NICE.

"Obesity is the most serious threat to the future health of our nation,'' Peter Littlejohns, NICE's clinical and public health director, said in the statement. "Its risks are as serious as smoking and urgent action is needed to tackle this problem.''

But the new guidelines published by NICE call for local authorities to establish cycling and walking routes, make streets cleaner, and ensure that building designs help people to be more active. Schools should encourage children to maintain a healthy weight and eat well, while individuals are encouraged to change their diet and exercise habits.

Surgery shouldn't be considered for most obese adults, according to the new NICE treatment guidelines, and drugs are recommended only if the patient has complicating factors such as sleep apnea or a psychological condition.