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The exact mechanism of the coat hanger phenomenon is unknown, but one theory suggests it is a kind of cramp caused when the antigravity muscles holding up the head receive too little blood flow

While the 10.612.8% mean weight reduction at 24 weeks was clinically significant, the risk-benefit calculus for a chronic weight loss medication with sympathomimetic cardiovascular effects didnt meet regulatory safety thresholds

The follow-up pivotal trial (METAOD006 / OPTIONS) enrolled a larger cohort and failed to replicate statistically significant weight loss, which led Metabolic Pharmaceuticals to halt the formal drug development program in 2007