In Britain it is estimated more than two million people have type 2 diabetes.
It is available only on prescription from today and costs £55.20 for a month's supply.
In all cases people must have already tried diet and exercise to shed excess weight before getting the drug and continue with such efforts while on the pill.
In trials when overweight people took a daily 20 mg pill, up to 40 per cent of them lost 10 per cent of their body weight, much of it from around their waist.
The drug also boosted levels of protective good cholesterol, while lowering harmful blood fats, and helped diabetics improve control of their blood sugar levels.
The pill works by interfering with a system in the body that controls energy levels, regulates body weight plus breaks down sugars and fats.
When people regularly eat too much the system goes into overdrive and this encourage the body to store more fat, especially around the stomach.
The pill blocks a key part of the system, reducing the cravings for food and helping prevent fat being deposited.
According to the makers French firm Sanofi-Aventis, the benefits do not just come from the weight loss.
This is because the pill targets fat around the waist, which is known to particularly raise the risk of diabetes and heart problems.
Henry Purcell, head of obesity research at the Royal Brompton Hospital in London, warned that obesity levels in Britain are now at epidemic proportions with rates among adults having doubled since the 1980s.
Dr David Haslam, clinical director of the National Obesity Forum, said: 'We have a very limited opportunity to do something about the problem of obesity before it is too late.
'Obesity is not a cosmetic or social issue but a serious medical one.
'A drug that can tackle each individual risk factor not just weight is potentially a very valuable tool.'
Some fear there could be delays getting the drug on the NHS because it has not yet been assessed by rationing watchdogs.
It has not yet been considered by the National Institute for Health and Clinical Excellence (NICE).
It can take 18 months for the watchdogs to issue guidance on use of a new medicine.
And some fear cash-strapped primary care trusts may be reluctant to fund the drug until this is completed.
Professor Anthony Barnett, professor of medicine at the University of Birmingham, said: 'Primary Care Trusts often wait for Nice guidance.
'There is a very distinct possibility that there will be some limitations on its use, which I think will be a very great shame.
'The real question is, can we afford not to treat obesity?'
A spokesman for NICE said drugs have to be referred to it by the Department of Health and it had not yet been asked to consider Acomplia.
A Department of Health spokeswoman said lack of NICE guidance should not be used as a reason to withhold drugs.
But she added the Government was considering referring Acomplia to NICE and an announcement is expected shortly.
Some have predicted the pill could generate worldwide sales in excess of £3billion.
It was given official European Union marketing approval last week but did not go on sale straight away.
The UK is the first place in the world where it is being launched with roll outs expected across Europe later this year.
The company also hopes to sell it in the USA once it wins approval from American licensing authorities.
As with any drug there are fears that once available, it could be traded on the blackmarket.
It could then be abused by anorexics or those who are not overweight but simply want to shed a few pounds.
A company spokesman insisted it was not being tested on such groups, it was only licensed for patients who were overweight or obese and it would be unlikely to benefit those without weight problems.
In one early trial the pill was also found the double the success rate of smokers trying to quit.
However a second study failed to show any significant effects and so the company is not now marketing it as an anti-smoking aid.
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