Some longer-term lifestyle intervention studies with sustained interventions demonstrate more durable weight loss (28, 29), with extent of weight loss in the first 3 6 months generally predicting longer-term success.
Tom Wadden, a clinical psychologist at the Center for Weight and Eating Disorders, at the University of Pennsylvania, told me, "Look, I'm a dyed-in-the-wool behavioral psychologist, and even I will tell you that there's no question that bariatric surgery is going to provide a larger and more durable weight loss than life-style modification, medication, or even a combination of the two".
"The ability of Qnexa to produce durable weight loss can be expected to contribute significantly toward ameliorating some of the consequences of obesity and weight-related comorbidities," Vivus said in its own briefing document, which was also posted on the F.D.A. Web site.
BACKGROUND: Laparoscopic gastric bypass (LGB) has proven efficacy in causing significant and durable weight loss.
Laparoscopic adjustable gastric banding (LAGB) has been proposed as a therapeutic approach to achieve durable weight loss in morbidly obese subjects [16].
In Western countries, bariatric surgery offers durable weight loss but morbidity rates are high, preventing its further application.
This is consistent with findings from 1-year pramlintide diabetes studies, which also showed durable weight loss over 1 year (12, 16, 17).
Collectively, the clinical data suggesting "durable weight loss" combined with the proposed cellular effects on energy metabolism continue to support metformin as a viable strategy for widespread translational efforts in prevention.
Thus, the data providing evidence that metformin is associated with "modest, but durable weight loss" over the 10 years of treatment and appears to be safe and well tolerated cannot be overstated.
Thus, evidence-based medicine demonstrates that the glucose-lowering effect of sulfonylureas is not durable and that loss of glycemic control is associated with progressive β-cell failure.
