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LetterLetters

Response

Arya M. Sharma
Canadian Family Physician June 2008, 54 (6) 849-850;
Arya M. Sharma
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Dr Lexchin and colleagues correctly note that the data on the long-term benefits of antiobesity medications are perhaps not as robust as I made them out to be. There is no doubt that high dropout rates and lack of follow-ups are severe methodologic shortcomings of studies in this field. Nevertheless, from the long-term data available, weight maintenance (especially in per-protocol analyses) in participating individuals appears substantially superior to the nonpharmacologic controls of these studies.1

A seemingly modest 5% to 10% reduction in body weight (achieved in most pharmacologic trials) is generally associated with clinically meaningful improvements in risk factors (of obesity) and quality-of-life indicators.2

The key challenges of pharmacotherapy are how to match the right patient with the right drug and how to ensure long-term compliance and adherence to the medication in order to maximize the benefits. Obesity is a remarkably heterogeneous condition; the expectation that any one drug will work for all patients with obesity is probably unrealistic.

I fully agree with Dr Lexchin and his colleagues that more research is needed to discover the best use of these medications; nonpharmacologic strategies are clearly unsuccessful in providing long-term control of this condition.3

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References

  1. ↵
    RuckerDPadwalRLiSKCurioniCLauDCLong term pharmacotherapy for obesity and overweight: updated meta-analysisBMJ2007335763111949
    OpenUrlAbstract/FREE Full Text
  2. ↵
    Pi-SunyerFXA review of the long-term studies evaluating the efficacy of weight loss in ameliorating disorders associated with obesityClin Ther199618100635
    OpenUrlCrossRefPubMed
  3. ↵
    MarkALDietary therapy for obesity is a failure and pharmacotherapy is the future: a point of viewClin Exp Pharmacol Physiol20063385762
    OpenUrlCrossRefPubMed
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Canadian Family Physician: 54 (6)
Canadian Family Physician
Vol. 54, Issue 6
1 Jun 2008
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Canadian Family Physician Jun 2008, 54 (6) 849-850;

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Canadian Family Physician Jun 2008, 54 (6) 849-850;
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