New Drugs — Does Lifestyle Intervention Still Count? Part 5

As mentioned in a recent post, drug trial literature mentions the term “lifestyle intervention” with astonishing frequency, and the phrase is even often prefaced by the adjective “extensive.”

To put it bluntly, their products don’t work unless the patient is also involved in some aspect of what they define as intervention. To be either a test subject or a regular patient, someone must reportedly partake in lifestyle interventions either before starting their GLP-1 medication, and/or during the course of it.

It appears that to be effective, these meds must be continued basically forever, with the strong implication that the patients are also meant to have intervention forever. Frequently mentioned are nutritional counseling, creating a reduced-calorie diet, and physical activity, typically 150 minutes per week. An example follows.

This article is about tirzepatide, but mentions a similar trial of liraglutide which provided “17 lifestyle counseling sessions during the medication phase of the study compared with only quarterly visits in the present trial.” Why was this brought up? Because the author wants to acknowledge the importance of counseling — which is apparent, because the placebo group of participants regained more weight than comparable placebo patients in other studies, who had partaken in more counseling.

In other words, lifestyle intervention makes a measurable and significant difference. Now back to the main subject of the piece:

Tirzepatide substantially increased the magnitude of weight loss when administered following an initial 12-week intensive lifestyle intervention that reduced baseline body weight by an average of 6.9% in successful program completers.

In other words, during the preparation stage, before starting on the drug, 12 weeks of lifestyle intervention helped the subjects lose nearly 7% of their baseline weight, which is a pretty darn good outcome for only three months of going at it. It might suggest to more conservative minds that anyone who can lose that much with only non-medicated intervention, would probably, overall, be best served by continuing on the same path.

The alternative is to start taking an expensive drug that might involve undesirable side effects, and that apparently needs to be continued forever. Why not just continue the lifestyle intervention aspect of the treatment forever, instead? Which they are supposed to do anyway because, according to reports, even the medicated person will need to stick with physical activity, calorie reduction, and probably counseling, forever, anyway.

(F)indings indicate that individuals with overweight or obesity who have lost approximately 5-10% of their body weight with supervised lifestyle intervention — or potentially through their own self-directed diet and exercise efforts — could expect to achieve further clinically meaningful weight loss with the addition of tirzepatide.

Those same findings could also be interpreted, by a skeptical type of person, as suggesting that the patient could probably achieve additional “meaningful weight loss” by simply continuing with the other interventions, and staying away from weight-loss drugs altogether.

And then, imagine how much additional pound-shedding might be achieved with the help of a powerful tool like BrainWeighve.

Your responses and feedback are welcome!

Source: “Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial,”, 10/15/23
Image by Tim Green/CC BY 2.0 DEED

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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