BOSTON - There's no free lunch with diet pills, new research concludes: They work much better accompanied by the hard work of dieting and exercise.
The study backed by the National Institutes of Health is the biggest yet to demonstrate why obese people should adopt healthy habits, even if they take weight-loss drugs, researchers said.
"If you pit this medication against your favorite all-you-can-eat buffet, the . . . buffet is going to win nine out of 10 times. So it's important you try to modify eating habits," said University of Pennsylvania psychologist Thomas Wadden, who led the study.
Medical guidelines have recommended that obese patients also change eating and exercise habits since doctors first began prescribing today's long-term weight-loss medicines in the late 1990s. Still, many patients fail or ignore the advice.
Yet in the one-year study, published in the New England Journal of Medicine, the most successful patients took the weight-loss drug Meridia along with 30 sessions of group counseling that promoted a 1,500-calorie daily diet and half-hour walks on most days. It was most effective when patients recorded what they ate each day.
Obese people who took pills alone typically lost 11 pounds in the study. When they added the full program promoting lifestyle changes, they lost 27 pounds.
A third group took the drug with brief doctor's counseling, and a fourth underwent only group counseling. Within five months, those two groups lost a bit more weight than the group that only took the drug, but all three groups were roughly equal after a year.
Dr. Samuel Klein, an obesity expert at Washington University in St. Louis, said the study establishes the importance of coupling dieting and exercise with drug therapy in obese patients.
Dr. Susan Yanovski, at the National Institutes of Health, warned in an accompanying editorial that obesity medicines should undergo especially careful scrutiny for safety, since they are often misused by patients who are not obese.
