Why Is Medication Recommended Only as an Adjunct to Diet, Exercise, and Behavior Therapy?
There are several reasons for recommending that pharmacotherapy be added to a program of lifestyle modification. First, growing evidence shows that a program of modest physical activity can reduce the risk of cardiovascular disease, independent of weight status (56, 57). Similarly, behavioral treatment encourages patients to eat a low-fat, low-cholesterol diet, which, by itself, may reduce the risk of coronary artery disease (58). These important benefits would be lost if weight loss were induced by medication alone.Second, without lifestyle modification, pharmacotherapy alone might result in suboptimal short- and long-term weight losses. Larger weight losses are desirable because they are generally associated with greater improvements in weight-related health complications (59). They are also eagerly desired by obese individuals (60).Third, adding pharmacotherapy to lifestyle modification fits well with a stepped-care approach in which the least aggressive intervention is tried first
