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In Reply: Dr Wing and colleagues raise a concern about the weight loss therapy provided for the conventional group, arguing that an intensive program such as the current Look AHEAD program¹ may have been more appropriate. When designing this study in 2000, we aimed to deliver standard good practice as would be provided by a multidisciplinary team within our community. Our conventional program adopted the lifestyle principles of the US Diabetes Prevention Program² and indeed provided weight loss similar to that described in a meta-analysis of the literature on lifestyle and behavioral interventions for weight loss.³ We did not plan for either a highly intensive experimental weight loss program or a potentially problematic intensive hypoglycemic program. Either or both of these quite different nonsurgical arms could have been used.

In the end, the choice of the control group's treatment is not critical. We are not arguing that the weight loss . . . [Full Text of this Article]

John B. Dixon, MBBS, PhD
john.dixon@med.monash.edu.au
School of Primary Care

Paul E. O’Brien, MD
Centre for Obesity Research and Education
Monash University
Melbourne, Australia

Joseph Proietto, MBBS, PhD
Department of Medicine
University of Melbourne
Melbourne

RELATED LETTER

Surgical vs Behavioral Therapy for Weight Loss in Patients With Type 2 Diabetes
Rena R. Wing, Thomas A. Wadden, and Mark Espeland
JAMA. 2008;299(18):2146.
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