To the Editor: The randomized trial by Dr Goodpaster and colleagues1 demonstrated a significant improvement in weight and cardiovascular risk in severely obese subjects who underwent a 1-year intensive lifestyle intervention consisting of diet and physical activity.
Randomized clinical trials are often the best approach to study the effect of therapeutic interventions. However, selection of the population for a trial involves excluding a variable proportion of patients, which can make it difficult to translate the results into clinical practice. This is particularly the case when dealing with a behavioral intervention.
Gondoni LA, Liuzzi A. Diet and Physical Activity Interventions in Severely Obese Adults. JAMA. 2011;305(6):563-564. doi:10.1001/jama.2011.82