Weight loss, exercise didn't affect heart outcomes in Look AHEAD

I think the trial has a good message: that lifestyle can work, that intervention can work, that education can work, but it's not the only solution. For many people with diabetes, we must use medication. And, in many people with coronary disease, we must use medications. But to call it a failed trial is ridiculous, in my mind. If I can delay complications by 4 or 5 years, then we did well, we saved money, and we improved somebody's life.

We saw a 6% reduction in weight over 10 years. This is awesome and has never been shown before. Actually 3.5% reduction in weight [over 10 years] hasn't been shown before. I think that if you read the study, a lot of good stuff came out of it.

I will tell my patients how well the lifestyle management works. But I still will tell them that lifestyle is important, but many times, it needs to come in combination with medication.

My issue is that the trial was cut [short]. They saw that other aspects improved, and they should have continued to see what it means. It's like anything; we want fast solution to long-term tissues. Maybe we need to see a population study over 25 or 30 years.

Dr. Yehuda Handelsman is the medical director and principal investigator of Metabolic Institute of America, and president-elect of the American College of Endocrinology. He is on the advisory board for Clinical Endocrinology News.