***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the effect of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity . METHODS A total of 126 patients with bilateral knee osteoarthritis and obesity were classified into 3 groups by their stages of osteoarthritis . Each group was divided into subgroups a , b , and c. The subjects in subgroup a received weight reduction treatment , those in subgroup b received weight reduction and electrotherapy modalities , and those in subgroup c received electrotherapy modalities to relieve pain . RESULTS Pain reduction , weight reduction , ambulation speed , and changes of Lequesne 's index were greater in patients in subgroups a and b than in subgroup c after treatment . Although the last pain scores in subgroup b were less than those in subgroup a , as measured by a visual analog scale ( VAS ) , there was no significant difference between their functional status . Significant pain relief ( VAS < 2 ) and an acceptable functional status ( Lequesne 's index < 7 ) were indicated when weight reduction was more than 15 % and 12 % , respectively , of the initial body weight of the individual . CONCLUSION Weight reduction was found to be a practical adjuvant treatment in the rehabilitation of patients with knee osteoarthritis BACKGROUND Lorcaserin is a selective serotonin 2C receptor agonist that could be useful in reducing body weight . METHODS In this double-blind clinical trial , we r and omly assigned 3182 obese or overweight adults ( mean body-mass index [ the weight in kilograms divided by the square of the height in meters ] of 36.2 ) to receive lorcaserin at a dose of 10 mg , or placebo , twice daily for 52 weeks . All patients also underwent diet and exercise counseling . At week 52 , patients in the placebo group continued to receive placebo but patients in the lorcaserin group were r and omly reassigned to receive either placebo or lorcaserin . Primary outcomes were weight loss at 1 year and maintenance of weight loss at 2 years .  Serial echocardiography was used to identify patients in whom valvulopathy ( as defined by the Food and Drug Administration ) developed . RESULTS At 1 year , 55.4 % of patients ( 883 of 1595 ) receiving lorcaserin and 45.1 % of patients ( 716 of 1587 ) receiving placebo remained in the trial ; 1553 patients continued into year 2 . At 1 year , 47.5 % of patients in the lorcaserin group and 20.3 % in the placebo group had lost 5 % or more of their body weight ( P<0.001 ) , corresponding to an average loss of 5.8+/-0.2 kg with lorcaserin and 2.2+/-0.1 kg with placebo during year 1 ( P<0.001 ) . Among the patients who received lorcaserin during year 1 and who had lost 5 % or more of their baseline weight at 1 year , the loss was maintained in more patients who continued to receive lorcaserin during year 2 ( 67.9 % ) than in patients who received placebo during year 2 ( 50.3 % , P<0.001 ) . Among 2472 patients evaluated at 1 year and 1127 evaluated at 2 years , the rate of cardiac valvulopathy was not increased with the use of lorcaserin . Among the most frequent adverse events reported with lorcaserin were headache , dizziness , and nausea . The rates of serious adverse events in the two groups were similar . CONCLUSIONS In conjunction with behavioral modification , lorcaserin was associated with significant weight loss and improved maintenance of weight loss , as compared with placebo . ( Funded by Arena Pharmaceuticals ; Clinical Trials.gov number , NCT00395135 . BACKGROUND Treatment of hypertension with diuretics , beta-blockers , or both leads to improved outcomes . It has been postulated that agents that inhibit the renin-angiotensin system confer benefit beyond the reduction of blood pressure alone . We compared the outcomes in older subjects with hypertension who were treated with angiotensin-converting-enzyme ( ACE ) inhibitors with the outcomes in those treated with diuretic agents . METHODS We conducted a prospect i ve , r and omized , open-label study with blinded assessment of end points in 6083 subjects with hypertension who were 65 to 84 years of age and received health care at 1594 family practice s. Subjects were followed for a median of 4.1 years , and the total numbers of cardiovascular events in the two treatment groups were compared with the use of multivariate proportional-hazards models . RESULTS At base line , the treatment groups were well matched in terms of age , sex , and blood pressure . By the end of the study , blood pressure had decreased to a similar extent in both groups ( a decrease of 26/12 mm Hg ) . There were 695 cardiovascular events or deaths from any cause in the ACE-inhibitor group ( 56.1 per 1000 patient-years ) and 736 cardiovascular events or deaths from any cause in the diuretic group ( 59.8 per 1000 patient-years ; the hazard ratio for a cardiovascular event or death with ACE-inhibitor treatment was 0.89 [ 95 percent confidence interval , 0.79 to 1.00 ] ; P=0.05 ) . Among male subjects , the hazard ratio was 0.83 ( 95 percent confidence interval , 0.71 to 0.97 ; P=0.02 ) ; among female subjects , the hazard ratio was 1.00 ( 95 percent confidence interval , 0.83 to 1.21 ; P=0.98 ) ; the P value for the interaction between sex and treatment-group assignment was 0.15 . The rates of nonfatal cardiovascular events and myocardial infa rct ions decreased with ACE-inhibitor treatment , whereas a similar number of strokes occurred in each group ( although there were more fatal strokes in the ACE-inhibitor group ) . CONCLUSIONS Initiation of antihypertensive treatment involving ACE inhibitors in older subjects , particularly men , appears to lead to better outcomes than treatment with diuretic agents , despite similar reductions of blood pressure CONTEXT Dapagliflozin , a selective sodium-glucose cotransporter 2 ( SGLT2 ) inhibitor , reduces hyperglycemia in patients with type 2 diabetes mellitus ( T2DM ) by increasing urinary glucose excretion , and weight loss is a consistent associated finding . OBJECTIVES Our objectives were to confirm weight loss with dapagliflozin and establish through body composition measurements whether weight loss is accounted for by changes in fat or fluid components . DESIGN AND SETTING This was a 24-wk , international , multicenter , r and omized , parallel-group , double-blind , placebo-controlled study with ongoing 78-wk site- and patient-blinded extension period at 40 sites in five countries . PATIENTS Included were 182 patients with T2DM ( mean values : women 63.3 and men 58.6 yr of age ; hemoglobin A1c 7.17 % , body mass index 31.9 kg/m2 , and body weight 91.5 kg ) inadequately controlled on metformin . INTERVENTION Dapagliflozin 10 mg/d or placebo was added to open-label metformin for 24 wk . MAIN OUTCOME MEASURES Primary endpoint was total body weight ( TBW ) change from baseline at wk 24 . Key secondary endpoints were waist circumference and dual-energy x-ray absorptiometry total-body fat mass ( FM ) changes from baseline at wk 24 , and patient proportion achieving body weight reduction of at least 5 % at wk 24 . In a subset of patients , magnetic resonance assessment of visceral adipose tissue ( VAT ) and sc adipose tissue ( SAT ) volume and hepatic lipid content were also evaluated . RESULTS At wk 24 , placebo-corrected changes with dapagliflozin were as follows : TBW , -2.08 kg [ 95 % confidence interval (CI)=-2.84 to -1.31 ; P<0.0001 ] ; waist circumference , -1.52 cm ( 95 % CI=-2.74 to -0.31 ; P=0.0143 ) ; FM , -1.48 kg ( 95 % CI=-2.22 to -0.74 ; P=0.0001 ) ; proportion of patients achieving weight reduction of at least 5 % , + 26.2 % ( 95 % CI=15.5 to 36.7 ; P<0.0001 ) ; VAT , -258.4 cm3 ( 95 % CI=-448.1 to -68.6 ; nominal P=0.0084 ) ; SAT , -184.9 cm3 ( 95 % CI=-359.7 to -10.1 ; nominal P=0.0385 ) . In the dapagliflozin vs. placebo groups , respectively , serious adverse events were reported in 6.6 vs. 1.1 % ; events suggestive of vulvovaginitis , balanitis , and related genital infection in 3.3 vs. 0 % ; and lower urinary tract infections in 6.6 vs. 2.2 % . CONCLUSIONS Dapagliflozin reduces TBW , predominantly by reducing FM , VAT and SAT in T2DM inadequately controlled with metformin AIMS This study evaluated change in health-related quality of life ( HRQOL ) associated with ongoing weight change among patients with type 2 diabetes mellitus ( T2DM ) treated with  dapagliflozin  , a highly selective sodium-glucose cotransporter 2 ( SGLT2 ) inhibitor that lowers blood glucose by increasing urinary glucose excretion and is associated with body weight reductions . METHODS Patients with T2DM who had inadequate glycaemic control on metformin ( MET ) alone were enrolled in a 24-week , double-blind , r and omized , placebo-controlled study with a 78-week extension to evaluate the effect of dapagliflozin + MET on body weight . Patients also completed the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes Weight Question naire-9 ( SHIELD-WQ-9 ) , a weight change-related HRQOL survey . Difference in proportions of patients treated with dapagliflozin 10 mg + MET ( n = 89 ) or placebo + MET ( n = 91 ) who reported improvement in HRQOL was analysed with Fisher 's exact test . RESULTS Dapagliflozin patients had significantly greater weight loss than placebo patients over 102 weeks ( p < 0.05 ) . This corresponded to a numerically greater proportion of dapagliflozin-treated patients reporting ongoing weight loss and associated improvements in most HRQOL domains at three different evaluation points ( weeks 24 , 50 and 102 ) than placebo-treated patients . In a post-hoc analysis among patients who reported ongoing weight loss regardless of treatment arm , a significantly greater proportion of patients reporting weight loss versus weight gain reported improvements in physical health , self-esteem and overall HRQOL at weeks 24 , 50 and 102 . CONCLUSIONS Dapagliflozin-induced weight loss was associated with improvement in overall HRQOL . Overall , ongoing weight loss was associated with improvements in several HRQOL domains compared with weight gain OBJECTIVE To determine whether high exercise adherence improved physical function among older adults with knee osteoarthritis ( OA ) who were overweight or obese . METHODS Associations between  exercise adherence , changes in 6-minute walking distance in meters , and self-reported disability ( Western Ontario and McMaster Universities Osteoarthritis Index function subscale ) after 6 and 18 months were examined among an Arthritis , Diet , and Activity Promotion Trial sub sample ( n = 134 ) using multiple linear regression models . RESULTS Higher exercise adherence was associated with greater improvements in 6-minute walking distance after 6 and 18 months and in disability after 6 months . Pain and body mass index ( BMI ) contributed , to some extent , to explaining the link between exercise adherence  and changes in physical performance and self-reported disability . CONCLUSION Higher exercise adherence is associated with improved physical function in overweight and obese older adults with knee OA . This indicates that promoting adherence is clinical ly relevant when prescribing exercise regimens that also focus on decreasing pain and BMI This prospect i ve study was carried out in order to evaluate the influence on liver morphology and function of a very-low-calorie formula diet .  Fourty-one morbidly obese , non-alcoholic subjects had liver biopsy performed before and after a median weight loss of 34 kg . Fatty change improved ( p less than 0.001 ) , but 24 % of the patients developed slight portal inflammation ( p = 0.039 ) or slight portal fibrosis ( p = 0.063 ) . Patients developing portal fibrosis had a higher degree of fatty change at entry ( p = 0.029 ) , a more pronounced reduction of fatty change ( p = 0.014 ) and a faster weight loss ( p = 0.026 ) . Liver biochemistry , which was of no individual diagnostic value , improved . It is concluded that morbidly obese subjects with a high degree of hepatic fatty change are at 
    Output:
    
Weight loss is a pathway to health improvement for patients with obesity-associated risk factors and comorbidities .
Medications approved for chronic weight management can be useful adjuncts to lifestyle change for patients who have been unsuccessful with diet and exercise alone .
Many medications commonly prescribed for diabetes , depression , and other chronic diseases have weight effects , either to promote weight gain or produce weight loss .
Knowledgeable prescribing of medications , choosing whenever possible those with favorable weight profiles , can aid in the prevention and management of obesity and thus improve health