In Reply We appreciate the letter from Ms Chen and colleagues about our article. First, differences in intensity of lifestyle interventions can affect weight reduction efficacy, with initial weight loss at 1 year ranging from −2% to −9%. Chen and colleagues ask about the efficacy of lifestyle interventions in our trial compared with results from the DIADEM-I and Look AHEAD trials, both of which included intensive lifestyle interventions. Our trial, similar to others investigating the efficacy and safety of antiobesity medications, implemented standard lifestyle interventions that closely reflected clinical practice. The weight reduction achieved in the placebo group was generally consistent with previous trials with similar objectives.