Objective-Improving the maintenance of lost weight remains a critical challenge, which can be addressed by long-term behavioral and/or pharmacological interventions.Methods-This study investigated the efficacy of combined behavioral and pharmacological treatment in facilitating weight loss maintenance (WLM) in 137 adults (86.1% female, 68.6% black, BMI=37.0±5.6 kg/m 2 ) who had lost ≥5% of initial weight during a 14-week, low-calorie diet (LCD) program (mean=9.3±2.9%). Participants were randomly assigned to lorcaserin (10 mg BID) or placebo and provided 16 group WLM counseling sessions over 52 weeks.Results-At 24 weeks post-randomization, more lorcaserin-than placebo-treated participants maintained ≥5% loss (73.9% vs 57.4%; p=.033), and the former participants lost an additional 2.4±0.8 kg versus a 0.6±0.8 kg gain for placebo (p=.010). However, at week 52, groups did not differ on either co-primary outcome; 55.1% and 42.6%, respectively, maintained ≥5% loss (p=0.110), with gains from randomization of 2.0±0.8 and 2.5±0.8 kg (p=0.630), respectively. From the start of the LCD, groups maintained reductions of 7.8% and 6.6%, respectively (p=0.318).Conclusion-Combined behavioral-pharmacologic treatment produced clinically meaningful long-term weight loss in this group of predominantly black participants. Lorcaserin initially improved upon weight loss achieved with WLM counseling, but this advantage was not maintained at 1 year.

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