Subjects were employees of Chatham County Municipal Government in Savannah. These employees were overweight or obese, with a body mass index (BMI) of 25 or greater (calculated as weight in kilograms divided by height in meters squared) and currently receiving treatment for hypertension, type 2 diabetes mellitus, and/or hyperlipidemia. All participants received intensive behavior, nutrition, and physical activity counseling from multidisciplinary staff. Dietary recommendations were based on the 2006 Scientific Statement from the American Heart Association Nutrition Committee.2,3 Regular physical activity was encouraged, and approaches to managing obesity and minimizing its complications were provided. Clinical objective data including BMI, waist circumference, blood pressure, and fasting blood glucose, hemoglobin A1c, and fasting lipid levels were collected on enrollment and at the completion of the program. Open-label use of generic medications was encouraged. Medication dose titration and adjustments were performed on the discretion of the physician.