on on the new medication that is the indian state pipeline now is a combination drug that contains two uh... medications one e is interning and what the other is to appear mate uh... both medications are familiar to us and familiar to positions and cure providers in general because they've been around a long time the information we're getting now uh... from the companies that are developing at a company that is developing the combination drug uh... is that it does have a modest a factor on in terms of helping patients with weight loss uh... in would be taken in combination on the concerns now what the f_d_a_ is working on inside the safety profile of the medications being given together the idea of helping patients with serious weight problems with medication has been around for a long time and medications uh... have been suggested for use that have really know known uh... research proven effect on way to medications have been use that seem to have sort of minimal to maybe modest uh... effects in terms of helping people with weight um... more recently uh... as we move toward more evidence based medicine or really want to be prescribing things that we know a lot about the effect before hand and a lot about the absence of important side-effects beforehand uh... we sort of put more of a burden on ourselves to to be uh... much more knowledgeable about what were offering to patients uh... in this particular situation uh... with weight loss medications or by that i mean medications that have an impact on appetite and on what we call satiety which is that they are feeling the fullness um... we know from history that these medications tend to have uh... certain side-effects that one might predict in certain side-effects that are not so predictable and looking at these medications there's always katie concern um... about important side-effects especially for these morbidly obese patients going into the process already having their weight has a risk factor uh... mainly for heart disease um... india diabetes pretension cholesterol problems other she's related to their way uh... console any potentially important side-effects that will come out of medications that would having impact to increased at risk profile are things that you have to worry about it a quite seriously put all uh... providers in will be seen at the center providers who treat a lot of morbidly obese patients would be in agreement on is that the the bedrock really of affective uh... held for these patients is lifestyle change and by that i mean uh... completely changing the way that people approach eating and hopefully physical activity level and and uh... talk to patients about that uh... come to the weight cena regardless whether they're just interest in the lifestyle base program even if they're interested weightloss surgery and certainly defer technicolor weight loss medications the lights up uh... change piece of it has to really be that the centerpiece around which everything else kind of his is built with weight loss medications again it's something that potentially can help people in terms of that impact that it may have on appetite and and fullness abut as time goes by patients again are going to become more more dependent terms of their long-term successful i'm changes that they can stick with permanently common with any intervention thiet lifestyle based surgical or vacation sociated people like a great long-term results for the people who are making the biggest change isn't doing the best rustic