[106] Confidence in the quality of the evidence is very low due to serious study limitations and imprecision. While SBP and DBP did decrease in the intervention groups for several studies, it was not clear whether it was a clinically meaningful reduction in As the recommendation on a diet directed at weight loss is Reviewed, New-added, the Work Group systematically reviewed evidence related to this recommendation identified in the evidence review conducted as part of this guideline update.[106-108] The Work Group had very low confidence in the quality of evidence supporting dietary interventions for weight loss for the treatment of HTN; there were serious limitations and a high risk of bias. While the data was somewhat limited, the effect sizes in the evidence were reasonably large. The benefits outweigh the harms, as only a few harms were associated with the interventions. There is a large variation in patient preferences as there are various versions of diet, and providers would need to get the patient to agree to participate in the dietary intervention. Some patients would not accept the intervention. Thus, the Work Group decided upon a Weak for recommendation. Recommendation 16. For the treatment of hypertension, there is insufficient evidence for or against offering weight loss medications for patients with obesity and hypertension. (Neither for nor against | Reviewed, New-added) Discussion The Work Group also looked at the evidence for offering weight loss medications for patients with obesity and HTN. There was insufficient evidence in the studies reviewed by the Work Group to recommend for or against offering weight loss medications for the treatment of HTN. An SR by Siebenhofer et al. (2016) compared weight loss medications (orlistat and phentermine/topiramate) to placebo in patients with HTN.