Clinical effectiveness of lifestyle management programs: importance of the class effect paradox.

OPINION STATEMENT: It is well appreciated in pharmacotherapy that all drugs belonging to the same class of agents are not necessarily equally safe or effective. Because of this so-called "class effect paradox," pharmaceutical companies must do extensive research to prove the safety and efficacy of a new drug before introducing it into the market, even if it belongs to a well-established class of medications. Like pharmaceutical agents, lifestyle management interventions can be organized into classes. This commentary examines the rationale for, and importance of, considering the class effect paradox when balancing the need for new and innovative lifestyle management programs with the need for evidence-based interventions with proven outcomes. In view of the fact that all lifestyle management programs within a specific broad intervention class do not necessarily result in clinical benefit, it is recommended that any new approach should not be widely implemented until it has been shown to be effective as evidenced by results of clinical studies published in peer-reviewed journals.