| I have no idea how common it is but sometimes I think it should be more common.
Unless a patient starts out trying to get control with just lifestyle modification and no meds, they can't get a baseline for how much improvement is possible.
Some people are severe at Dx, some are not. Some are more likely to actualize lifestyle changes than others. Some have more weight to lose than others and so more room for improvement. Some patients are quite advanced in age at Dx, so there may not be a lot of concern about long term complications. If lifestyle is already good/excellent at Dx then there's less room for improvement.
Many factors to consider so case by case basis for the decision. I think it best for doc and patient to discuss all this and decide if meds are warranted at Dx, or if the lifestyle change experiment makes sense.
Either way I don't think the decision is critical. If whichever approach is taken appears not to be working then simply go the other way.
__________________ Either write something worth reading or do something worth writing. -- Benjamin Franklin | 
