I've been running a Permatrim for about 8 years and I've experimented with it on and off the boat. To me it seems more like swapping out the cat-back muffler system on a car - I think it does more than it probably actually does, but it's nearly impossible to obtain empirical data... The things I've noticed is a very slight improvement in being able to plane (~18 mph instead of ~20) but it definitely handles a little more squirrelly in a following sea. Nothing awful, but its noticeable. It doesn't seem to affect fuel consumption. I get 1.9 to 2.1 mpg (statute) no matter what. I guess the ultimate answer is that I ran with it for a couple years, then took it off for a season and ended up putting it back on. Not because it made such a huge difference, but it was slightly better and the trade-off was worth it.
My situation might be a bit unique - 140 gal tank right at the stern, so very stern heavy and an older style bracket without much flotation.