Author Affiliations: New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts (Drs Ludwig and Ebbeling); and Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, Dallas (Dr Livingston). Dr Livingston is now Deputy Editor, JAMA.
Recent clinical trials have reported that substantially more weight loss and greater likelihood of diabetes remission occur following bariatric surgery compared with medical therapy,1 leading to calls for earlier consideration of surgery in the treatment of this obesity-related metabolic disease. Although these studies demonstrate the lack of efficacy of conventional practices, they do not prove the inherent superiority of surgery to lifestyle change. This Viewpoint considers the limitations of published research and highlights the need for clinical trials with improved design.
Ludwig DS, Ebbeling CB, Livingston EH. Surgical vs Lifestyle Treatment for Type 2 Diabetes. JAMA. 2012;308(10):981–982. doi:10.1001/2012.jama.10156