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September 28, 2011

Survival After Bariatric Surgery Among High-Risk Patients

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Legacy Good Samaritan Weight Management Institute, Portland, Oregon (Dr Patterson); University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (Dr Belle); and Department of Surgery, Oregon Health and Science University, Portland (Dr Wolfe) (wolfeb@ohsu.edu).

JAMA. 2011;306(12):1323-1324. doi:10.1001/jama.2011.1350

To the Editor: Dr Maciejewski and colleagues reported that mortality was not reduced in severely obese patients in Veterans Affairs medical centers following bariatric surgery compared with a nonsurgical group of obese individuals.1 Their conclusion is in contrast to that of a meta-analysis of 8 previous reports comparing mortality risk following bariatric surgery with a variety of comparator groups.2 We are unaware of other evidence to suggest that substantial weight loss is not associated with a reduction in long-term mortality risk in such a population. The authors suggested several possible explanations for their different conclusion, emphasizing the predominantly male and somewhat older (mean age, 49.5 years) population studied. We believe that several methodological issues are a more likely explanation for the negative conclusion reached by Maciejewski et al.