To the Editor.
—The Grand Rounds at the Clinical Center of the National Institutes of Health (NIH) by Dr Wilber entitled "Neural peptides, appetite regulation, and human obesity"1 that appeared in JAMA failed to describe gastric surgery for the management of severe obesity in the treatment section.This topic was recently discussed at a Consensus Panel on the Surgical Treatment of Severe Obesity at the NIH at which it was concluded that gastric surgery is appropriate for patients who have a body mass index of less than 40 without comorbidity and that patients who have significant comorbidity and a body mass index of 35 to 40 should be considered as candidates for the procedure. Clearly, this has had the most effective long-term efficacy in the management of severe obesity with the data now showing the average loss of excess weight between 50% to 60% for as long as 10 years
Sugerman HJ. Obesity: The Role of Gastric Surgery. JAMA. 1991;266(22):3130. doi:10.1001/jama.1991.03470220046020