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April 3, 1996

Estrogen Replacement Therapy and Body Fat-Reply

Author Affiliations

University of California, San Diego La Jolla

JAMA. 1996;275(13):987-988. doi:10.1001/jama.1996.03530370025022

In Reply.  —Ms Blackman has queried the methods used in our article reporting that long-term use of hormone replacement therapy was not associated with the weight gain or central obesity commonly observed in postmenopausal women. We think it is unlikely that our results were attributable to misclassification of obesity based on BMI because there were no significant differences between the intermittent or continuous hormone users compared with the never users in the change in height between baseline and follow-up (P>.10). We also found no differences between hormone users and nonusers in fat mass or lean body mass (data not shown) as assessed by bioelectric impedance.As we noted in our article, survival bias (whereby hormone users gained more weight than nonusers but died prior to follow-up) is unlikely because the women who used hormones lived longer than the untreated women. Although Manson et al1 reported that among middle-aged