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November 8, 2006

Extreme Obesity in Women and Associated Risks—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296(18):2205-2206. doi:10.1001/jama.296.18.2205-c

In Reply: Dr Middleton questions the relevance of our findings to individuals' health decision making. This should be considered in the context of shared decision making, which has the goal of reaching a decision that is informed and is jointly made between patient and clinician. The patient must understand the risk of the disease or condition to be prevented; understand the preventive service, including its risks, benefits, alternatives, and uncertainties; weigh his or her values regarding the potential benefits and harms associated with the service; and engage in decision making at a level that he or she desires.1 Accurate understanding of weight-related health risk is therefore integral to shared decision making for obesity.