In his article entitled “Bariatric Surgery Outcomes at Designated Centers of Excellence vs Nondesignated Programs,”1 Dr Livingston asserts that “designation as a bariatric surgery center of excellence does not ensure better outcomes” and “neither does high annual procedure volume.” Livingston uses complex statistical equations and formulas to convince readers that he has done his research. Most will skim through the intricate details and move quickly to the commentary, leaving the statistical analyses to Livingston, who wrote the article alone without a statistician coauthor.