Author Contributions: Dr Peltonen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: L. Sjöström, Peltonen, Karason, Wedel, Bengtsson, Bouchard, Dahlgren, Karlsson, Näslund, L. Carlsson.
Acquisition of data: L. Sjöström, Jacobson, C. Sjöström, Karason, Bengtsson, Bergmark, Dahlgren, Lindroos, Lönroth, Narbro, Näslund, Olbers, Svensson, L. Carlsson.
Analysis and interpretation of data: L. Sjöström, Peltonen, C. Sjöström, Karason, Wedel, Ahlin, Anveden, Bengtsson, Bouchard, B. Carlsson, Dahlgren, Karlsson, Näslund, Svensson, L. Carlsson.
Drafting of the manuscript: L. Sjöström, Peltonen, L. Carlsson.
Critical revision of the manuscript for important intellectual content: L. Sjöström, Peltonen, Jacobson, C. Sjöström, Karason, Wedel, Ahlin, Anveden, Bengtsson, Bergmark, Bouchard, B. Carlsson, Dahlgren, Karlsson, Lindroos, Lönroth, Narbro, Näslund, Olbers, Svensson, L. Carlsson.
Statistical analysis: Peltonen, Wedel.
Obtained funding: L. Sjöström, Jacobson, C. Sjöström, Karason, Svensson, L. Carlsson.
Administrative, technical, or material support: L. Sjöström, Jacobson, Karason, Ahlin, Anveden, Bergmark, Dahlgren, Lindroos, Lönroth, Narbro, Svensson, L. Carlsson.
Study supervision: L. Sjöström, Karason, Dahlgren, L. Carlsson.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr L. Sjöström reported obtaining unrestricted Swedish Obese Subjects grants from sanofi-aventis and Johnson & Johnson since 2007; receiving lecture and consulting fees from AstraZeneca, Biovitrum, Bristol-Myers Squibb, GlaxoSmithKline, Johnson & Johnson, Lenimen, Merck, Novo Nordisk, Hoffmann LaRoche, sanofi-aventis, and Servier; and holding stocks in Lenimen and being chairman of its board. Dr Jacobson reported receiving research grants from Hoffmann LaRoche. Dr C. Sjöström reported being employed by AstraZeneca and receiving consulting and/or lecture fees from sanofi-aventis, MSD, and Ethicon. Dr Wedel reported receiving consulting fees from AstraZeneca, Pfizer, Novartis, and Hoffmann LaRoche without relation to the submitted work. Dr Bouchard reported receiving consulting fees from the Weight Watchers Scientific Advisory Board and unrestricted grants from Bristol-Myers Squibb. Dr B. Carlsson reported being employed by and holding stocks in AstraZeneca. Dr Karlsson reported serving as consultant for Pfizer. Dr Lindroos reported serving as a consultant for Abbott. Dr Näslund reported receiving lecture fees from Johnson & Johnson. Dr Olbers reported receiving lecture fees on speakers bureaus from Johnson & Johnson and Covidien and receiving travel expenses from Johnson & Johnson. Dr L. Carlsson reported serving as a consultant for AstraZeneca and holding stocks in Sahltech. All other authors declared no conflicts of interest.
Funding/Support: This study was supported by grants from the Swedish Medical Research Council, the Swedish Research Council (K2010-55X-11285-13), the Swedish Foundation for Strategic Research to Sahlgrenska Centre for Cardiovascular and Metabolic Research, and the Swedish federal government under the LUA/ALF agreement (Dr L. Sjöström). These research grants applied for as ordinary Research Council grants are paid by the Swedish State to the university hospitals as compensation for teaching costs. Unconditional support was also obtained from Hoffmann LaRoche, AstraZeneca, Cederroths, sanofi-aventis, and Johnson & Johnson.
Role of the Sponsors: Funding organizations and industrial sponsors were not involved in the design and conduct of the study or in the collection, management, analysis, and interpretation of the data. Similarly, funding organizations and industrial sponsors were not involved in the preparation, review, or approval of the manuscript. Medical writers have not been used.
Additional Contributions: We thank the staff members at 480 primary health care centers and 25 surgical departments in Sweden who participated in the study. Lisbeth Ericsson (The Swedish Obese Subjects administrative secretary) provided invaluable administrative support and is employed by the Institute of Medicine, University of Gothenburg.