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Survival After Bariatric Surgery Among High-Risk Patients

Emma J. Patterson, MD; Steven H. Belle, PhD; Bruce M. Wolfe, MD
JAMA. 2011;306(12):1323-1324. doi:10.1001/jama.2011.1350.
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To the Editor: Dr Maciejewski and colleagues reported that mortality was not reduced in severely obese patients in Veterans Affairs medical centers following bariatric surgery compared with a nonsurgical group of obese individuals.1 Their conclusion is in contrast to that of a meta-analysis of 8 previous reports comparing mortality risk following bariatric surgery with a variety of comparator groups.2 We are unaware of other evidence to suggest that substantial weight loss is not associated with a reduction in long-term mortality risk in such a population. The authors suggested several possible explanations for their different conclusion, emphasizing the predominantly male and somewhat older (mean age, 49.5 years) population studied. We believe that several methodological issues are a more likely explanation for the negative conclusion reached by Maciejewski et al.

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September 28, 2011
Matthew L. Maciejewski, PhD; Edward H. Livingston, MD; David E. Arterburn, MD, MPH
JAMA. 2011;306(12):1323-1324. doi:10.1001/jama.2011.1351.
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