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Gastric Restrictive Surgery for Morbid Obesity

John G. Kral, MD, PhD
JAMA. 1985;254(17):2410-2411. doi:10.1001/jama.1985.03360170050019.
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To the Editor.—  I am writing in response to the Diagnostic and Therapeutic Technology Assessment (DATTA) report on gastric restrictive surgery for morbid obesity.1 I would like to point out several inaccuracies in the text.There have been several "published reports of controlled clinical studies" of gastric bypass and gastroplasty,2-4 contrary to the first sentence in the report. Also contrary to the statement in the DATTA report, gastric exclusion is not as effective at inducing weight reduction as intestinal bypass. Increased confusion arises when the last paragraph of the report states that "there is general agreement that these gastric restrictive operations... also... tend to be less effective at ensuring weight reduction."We know of no published data indicating that weight loss after "Mason's vertical plication" (in the literature commonly referred to as "vertical banded gastroplasty") is "less dramatic initially than with horizontal plication," no matter how this term


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