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Correspondence
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Volume 351:2771-2773 December 23, 2004 Number 26
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Case 25-2004: A Woman with Severe Obesity, Diabetes, and Hypertension

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by Pratt, J. S.
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To the Editor: Pratt and colleagues (Aug. 12 issue)1 provide an excellent discussion of the multidisciplinary treatment of a severely obese woman. One point that deserves further discussion is the evidence base, or lack thereof, behind the use of bariatric surgery. To date, no randomized, controlled trials or prospective cohort studies have reported a reduction in the incidence of myocardial infarction, stroke, or death with surgical treatment. The Swedish Obese Subjects study has reported a lower incidence of diabetes (odds ratio, 0.16; 95 percent confidence interval, 0.07 to 0.36) in surgically treated patients than in matched controls but not a . . . [Full Text of this Article]



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