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Danny O. Jacobs, MD, MPH

Arch Surg. 2004;139:1093.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Dr Lee and colleagues' report of a 1-year follow-up study of 645 patients who underwent laparoscopic vertical banded gastroplasty or gastric bypass as part of a supervised weight loss program is provocative but may be overstated. As the authors indicate, it would not be surprising if the weight loss facilitated by bariatric surgery abrogated the risk factors that characterize the metabolic syndrome. Indeed, their data (and those of Kral et al¹) suggest that this is the case. Other investigations indicate that modest weight loss of 5% to 7% together with increased physical activity (150 min/wk) may be equally effective. Maintenance of the necessary weight lost is the pertinent issue—in concert with a balanced consideration of the risks and benefits of surgery vs a more conservative option.

There are many unanswered questions that would help put some of the authors' comments in perspective—in particular, their . . . [Full Text of this Article]

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