We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Results of Roux-en-Y Gastric Bypass in Morbidly Obese vs Superobese Patients—Invited Critique

Jon Gould, MD
Arch Surg. 2009;144(4):318. doi:10.1001/archsurg.2009.13.
Text Size: A A A
Published online


Suter and colleagues have touched on an important issue in their study. In 2007, the American Society of Bariatric Surgeons changed its name to more accurately reflect what is accomplished with a bariatric operation. Metabolic was added to the society name to emphasize the fact that these are more than weight-loss operations. The primary objective of bariatric surgery is improved health. A formerly diabetic patient who is still obese long after undergoing bariatric surgery has had a successful, life-altering outcome regardless of the amount of weight lost. Rather than reporting surgical results in terms of percentage of EWL, the bariatric surgical community should emphasize the changes in health and quality of life that follow these operations. Some may argue that bariatric surgeons are doing that now. I would argue that we are not doing it well enough. When we discuss surgical criteria, it is BMI that receives the headline; comorbidities get honorable mention. Weight loss is the first outcome discussed in our bariatric surgery lectures, in our clinical encounters with patients, and in our published reports. It is no wonder that, despite mountains of clinical evidence touting the health benefits of bariatric surgery, it is still acceptable for insurance companies to deny benefits for “weight-loss surgery.” As these authors state in the conclusion of their article, “weight loss or residual BMI is not all that matters. . . . ”

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Characterizing Readmissions After Bariatric Surgery. J Gastrointest Surg Published online Sep 9, 2016;

Promoción de la salud en el ciclo de vida