This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Related letter  • Similar articles in JAMA  Topic Collections  • Obesity  • Diabetes Mellitus  • Surgical Interventions  • Bariatric Surgery  • Alert me on articles by topic

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

To the Editor: In their randomized controlled trial, Dr Dixon and colleagues¹ compared adjustable gastric banding vs conventional therapy for type 2 diabetes. The authors observed that participants randomized to surgical therapy were more likely to achieve remission of type 2 diabetes compared with those who were assigned to conventional therapy. They concluded that magnitude of weight loss was the primary determinant of diabetes remission.

Given the importance of amount of weight loss in determining outcome, the failure to use a state-of-the-art behavioral weight reduction program that produces representative weight losses is of major concern in interpreting the study's findings. Lifestyle interventions that include frequent contact (typically weekly), group support, and behavioral strategies are most effective for weight loss and maintenance.^2-4 With this type of program, weight losses of 7% (7 kg) were obtained in the Diabetes Prevention Program at 1 year with approximately 6-kg weight loss at 2 years.³ . . . [Full Text of this Article]

Rena R. Wing, PhD
rwing@lifespan.org
Brown University Medical School
Providence, Rhode Island

Thomas A. Wadden, PhD
University of Pennsylvania School of Medicine
Philadelphia

Mark Espeland, PhD
Wake Forest University School of Medicine
Winston-Salem, North Carolina

RELATED ARTICLE

Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial
John B. Dixon, Paul E. O’Brien, Julie Playfair, Leon Chapman, Linda M. Schachter, Stewart Skinner, Joseph Proietto, Michael Bailey, and Margaret Anderson
JAMA. 2008;299(3):316-323.
ABSTRACT | FULL TEXT  

RELATED LETTER

Surgical vs Behavioral Therapy for Weight Loss in Patients With Type 2 Diabetes—Reply
John B. Dixon, Paul E. O’Brien, and Joseph Proietto
JAMA. 2008;299(18):2146-2147.
EXTRACT | FULL TEXT