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Extreme Obesity in Women and Associated Risks—Reply
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In Reply: Dr Middleton questions the relevance of our findings to individuals' health decision making. This should be considered in the context of shared decision making, which has the goal of reaching a decision that is informed and is jointly made between patient and clinician. The patient must understand the risk of the disease or condition to be prevented; understand the preventive service, including its risks, benefits, alternatives, and uncertainties; weigh his or her values regarding the potential benefits and harms associated with the service; and engage in decision making at a level that he or she desires.1 Accurate understanding of weight-related health risk is therefore integral to shared decision making for obesity.
Counseling-based interventions, a cornerstone of obesity treatment, are expensive and difficult and require substantial patient commitment but can have significant health benefits.2 I disagree with Middleton's suggestion that understanding how risk changes throughout the obese range increases . . . [Full Text of this Article]
Kathleen McTigue, MD, MS, MPH
mctiguekm@upmc.edu
Division of General Internal Medicine
Department of Medicine
University of Pittsburgh
Pittsburgh, Pa
RELATED LETTER
Extreme Obesity in Women and Associated Risks
Jennifer Middleton
JAMA. 2006;296(18):2205.
EXTRACT
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RELATED ARTICLE
Mortality and Cardiac and Vascular Outcomes in Extremely Obese Women
Kathleen McTigue, Joseph C. Larson, Alice Valoski, Greg Burke, Jane Kotchen, Cora E. Lewis, Marcia L. Stefanick, Linda Van Horn, and Lewis Kuller
JAMA. 2006;296(1):79-86.
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