Our discussion of the impact of weight-loss treatments on the quality of life is limited to the studies we included in our review and is by no means exhaustive (1). Several well-designed randomized controlled trials with quality of life as the primary endpoint would be required to fully answer the question. Due to their methodological limitations, it is difficult to draw conclusions about the impact of weight-loss treatments on quality of life from the studies cited in the reader's comment (2, 3). Whether the study mentioned first (2) was designed as a randomized, controlled trial remains unclear. Irrespective of this, it was not possible to link the demonstrated improvement in quality of life specifically to the weight-loss treatment, as patients of the control group treated with a relaxation technique also improved in this respect. In the study mentioned second (3), the critical methodological limitation is the lack of a control group, as without control group no conclusion about the specific effectivity of the weight-loss treatment can be drawn. Nevertheless, improved quality of life independent of a change in weight is an interesting finding, raising further questions. Lastly, the need for further research on this aspect is highlighted by the fact that only one of the studies we included in our review used quality of life as its primary outcome measure (4). Whether it is necessary to address the issue of obesity to improve quality of life remains to be ascertained. Here, the decisive factor could be to break the social isolation of those affected. If this were the case, it would allow to improve the quality of life of patients with obesity using simple approaches.
Dipl.-Psych. Yvonne Mühlig
LVR-Klinikum Essen, Germany
Conflict of interest statement
The authors have received financial support from the German Federal Ministry of Education and Research for a research project that they initiated within the Consortium “Youth With Extreme Obesity” (project no. 01GI1120A/B) of the Competence Network Obesity.
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