Dear Editor,

We thank the authors for their comments. We agree that their comments provide an interesting historical perspective on our findings, and we wholeheartedly agree with their conclusions that more research is needed in this area.

The intention of our study was to provide some insight into occupational outcomes after bariatric surgery in a manner which would be relevant to the modern practitioner. As such, we choose to focus our attention on studies which assessed occupational outcomes within modern bariatric practices. The occupational outcomes of patients undergoing vertical banded gastroplasty or ileojejunal bypass in the 1970s and 1980s may be of historical interest but are of little relevance to today’s patients.

In addition, we choose not to include studies which only described changes in disability benefits. The reason for this was that, firstly, this does not directly relate to occupational employment status, albeit they are closely related and secondly, disability benefit systems differ vastly between countries and therefore findings within one country are not necessarily relevant in other areas of the world.

We believe it is impossible to directly compare studies from 20 or 30 years ago with more recent studies. Therefore it is very difficult to make conclusions regarding perceived trends in employment outcomes between what are vastly different patient populations and surgical techniques.