Dear Editor,

We thank the authors of this letter to the editor for their thoughtful insights and comments regarding our recent findings concerning the impact of bariatric surgery on outcomes of patients with sickle cell disease (SCD) [1]. The results of our study suggest patients with SCD and bariatric surgery have overall lower rates of vaso-occlusive crises with no difference in mortality. While these authors correctly acknowledge obesity is not common among patients with SCD, management of patients with obesity is pivotal as previous data has shown an overall inverse relationship between body mass index (BMI) and number of admissions [2].

Based upon our study design and nature of the Nationwide Inpatient Sample database, the authors further describe that our study does not provide important information on variants of SCD. However, as they have clearly suggested, and based upon previous literature, it is highly likely that patients included in our analysis had milder forms of disease [3, 4]. Even though these patients may have milder forms of disease, the findings of this Nationwide Inpatient Sample study advocate for an important role of weight reduction surgery in the management of this specific population.

We appreciate the authors’ conclusions that appear to echo the findings in our study, suggesting physicians should consider bariatric surgery as a safe and effective treatment option for specific SCD patients with morbid obesity. Although the results of our study are limited based upon database and study design constraints, we hope our study encourages future exploration on the subject of sickle cell disease and bariatric surgery.