Dear Dr. Tao and Coworkers,

I enjoyed reading your meta-analysis on bariatric surgery improving cognitive functions in obese patients. The paper was comprehensive, scholarly, and convincing. It places strong emphasis on the expanding role for, and outcomes achieved, by metabolic bariatric surgery, emphasizing the metabolic processes initiated thereby. With increasing knowledge, we may develop metabolic surgery specifically to mitigate the cognitive manifestation of traumatic brain injury (TBI), which leads to chronic traumatic encephalopathy (CTE) and death.

The literature in this field is expanding. Our background review in three successive issues of Obesity Surgery, 2020–2021 (McGlennon TW, et al. Bypassing TBI: Metabolic Surgery and the Link between Obesity and Traumatic Brain Injury—a Review. ObesSurg. 2020 Dec; 30(12):4704–4714) provides well-over 300 pertinent references. Though not mentioned in your paper, your group is undoubtedly familiar with this work because your methods state that you reviewed the literature in PubMed, etc., up to August 2022.