REPORTING OUR RESULTS American Society for Bariatric Surgery Distinguished Guest Lecture, Dallas, USA, 6 June 1991

Morbid obesity is a life-threatening disease that has reached epidemic proportions, especially in the upper midwestern part of the USA. The surgical treatment of morbid obesity is generally effective while the non-surgical treatment is usually not effective. Yet many of our colleagues and much of the public have not accepted these facts for a variety of reasons. Chief among them is the perception that we, as bariatric surgeons, do not really know our results. At times we have been too quick to report on a few early spectacular results, and much too slow to come forward with poor results. We can do something about this. My purpose today is to examine the way in which we should report our results. In approaching a subject, one can take a historical, a philosophical or a scientific approach, but I am not a historian, a philosopher or a statistician. With this denial, I will now feel perfectly comfortable to dabble in all three areas. Historically, I recall that the bearer of good news has a thousand parents while the bearer of bad news is forever an orphan. Philosophically, it is the open mouth that catches the files. In spite of these warnings, I propose to examine the subject by asking and answering, at least to some extent, a series of questions. Some answers are more obvious and shorter than others.