In Reply.—

We are grateful to Santoro et al for their comments and for sharing their data with us. We totally agree with their general concept and conclusion. However, it is difficult to compare our data with theirs. Santoro et al used other BMI percentiles (which were not defined) to define the degree of overweight than we did, because the mean SD score (SDS) BMI at baseline was 5.0 in their study. In our study, consisting of obese and extremely obese children, the median SDS BMI was 2.2. Overweight is defined by an SDS BMI of >1.3, obesity is defined by an SDS BMI of >1.9, and extreme obesity is defined by an SDS BMI of >2.3 in the percentiles underlying our study. Furthermore, if the LMS method is not used to calculate SDS BMI, the effect of weight reduction could be overestimated in the study of...

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