Even in the asymptomatic woman, hysterectomy near menopause may appear cost-effective. Newer procedures such as endometrial ablations do not appear cost-effective for the long term, since some patients later require hysterectomies, Pap smears are still needed because of the continuing presence of the cervix, and progesterone is still needed because of residual endometrial tissue. Of course, this brief analysis is incomplete and factors in neither the patient's values related to immediate complications versus long-term benefit nor the discounted value of money. Istre O, Holm-Nielsen P, Bourne T, Forman A. Hormone replacement therapy after transcervical resection of the endometrium. Furthermore, weighing people is not a benign intervention.
Overweight women delay medical care.
There is substantial evidence as presented in the task force chapter 1 that obesity is a significant risk factor for many causes of morbidity and mortality including cardiac problems, diabetes mellitus, hypertension, arthritis and other diseases. It is also true that obesity can be detected by means other than height and weight, including simply observing the patient. Thus, height and weight measurement is not the only way to screen for obesity. The crux of Dr. Beasley and Dr. Olson's letter is that there is no evidence of long-term benefit from treatment of obesity. The task force points out that there is evidence from both controlled and uncontrolled trials that low-calorie diets in obese diabetic patients are associated with improved glycemic control and a reduced need for hypoglycemic agents.