In Reply We appreciate the opportunity to respond to the Letter to the Editor by Van De Maele et al about our study.1 We would like to make it clear that we did not mention metabolic and bariatric surgery (MBS) as a solution to fight against childhood obesity and we think that there is no evidence to suggest that. Indeed, we have highlighted a decrease in the rate of macrosomia after MBS; however, we have also reported an increase in the rate of neonates who are small for gestational age. Numerous studies have shown that being small for gestational age is a risk factor for obesity.2