Livhits and colleagues performed a meta-analysis of 15 articles including 3,404 patients. Only two of the included cohorts were excluded from the Cassie review. Not surprisingly, the authors drew similar conclusions. Of the 15 articles analyzed, 5 studies had positive effects for PWL, 2 studies showed positive short-term effects, 5 studies showed no difference, and 1 study showed a negative effect. Overall no significant heterogeneity was seen among the studies with results of postoperative weight loss [3].