The authors thank Shiri for his questions and concerns [1] and appreciate the opportunity to respond to them. The primary concern was that the study population may be sicker than the general Israeli population and thus the reported prevalence of obesity and co-morbidities in the study population is not representative of the general Israeli population. We respond to this with two points: the first clarifies our selection of the study population and the second describes disease prevalence data in the Clalit Health System.