Response to the letter to the editor: Inconsistencies in obesity criteria: implications for systematic reviews on endoscopic spine surgery

To the Editor, We sincerely thank the correspondents for their insightful comments and for their interest in our systematic review and meta-analysis entitled "Endoscopic spine surgery for obesity-related surgical challenges: a systematic review and meta-analysis of current evidence [1]." We appreciate the opportunity to clarify the methodological concern raised regarding inconsistencies in the definition of obesity, particularly in Asian populations.In our systematic review and meta-analysis, obesity was defined a priori as body mass index (BMI) ≥30 kg/m 2 according to the World Health Organization (WHO) global classification, which remains the most widely used standard in international research and evidence synthesis [1].However, we acknowledge that several included studies, particularly from Asian cohorts, adopted lower BMI cutoffs such as >25 kg/m 2 Response to the letter to the editor: Inconsistencies in obesity criteria: implications for systematic reviews on endoscopic spine surgery