On Thursday, Time magazine put the newly re-elected and clearly overweight Chris Christie on its cover with the words “The Elephant in the Room” displayed prominently. Now people far and wide are deciding whether to pile on or to castigate Time for making its clever joke. After all, the symbol of the Republican party is an elephant.

When asked what he meant by the headline, executive editor Michael Duffy told Chris Matthews, “Well, he’s obviously a big guy. He’s obviously a big Republican. But he’s also done a really huge thing here this week.” Duffy can say what he likes, to most people the cover is one big fat joke that raises one big question: Is it mean to joke about a politician’s weight?

Of course. It’s cruel to joke about anyone’s weight. Does it matter at all that Christie is a public figure? Maybe Adele or Melissa McCarthy, who have been criticized for being overweight, or for that matter Calista Flockhart and Kate Moss, who have been criticized for being too thin, would want to answer that one. Being in the public eye is an excuse to turn people into fair game for attacks on their appearance. No matter what you believe, though, there’s a big difference between a comment made to your sister, say, and a splashy Time cover.

Then again another issue — other than political influence — is in play here. Earlier this year Christie revealed that he had undergone weight-loss surgery in February. Because he revealed this procedure himself, it seems legitimate to ask about the success of his surgery. Quite a few public personalities before him have discussed the ins and outs of their weight loss. Al Roker for one successfully turned his struggle with weight into an interview centerpiece (as well as a popular book). We the people have simply come to expect continuing disclosure on these matters.

More than that, it is valid and not mean to wonder, did the surgery work? Christie elected to undergo gastric band surgery, known as Lap-Band, only one of many weight loss procedures. The question as to whether this is an effective method for losing weight is more than valid. Lap-Band is a Food and Drug Administration (FDA) approved procedure. In a study quoted by the FDA, 80 percent of patients with a body mass index between 30 and 40 lost at least 30 percent of their weight after Lap-Band surgery and kept it off for at least a year. People with a BMI over 30 are generally considered to be obese. That said, some participants in the same study lost no weight at all while others lost over 80 percent. Lap-Band, then, does not help everyone.

In a 2011 study published by JAMA Surgery, Belgian researchers followed patients for 12 years or longer after Lap-Band surgery. They discovered that most people were satisfied with their results. The procedure resulted in a mean excess weight loss of 42.8 percent after that amount of time. Despite the weight loss, nearly one out of every three had experienced band erosion, and nearly half required removal of their bands. A high complication rate and the procedure, the authors wrote, "appears to result in relatively poor long-term outcomes."

To question Christie's experience with the surgery is more than valid. After all, over one third of U.S. adults are obese and probably worried about their health. No matter what Time's editor intended, a cover featuring Christie's weight simply shows how well he can relate to a third of the voting population.

Source: Himpens J, Cadiere G-B, Bazi M, et al. Long-term Outcomes of Laparoscopic Adjustable Gastric Banding. JAMA Surgery. 2011.