ABSTRACT
Obesity is becoming the plague of the twenty-first century. With overweight becoming the norm in most Western countries and developing countries, two-thirds of adults suffer from overweight or obesity. Bariatric surgery is the branch of surgery involving manipulation of the stomach and/or small bowel to achieve weight loss and control of obesity-related disease. Bariatric surgery leads to weight loss of 25–35% of body weight after 1 year, and sustained weight loss maintenance at 15–25% after 20 years. The phrases ‘metabolic’ or ‘diabetes’ surgery are increasingly being used in conjunction with, or instead of, ‘bariatric surgery’ owing to the highly effective way that surgery improves the metabolic syndrome, with weight loss being a welcome additional effect. A 2009 Health Technology Assessment report in the UK showed bariatric surgery to be cost-effective compared with non-surgical options. Eligibility criteria were first proposed by the US National Institutes of Health in 1991, when the obesity epidemic was first recognised.
