Summary
Background: Morbid obesity leads to serious, progressive secondary diseases.
Methods: An overview is given of the malabsorption and gastric restriction operations which have been developed for patients who cannot maintain weight loss by conservative means.
Results: The intestinal bypass operations require surveillance for protein malnutrition and other sequelae; the restriction operations require a permanent tiny gastric reservoir. Long-term follow-up is necessary. After surgery, from 15 to 40% of patients, depending on the operation performed, fail to maintain adequate weight-loss.
Conclusion: Successful weight-loss in the majority of patients makes bariatric operations worthwhile, with reversal of comorbidities and improvement in quality of life.