Bariatric surgery includes a type of procedure performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with a gastric band or by removing a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and redirecting the small intestine to small stomach pouches (gastric band surgery) .

The fundamental basis of bariatric surgery for the purpose of achieving weight loss is the determination that severe obesity is a disease associated with multiple adverse health effects that can be reversed or improved with successful weight loss in patients who do not they have been able to maintain weight loss through non-surgical means. It even helps reduce cardiovascular disease (CVD) and other benefits expected from this intervention. The ultimate benefit of weight reduction is related to a reduction in comorbidities, quality of life, and all-cause mortality.

Specific criteria established by the NIH consensus panel indicated that bariatric surgery is appropriate for all patients with BMI (kg / m2)> 40 and for patients with BMI 35-40 with associated comorbid conditions. These standards have been maintained for many years, although specific indications for bariatric / metabolic surgery have been recognized for people with less severe obesity, such as people with BMI 30-35 with type 2 diabetes. Indications for bariatric surgery are evolving quickly to consider the presence or absence of comorbid conditions, as well as the severity of obesity, as reflected by BMI.

Specific bariatric surgical procedures are Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy, biliopancreatic diversion with duodenal switch, device implantation (includes adjustable gastric band, intermittent vagal block, gastrointestinal endoscopic devices).

The bariatric surgery community enacted a number of changes to result in this improved safety record. It includes the identification of the importance of the surgeon’s and the center’s experience, the establishment of pathways, care protocols and quality initiatives, and the incorporation of all these aspects of care into a center accreditation program. The transition to laparoscopic methodology occurred during the same time period and also contributed to improved safety.

Weight loss after bariatric surgery has been studied and reported in both the short and long term after all surgical procedures performed, as weight loss is the main goal of bariatric surgery. Average weight loss is reported evenly. However, it is crucial to identify the high variability of weight loss after seemingly standardized surgical procedures such as RYGB or Laparoscopic Adjustable Gastric Banding (LAGB).

The ultimate benefit of weight reduction, whether medical or surgical, is related to a reduction in comorbidities, quality of life, and all-cause mortality. Despite the importance of assessing these risks and taking steps to implement effective medical treatment with varying success, surgery has been shown to be more effective.