Surgical intervention as a strategy for treatment of obesity

A very large number of weight-reducing surgical techniques have been develo ped over the last 25 years. Today only a handful of these techniques can be recommended. Gastric bypass, vertical banded gastroplasty, and variable ba nding can all be recommended although gastric bypass should be reserved for heavier patients. For the heaviest, biliopancreatic diversion or biliopanc reatic diversion with duodenal switch might be considered, The controlled i ntervention study Swedish Obese Subjects has shown that most but not all ca rdiovascular risk factors are improved over 10 years by surgically induced weight loss. Quality of life as well as cardiac structure and function are dramatically improved. The average weight loss for gastric bypass and verti cal banded gastroplasty was 16% after 10 years. No non-surgical treatment a vailable today can achieve such results, not even over 2 years. Surgical tr eatment for obesity needs to become much more common, particularly in obese patients with metabolic disturbances.