With the development of new surgical techniques (laparoscopic procedure, ad
justable gastric banding) bariatric surgery is still increasing. In France
about 10 000 adjustable gastric banding have been performed during the last
year, as well as a thousand of gastric operations and approximately fifty
gastric by-pass. The surgical approach has a real efficacy on weight loss a
nd is associated with a reduction in comorbid conditions. However its long-
term efficacy, its effects on quality of life, its nutritional consequences
and the surgical-linked complication incidence are only poorly evaluated,
especially for adjustable gastric banding. Therefore bariatric surgery indi
cations should be thoroughly examined. As recommended by the experts, surgi
cal treatment for obesity should be restricted to patients presenting morbi
d obesity, and this despite a multidisciplinary medical treatment. Long-ter
m post-surgical follow-up is necessary and may be an important determinant
of long-term efficacy. Considering the growing number of this type of inter
vention outside of any evaluation, a national register is recommended.