As the incidence of obesity continues to rise, increasing numbers of patients are undergoing bariatric surgery to address morbid obesity and weight related health issues. Bariatric procedures aim to reduce dietary intake and/or interfere with food absorption and are now in widespread use but with a huge capacity shortfall leading to a degree of rationing of the resource. Such treatment should be regarded as palliative in that it does not cure the underlying disorder, and guidelines have been produced to define which patients should be considered for this type of surgery, which must be undertaken in a multidisciplinary setting. Long term results show this to be a cost-effective intervention with a durable positive impact on cardiac risk factors and in particular type 2 diabetes and obstructive sleep apnoea, together with a reduction in all cause mortality and malignancy and an improvement in quality of life. Systematic data collection has now started in the UK and will assist in defining the best application of the resource.
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