Surgery for obesity in adulthood.

The relation between morbid obesity, serious morbidity, and early mortality is well known (fig 1 and table 1).1 2 A recent systematic review of over 890 000 participants found that each 5 point increase in body mass index (kg/m2) over 25 was associated with a 30% increase in overall mortality.3 Conservative approaches to managing obesity (dieting, exercise, and cognitive behavioural therapy) achieve long term weight loss in only a small minority of highly motivated individuals.4 Weight loss drugs such as orlistat and sibutramine produce modest weight loss and can be prescribed only for a short time.5 Bariatric (weight loss) surgery is the only treatment that randomised controlled trials have shown to produce effective long term weight loss.6 This review provides an overview of surgical procedures for adult obesity, including results, follow-up, and complications of surgery. It focuses mainly on practice in the United Kingdom.