Bariatric surgery: Is it right for your patient?

Obesity bas become an international problem with the population rapidly gaining weight. The optimal treatment is diet and exercise; however, it is rarely effective in very heavy patients. Diet medications are also ineffective for these individuals. Because of its success in causing weight loss and controlling comorbid conditions, bariatric surgery has become increasingly popular. The most accepted operations are the Roux-en-Y gastric bypass (RYGB) and the laparoscopic adjustable band procedure. Both procedures are associated with low morbidity and mortality. The gastric bypass results in rapid and substantial weight loss with rapid resolution of diabetes mellitus, sleep apnea, and other medical problems associated with obesity. Laparoscopic banding procedures achieve the same effect but more gradually and confer the advantage of very few complications. Careful patient selection is essential for the success of these procedures as is a structured follow-up process once the operations are performed.