Evolution and current status of surgery for morbid obesity: Part II.

Persons who are 20 percent or more over ideal weight have a greatly increased risk of premature death as well as being subject to a range of debilitating diseases. When a person reaches 100 pounds or more above ideal weight, he or she may become a potential candidate for surgery to promote weight loss and maintenance of weight loss, with its accompanying improvement in related medical problems. The earliest successful surgical procedure, jejunoileal bypass, is no longer done because better bariatric surgical procedures have been developed. Gastric bypass is an efficient successful procedure for producing extensive long-term weight loss, but it is difficult to perform and may have a high rate of complications in inexperienced hands. Vertical banded gastroplasty appears to be the safest procedure in the variatric surgeon's repertoire at this time for the management of medical problems related to morbid obesity.