[Surgical treatment of serious obesity: many questions on medical indications and results remain]

Abstract

Obesity is associated with increased mortality and a whole spectrum ofco-morbidities. Weight loss is indicated to relieve or prevent these co-morbidities and to reduce psychosocial and socio-economic consequences. The step-wise approach of obesity treatment is first the combination of energy restriction, physical activity and behavioural changes, followed by pharmacotherapy. The last step is bariatric surgery. From the results oflaparoscopic gastric banding, as published in this issue of the journal, two important aspects emerge. First, a change in the operation technique considerably reduced the long-term complication rate and second, the attrition rate decreased due to follow-ups managed by nurse practitioners. The study can also be criticised for not giving details of the selection procedures and the number of and reasons for rejection as well as for not reporting the improvements in co-morbidity and quality of life.