Bariatric surgery

Obesity and metabolic syndrome is considered an epidemic in Western societies. An adult is considered to be obese with a BMI of 30 or above. Obesity imposes a significant human burden of disease, mortality, social exclusion and poor quality of life. It is closely associated with multiple comorbidities including type 2 diabetes, coronary heart disease, and poor health status, and has a substantial human cost by contributing to the onset of disease and premature mortality. Surgical interventions are significantly more effective than non-surgical therapies for the treatment of severe obesity, reduction of cardiovascular morbidities, prevention of some cancers, type 2 diabetes and improved quality of life. Although there are various surgical options, Roux-en-Y gastric bypass is considered the gold standard; sleeve gastrectomy is now the second most common procedure having replaced gastric banding with mini-gastric bypass the third worldwide. Endoscopic procedures are also growing in popularity but are still under research. A robust hospital infrastructure with multidisciplinary approach is crucial for a bariatric service including appropriate staffing and facilities to provide pre- and perioperative care. As the bariatric practice is increasing worldwide, it is essential to safeguard the standard of bariatric training to ensure surgical competence and patient safety.