[Morbid obesity, public health problem: laparoscopic surgical treatment]

Morbid obesity, commonly defined as a condition in which the weight exceed twice the ideal body weight, is a major public health concern, widely unrecognized in France whereas causing 55,000 deaths per year to compare to 8,000 deaths per year by traffic accidents. Its pathogenesis is discussed even if much attention in recent years has centered on genetic causes since the identification of the ob-gene and its protein product leptin. Due to the long term failure of medical treatments, the advent of laparoscopy had disrupted therapeutic and carried on exponential development of laparoscopic operations mainly by gastric banding using an adjustable ring not without complications. It is why we have performed a prospective study by laparoscopy in 100 patients comparing 3 operations with the aim that each indication could be adapted to the alimentary behaviour. The short term results are extremely favourable and comparable to international literature data. Moreover, the study is a plea for a multidisciplinary approach of morbid obesity and a core for a public health action.