[Management of obese patients: surgical therapy]

At present, the management of obesity includes integration of therapeutic strategies such as diet, physical training, behaviour therapy and pharmacologic therapy. An increased number of selected patients with morbid obesity, where medical therapy was ineffective, have been surgically treated in the last years due to less invasive surgical techniques, such as laparoscopic surgery. Main operations include gastroplasty, adjustable gastric banding, gastric bypass, bilio-pancreatic diversion. A less invasive procedure is intragastric balloon, i.e. a temporary device which is removed after few months. Surgery shows efficacy to induce weight loss and duration in time. All obese patients can't be treated by the same operation. Available surgical techniques are different and have to be chosen in each case according to the patient's clinical conditions.